O Raaschou-Nielsen1, R Beelen2, M Wang2, G Hoek2, Z J Andersen3, B Hoffmann4, M Stafoggia5, E Samoli6, G Weinmayr7, K Dimakopoulou6, M Nieuwenhuijsen8, W W Xun9, P Fischer10, K T Eriksen11, M Sørensen11, A Tjønneland11, F Ricceri12, K de Hoogh13, T Key14, M Eeftens15, P H Peeters16, H B Bueno-de-Mesquita17, K Meliefste2, B Oftedal18, P E Schwarze18, P Nafstad19, C Galassi12, E Migliore12, A Ranzi20, G Cesaroni5, C Badaloni5, F Forastiere5, J Penell21, U De Faire21, M Korek21, N Pedersen22, C-G Östenson23, G Pershagen21, L Fratiglioni24, H Concin25, G Nagel26, A Jaensch27, A Ineichen28, A Naccarati28, M Katsoulis29, A Trichpoulou29, M Keuken30, A Jedynska30, I M Kooter30, J Kukkonen31, B Brunekreef32, R S Sokhi33, K Katsouyanni34, P Vineis9. 1. Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark. Electronic address: ole@cancer.dk. 2. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. 3. Danish Cancer Society Research Center, Copenhagen, Denmark; Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 4. IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany. 5. Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy. 6. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 7. IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany. 8. Center for Research in Environmental Epidemiology, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain. 9. MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom. 10. National Institute for Public Health and the Environment, Center for Sustainability and Environmental Health, Bilthoven, The Netherlands. 11. Danish Cancer Society Research Center, Copenhagen, Denmark. 12. Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy. 13. MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 14. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. 15. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 16. Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; School of Public Health, Imperial College London, London, United Kingdom. 17. Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 18. Norwegian Institute of Public Health, Oslo, Norway. 19. Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway. 20. Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy. 21. Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. 22. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. 23. Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden. 24. Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden. 25. Agency for Preventive and Social Medicine, Bregenz, Austria. 26. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria. 27. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany. 28. Human Genetics Foundation, Molecular and Genetic Epidemiology Unit, Turin, Italy. 29. Hellenic Health Foundation, Athens, Greece. 30. Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands. 31. Finnish Meteorological Institute, Helsinki, Finland. 32. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands. 33. Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, United Kingdom. 34. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Primary Care and Public Health Sciences and Environmental Research Group, King's College London, United Kingdom.
Abstract
BACKGROUND: Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. METHODS: We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. RESULTS: The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant. In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 1.25; 95% CI, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m(3)), PM10 S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10 K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PM10 and PM2.5 and lung cancer were largely explained by PM2.5 S. CONCLUSIONS: This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.
BACKGROUND: Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. METHODS: We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. RESULTS: The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant. In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 1.25; 95% CI, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m(3)), PM10 S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10 K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PM10 and PM2.5 and lung cancer were largely explained by PM2.5 S. CONCLUSIONS: This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.
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