title: Air pollution and cardiovascular mortality with over 25years follow-up: A combined analysis of two British cohorts.
abstract: Adverse effects of air pollution on cardiovascular disease (CVD) mortality are well established. There are comparatively fewer studies in Europe, and in the UK particularly, than in North America. We examined associations in two British cohorts with >25years of follow-up.
  
  
  
  Annual average NO2, SO2and black smoke (BS) air pollution exposure estimates for 1991 were obtained from land use regression models using contemporaneous monitoring data. From the European Study of Cohorts and Air Pollution (ESCAPE), air pollution estimates in 2010-11 were obtained for NO2, NOx, PM10, PMcoarseand PM2.5. The exposure estimates were assigned to place of residence 1989 for participants in a national birth cohort born in 1946, the MRC National Study of Health and Development (NSHD), and an adult multi-ethnic London cohort, Southall and Brent Revisited (SABRE) recruited 1988-91. The combined median follow-up was 26years. Single-pollutant competing risk models were employed, adjusting for individual risk factors.
  
  
  
  Elevated non-significant hazard ratios for CVD mortality were seen with 1991 BS and SO2and with ESCAPE PM10and PM2.5in fully adjusted linear models. Per 10μg/m3increase HRs were 1.11 [95% CI: 0.76-1.61] for BS, 1.05 [95% CI: 0.91-1.22] for SO2, 1.16 [95% CI: 0.70-1.92] for PM10and 1.30 [95% CI: 0.39-4.34] for PM2.5, with largest effects seen in the fourth quartile of BS and PM2.5compared to the first with HR 1.24 [95% CI: 0.91-1.61] and 1.21 [95% CI: 0.88-1.66] respectively. There were no consistent associations with other ESCAPE pollutants, or with 1991 NO2. Modelling using Cox regression led to similar results.
  
  
  
  Our results support a detrimental long-term effect for air pollutants on cardiovascular mortality.
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK. Electronic address: hakdehbi@gmail.com.
authors.forename: Hakim-Moulay
authors.initials: HM
authors.lastname: Dehbi
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: Blangiardo
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK.
authors.forename: John
authors.initials: J
authors.lastname: Gulliver
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK.
authors.forename: Daniela
authors.initials: D
authors.lastname: Fecht
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Kees
authors.initials: K
authors.lastname: de Hoogh
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK.
authors.forename: Zaina
authors.initials: Z
authors.lastname: Al-Kanaani
authors.affiliation: Institute of Cardiovascular Science, University College London, London, WC1E 7HB, UK.
authors.forename: Therese
authors.initials: T
authors.lastname: Tillin
authors.affiliation: MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, WC1B 5JU, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.affiliation: Institute of Cardiovascular Science, University College London, London, WC1E 7HB, UK.
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
authors.affiliation: MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, W2 1PG, UK; Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hansell
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005740:Gases / Q000032:analysis*; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000032:analysis*; D016016:Proportional Hazards Models; D012906:Smoke; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D005740:Gases; D052638:Particulate Matter; D012906:Smoke
keywords: Environmental epidemiology; Follow-up studies; Long-term exposure; Particles; Particulate matter