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Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project.

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Title: Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project.
Authors: Beelen, Rob, Raaschou-Nielsen, Ole, Stafoggia, Massimo, Andersen, Zorana Jovanovic, Weinmayr, Gudrun, Hoffmann, Barbara, Wolf, Kathrin, Samoli, Evangelia, Fischer, Paul, Nieuwenhuijsen, Mark, Vineis, Paolo, Wei W. Xun, Katsouyanni, Klea, Dimakopoulou, Konstantina, Oudin, Anna, Forsberg, Bertil, Modig, Lars, Havulinna, Aki S., Lanki, Timo, Turunen, Anu
Source: Lancet. 3/1/2014, Vol. 383 Issue 9919, p785-795. 11p. 6 Charts, 2 Graphs.
Subjects: Air pollution, Pollution, Pollutants, Air quality, Mortality, Death (Biology)
Abstract: Summary Background Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants. Methods We used data from 22 European cohort studies, which created a total study population of 367 251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2 • 5 µm (PM 2 • 5), less than 10 µm (PM10), and between 10 µm and 2 • 5 µm (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOX), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buffer. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta- analysis. Findings The total study population consisted of 367 251 participants who contributed 5 118 039 person-years at risk (average follow-up 13 • 9 years), of whom 29 076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2 • 5 of 1 • 07 (95% CI 1 • 02-1 • 13) per 5 µg/m3 was recorded. No heterogeneity was noted between individual cohort effect estimates (I2 p value=0 • 95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 µg/m3 (HR 1 • 06, 95% CI 1 • 00-1 • 12) or below 20 µg/m3 (1 • 07, 1 • 07, 1 • 01-1 • 13). Interpretation Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value. Funding European Community's Seventh Framework Program (FP7/2007-2011). [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project.
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 3/1/2014, Vol. 383 Issue 9919, p785-795. 11p. 6 Charts, 2 Graphs.
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  Data: Summary Background Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants. Methods We used data from 22 European cohort studies, which created a total study population of 367 251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2 • 5 µm (PM 2 • 5), less than 10 µm (PM10), and between 10 µm and 2 • 5 µm (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOX), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buffer. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta- analysis. Findings The total study population consisted of 367 251 participants who contributed 5 118 039 person-years at risk (average follow-up 13 • 9 years), of whom 29 076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2 • 5 of 1 • 07 (95% CI 1 • 02-1 • 13) per 5 µg/m3 was recorded. No heterogeneity was noted between individual cohort effect estimates (I2 p value=0 • 95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 µg/m3 (HR 1 • 06, 95% CI 1 • 00-1 • 12) or below 20 µg/m3 (1 • 07, 1 • 07, 1 • 01-1 • 13). Interpretation Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value. Funding European Community's Seventh Framework Program (FP7/2007-2011). [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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