TY - JOUR
T1 - Long-term exposure to air pollution and mortality in a Danish nationwide administrative cohort study
T2 - Beyond mortality from cardiopulmonary disease and lung cancer
AU - So, Rina
AU - Andersen, Zorana J
AU - Chen, Jie
AU - Stafoggia, Massimo
AU - de Hoogh, Kees
AU - Katsouyanni, Klea
AU - Vienneau, Danielle
AU - Rodopoulou, Sophia
AU - Samoli, Evangelia
AU - Lim, Youn-Hee
AU - Jørgensen, Jeanette T
AU - Amini, Heresh
AU - Cole-Hunter, Tom
AU - Mahmood Taghavi Shahri, Seyed
AU - Maric, Matija
AU - Bergmann, Marie
AU - Liu, Shuo
AU - Azam, Shadi
AU - Loft, Steffen
AU - Westendorp, Rudi G J
AU - Mortensen, Laust H
AU - Bauwelinck, Mariska
AU - Klompmaker, Jochem O
AU - Atkinson, Richard
AU - Janssen, Nicole A H
AU - Oftedal, Bente
AU - Renzi, Matteo
AU - Forastiere, Francesco
AU - Strak, Maciek
AU - Thygesen, Lau C
AU - Brunekreef, Bert
AU - Hoek, Gerard
AU - Mehta, Amar J
N1 - Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: The association between long-term exposure to air pollution and mortality from cardiorespiratory diseases is well established, yet the evidence for other diseases remains limited.OBJECTIVES: To examine the associations of long-term exposure to air pollution with mortality from diabetes, dementia, psychiatric disorders, chronic kidney disease (CKD), asthma, acute lower respiratory infection (ALRI), as well as mortality from all-natural and cardiorespiratory causes in the Danish nationwide administrative cohort.METHODS: We followed all residents aged ≥ 30 years (3,083,227) in Denmark from 1 January 2000 until 31 December 2017. Annual mean concentrations of fine particulate matter (PM
2.5), nitrogen dioxide (NO
2), black carbon (BC), and ozone (warm season) were estimated using European-wide hybrid land-use regression models (100 m × 100 m) and assigned to baseline residential addresses. We used Cox proportional hazard models to evaluate the association between air pollution and mortality, accounting for demographic and socioeconomic factors. We additionally applied indirect adjustment for smoking and body mass index (BMI).
RESULTS: During 47,023,454 person-years of follow-up, 803,881 people died from natural causes. Long-term exposure to PM
2.5 (mean: 12.4 µg/m
3), NO
2 (20.3 µg/m
3), and/or BC (1.0 × 10
-5/m) was statistically significantly associated with all studied mortality outcomes except CKD. A 5 µg/m
3 increase in PM
2.5 was associated with higher mortality from all-natural causes (hazard ratio 1.11; 95% confidence interval 1.09-1.13), cardiovascular disease (1.09; 1.07-1.12), respiratory disease (1.11; 1.07-1.15), lung cancer (1.19; 1.15-1.24), diabetes (1.10; 1.04-1.16), dementia (1.05; 1.00-1.10), psychiatric disorders (1.38; 1.27-1.50), asthma (1.13; 0.94-1.36), and ALRI (1.14; 1.09-1.20). Associations with long-term exposure to ozone (mean: 80.2 µg/m
3) were generally negative but became significantly positive for several endpoints in two-pollutant models. Generally, associations were attenuated but remained significant after indirect adjustment for smoking and BMI.
CONCLUSION: Long-term exposure to PM
2.5, NO
2, and/or BC in Denmark were associated with mortality beyond cardiorespiratory diseases, including diabetes, dementia, psychiatric disorders, asthma, and ALRI.
AB - BACKGROUND: The association between long-term exposure to air pollution and mortality from cardiorespiratory diseases is well established, yet the evidence for other diseases remains limited.OBJECTIVES: To examine the associations of long-term exposure to air pollution with mortality from diabetes, dementia, psychiatric disorders, chronic kidney disease (CKD), asthma, acute lower respiratory infection (ALRI), as well as mortality from all-natural and cardiorespiratory causes in the Danish nationwide administrative cohort.METHODS: We followed all residents aged ≥ 30 years (3,083,227) in Denmark from 1 January 2000 until 31 December 2017. Annual mean concentrations of fine particulate matter (PM
2.5), nitrogen dioxide (NO
2), black carbon (BC), and ozone (warm season) were estimated using European-wide hybrid land-use regression models (100 m × 100 m) and assigned to baseline residential addresses. We used Cox proportional hazard models to evaluate the association between air pollution and mortality, accounting for demographic and socioeconomic factors. We additionally applied indirect adjustment for smoking and body mass index (BMI).
RESULTS: During 47,023,454 person-years of follow-up, 803,881 people died from natural causes. Long-term exposure to PM
2.5 (mean: 12.4 µg/m
3), NO
2 (20.3 µg/m
3), and/or BC (1.0 × 10
-5/m) was statistically significantly associated with all studied mortality outcomes except CKD. A 5 µg/m
3 increase in PM
2.5 was associated with higher mortality from all-natural causes (hazard ratio 1.11; 95% confidence interval 1.09-1.13), cardiovascular disease (1.09; 1.07-1.12), respiratory disease (1.11; 1.07-1.15), lung cancer (1.19; 1.15-1.24), diabetes (1.10; 1.04-1.16), dementia (1.05; 1.00-1.10), psychiatric disorders (1.38; 1.27-1.50), asthma (1.13; 0.94-1.36), and ALRI (1.14; 1.09-1.20). Associations with long-term exposure to ozone (mean: 80.2 µg/m
3) were generally negative but became significantly positive for several endpoints in two-pollutant models. Generally, associations were attenuated but remained significant after indirect adjustment for smoking and BMI.
CONCLUSION: Long-term exposure to PM
2.5, NO
2, and/or BC in Denmark were associated with mortality beyond cardiorespiratory diseases, including diabetes, dementia, psychiatric disorders, asthma, and ALRI.
U2 - 10.1016/j.envint.2022.107241
DO - 10.1016/j.envint.2022.107241
M3 - Journal article
C2 - 35544998
VL - 164
JO - Environment international
JF - Environment international
SN - 0160-4120
M1 - 107241
ER -