title: Long-term exposure to traffic-related air pollution and the risk of death from hemorrhagic stroke and lung cancer in Shizuoka, Japan.
abstract: A number of studies have linked exposure to long-term outdoor air pollution with cardiopulmonary disease; however, the evidence for stroke is limited. Furthermore, evidence with the risk for lung cancer (LC) is still inconsistent. We, therefore, evaluated the association between long-term exposure to traffic-related air pollution and cause-specific mortality. Individual data were extracted from participants of an ongoing cohort study in Shizuoka, Japan. A total of 14,001 elderly residents completed questionnaires and were followed from December 1999 to January 2009. Annual individual nitrogen dioxide (NO(2)) exposure data, as an index for traffic-related exposure, were modeled using a Land Use Regression model and assigned to the participants. We then estimated the adjusted hazard ratios (HRs) and their confidence intervals (CIs) associated with a 10 μg/m(3) elevation in NO(2) for all-cause or cause-specific mortality using time-varying Cox proportional hazards models. We found positive associations of NO(2) levels with all-cause (HR=1.12, 95% CI: 1.07-1.18), cardiopulmonary disease (HR=1.22, 95% CI: 1.15-1.30), and LC mortality (HR=1.20, 95% CI: 1.03-1.40). Among cardiopulmonary disease mortality, not only the risk for ischemic heart disease (HR=1.27, 95% CI: 1.11-1.47) but also the risks for stroke were elevated: intracerebral hemorrhage (HR=1.28, 95% CI: 1.05-1.57) and ischemic stroke (HR=1.20, 95% CI: 1.04-1.39). The present study supports the existing evidence that long-term exposure to traffic-related air pollution increases the risk of cardiopulmonary as well as LC mortality, and provides additional evidence for adverse effects on intracerebral hemorrhage as well as ischemic stroke.
authors.affiliation: Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, 1-1-1 Tsushima-naka, Okayama 700-8530, Japan. yorichan@md.okayama-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Yorifuji
authors.forename: Saori
authors.initials: S
authors.lastname: Kashima
authors.forename: Toshihide
authors.initials: T
authors.lastname: Tsuda
authors.forename: Kazuko
authors.initials: K
authors.lastname: Ishikawa-Takata
authors.forename: Toshiki
authors.initials: T
authors.lastname: Ohta
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Doi
mesh_terms: D000368:Aged; D000397:Air Pollution; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000401:mortality; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000401:mortality; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced* / Q000401:mortality; D001335:Vehicle Emissions / Q000633:toxicity*
chemical_list: D001335:Vehicle Emissions