title: Long-term exposure to NO2 and PM10 and all-cause and cause-specific mortality in a prospective cohort of women.
abstract: We assessed whether long-term exposure to air pollution is associated with all-cause and cause-specific mortality during a period of declining particulate matter concentrations. Approximately 4800 women aged 55 years from North Rhine-Westphalia, Germany, were followed for up to 18 years. Exposure to air pollution was assessed in two ways: (1) using the distance between the residential address and the nearest major road, as calculated from Geographic Information System data and (2) calculating 1-year average particulate matter concentrations below 10 µm (PM(10)) and nitrogen dioxide (NO(2)) levels using data from the nearest air-monitoring station data to the subjects' residences. Ninety-two per cent of all subjects lived in the same community during the entire follow-up period. Associations between mortality and exposure were assessed using Cox's proportional hazards models, including confounder adjustment. Sixteen per cent of women passed away during the follow-up period. An increase of 7 μg/m(3) PM(10) (IQR) was associated with an increased HR for all-cause (HR 1.15, 95% CI (1.04 to 1.27)), cardiopulmonary (HR 1.39, 95% CI (1.17 to 1.64)), and lung cancer mortality (HR 1.84, 95% CI (1.23 to 2.74)). An increase of 16 μg/m(3) (IQR) NO(2) exposure was associated with all-cause (HR 1.18, 95% CI (1.07 to 1.30)) and cardiopulmonary mortality (HR 1.55, 95% CI (1.30 to 1.84)). The association between cardiopulmonary mortality and PM(10) was reduced for the extended follow-up period, during which PM(10) concentrations (but not NO(2) concentrations) were lower. Living close to a major road was associated with an increased relative risk for all-cause, cardiopulmonary and respiratory mortality. These associations were temporally stable. Long-term exposure to ambient PM(10) and NO(2) was associated with increased mortality rates.
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology I, Neuherberg, Germany. heinrich@helmholtz-muenchen.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Thiering
authors.forename: Peter
authors.initials: P
authors.lastname: Rzehak
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Knut M
authors.initials: KM
authors.lastname: Rauchfuss
authors.forename: Ulrike
authors.initials: U
authors.lastname: Gehring
authors.forename: H-Erich
authors.initials: HE
authors.lastname: Wichmann
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004784:Environmental Monitoring; D005260:Female; D005500:Follow-Up Studies; D040362:Geographic Information Systems; D005858:Germany; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008171:Lung Diseases / Q000401:mortality*; D008175:Lung Neoplasms / Q000401:mortality; D008875:Middle Aged; D009569:Nitric Oxide / Q000009:adverse effects*; D052638:Particulate Matter / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics; D014186:Transportation; D001335:Vehicle Emissions
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001335:Vehicle Emissions; D009569:Nitric Oxide