title: Air pollution and risk of uterine leiomyomata.
abstract: BACKGROUND
  Air pollution, particularly from vehicle exhaust, has been shown to influence hormonal activity. However, it is unknown whether air pollution exposure is associated with the occurrence of uterine leiomyomata, a hormonally sensitive tumor of the uterus.
  
  
  METHODS
  For 85,251 women 25-42 years of age at enrollment in the Nurses' Health Study II, we examined proximity to major roadways and outdoor levels of particulate matter less than 10 microns (PM10) or 2.5 microns (PM2.5) or between 10 and 2.5 microns (PM10-2.5) in diameter for all residential addresses from September 1989 to May 2007. To be eligible for this analysis, a woman had to be alive and respond to questionnaires, premenopausal with an intact uterus, and without diagnoses of cancer or prevalent uterine leiomyomata. Incidence of ultrasound- or hysterectomy-confirmed uterine leiomyomata and covariates were reported on biennial questionnaires sent through May 2007. Multivariable time-varying Cox proportional hazard models were used to estimate the relationship between distance to road or PM exposures and uterine leiomyomata risk.
  
  
  RESULTS
  During 837,573 person-years of follow-up, there were 7760 incident cases of uterine leiomyomata. Living close to a major road and exposures to PM10 or PM10-2.5 were not associated with an increased risk of uterine leiomyomata. However, each 10 μg/m increase in 2-year average, 4-year average, or cumulative average PM2.5 was associated with an adjusted hazard ratio of 1.08 (95% confidence interval = 1.00-1.17), 1.09 (0.99-1.19), and 1.11 (1.03-1.19), respectively.
  
  
  CONCLUSIONS
  Chronic exposure to PM2.5 may be associated with a modest increased risk of uterine leiomyomata.
authors.affiliation: From the aDepartment of Obstetrics and Gynecology, Boston Medical Center and Boston University, Boston, MA; bChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; cExposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA; dDepartment of Epidemiology, Harvard School of Public Health, Boston, MA; eObstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA; fDepartment of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; gDivision of General Pediatrics, Boston University School of Medicine, Boston, MA; and hDepartment of Epidemiology, Boston University School of Public Health, Boston, MA.
authors.forename: Shruthi
authors.initials: S
authors.lastname: Mahalingaiah
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hart
authors.forename: Francine
authors.initials: F
authors.lastname: Laden
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Terry
authors.forename: Renée
authors.initials: R
authors.lastname: Boynton-Jarrett
authors.forename: Ann
authors.initials: A
authors.lastname: Aschengrau
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004784:Environmental Monitoring; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007889:Leiomyoma / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D001335:Vehicle Emissions / Q000032:analysis / Q000633:toxicity*
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001335:Vehicle Emissions