Mariska Bauwelinck1, Jie Chen2, Kees de Hoogh3, Klea Katsouyanni4, Sophia Rodopoulou5, Evangelia Samoli6, Zorana J Andersen7, Richard Atkinson8, Lidia Casas9, Patrick Deboosere10, Claire Demoury11, Nicole Janssen12, Jochem O Klompmaker13, Wouter Lefebvre14, Amar Jayant Mehta15, Tim S Nawrot16, Bente Oftedal17, Matteo Renzi18, Massimo Stafoggia19, Maciek Strak20, Hadewijch Vandenheede21, Charlotte Vanpoucke22, An Van Nieuwenhuyse23, Danielle Vienneau24, Bert Brunekreef25, Gerard Hoek26. 1. Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: mariska.bauwelinck@vub.be. 2. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands. Electronic address: j.chen1@uu.nl. 3. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: c.dehoogh@swisstph.ch. 4. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group Imperial College, London, London, UK. Electronic address: kkatsouy@med.uoa.gr. 5. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: srodopoyl@med.uoa.gr. 6. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: esamoli@med.uoa.gr. 7. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: vlq961@sund.ku.dk. 8. Population Health Research, Institute St George's, University of London, London, UK. Electronic address: atkinson@sgul.ac.uk. 9. Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Medical Sociology and Health Policy, Department of Epidemiology and Social Medicine, University of Antwerp, Wilrijk, Belgium. Electronic address: Lidia.CasasRuiz@uantwerpen.be. 10. Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: patrick.deboosere@vub.be. 11. Risk and Health Impact Assessment Unit, Sciensano, Brussels, Belgium. Electronic address: Claire.Demoury@sciensano.be. 12. National Institute for Public Health and the Environment, Bilthoven, the Netherlands. Electronic address: nicole.janssen@rivm.nl. 13. National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address: jklompmaker@hsph.harvard.edu. 14. Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium. Electronic address: wouter.lefebvre@vito.be. 15. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: amar.mehta@sund.ku.dk. 16. Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Centre for Environmental Sciences, University of Hasselt, Diepenbeek, Belgium. Electronic address: tim.nawrot@uhasselt.be. 17. Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway. Electronic address: BenteMargaret.Oftedal@fhi.no. 18. Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy. Electronic address: m.renzi@deplazio.it. 19. Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: m.stafoggia@deplazio.it. 20. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands. Electronic address: maciek.strak@rivm.nl. 21. Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: hadewijch.vandenheede@vub.be. 22. Belgian Interregional Environment Agency (IRCEL-CELINE), Brussel, Belgium. Electronic address: vanpoucke@irceline.be. 23. Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Risk and Health Impact Assessment Unit, Sciensano, Brussels, Belgium. Electronic address: An.vanNieuwenhuyse@lns.etat.lu. 24. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: danielle.vienneau@swisstph.ch. 25. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands. Electronic address: B.Brunekreef@uu.nl. 26. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands. Electronic address: g.hoek@uu.nl.
Abstract
BACKGROUND: Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions. METHODS: We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43). RESULTS: We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 μg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 μg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3]. CONCLUSION: Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method.
BACKGROUND: Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions. METHODS: We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43). RESULTS: We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 μg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 μg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3]. CONCLUSION: Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method.
Authors: Haitong Zhe Sun; Pei Yu; Changxin Lan; Michelle W L Wan; Sebastian Hickman; Jayaprakash Murulitharan; Huizhong Shen; Le Yuan; Yuming Guo; Alexander T Archibald Journal: Innovation (Camb) Date: 2022-04-20