Dataset Information

Long-term associations of outdoor air pollution with mortality in Great Britain.

ABSTRACT:

Background

Recent studies have indicated long-term effects on mortality of particulate and sulphur dioxide (SO(2)) pollution, but uncertainties remain over the size of any effects, potential latency and generalisability.

Methods

A small area study was performed across electoral wards in Great Britain of mean annual black smoke (BS) and SO(2) concentrations (from 1966) and subsequent all-cause and cause-specific mortality using random effect models within a Bayesian framework adjusted for social deprivation and urban/rural classification. Different latencies and changes in associations over time were assessed.

Results

Significant associations were found between BS and SO(2) concentrations and mortality. The effects were stronger for respiratory illness than other causes of mortality for the most recent exposure periods (shorter latency times) and most recent mortality period (lower pollutant concentrations). In pooled analysis across four sequential 4 year mortality periods (1982-98), adjusted excess relative risk for respiratory mortality was 3.6% (95% CI 2.6% to 4.5%) per 10 microg/m(3) BS and 13.2% (95% CI 11.5% to 14.9%) per 10 ppb SO(2), and in the most recent period (1994-8) it was 19.3% (95% CI 5.1% to 35.7%) and 21.7% (95% CI 2.9% to 38.5%), respectively.

Conclusions

These findings add to the evidence that air pollution has long-term effects on mortality and point to continuing public health risks even at the relatively lower levels of BS and SO(2) that now occur. They therefore have importance for policies on public health protection through regulation and control of air pollution.

SUBMITTER: Elliott P

PROVIDER: S-EPMC2094283 | biostudies-literature | 2007 Dec

REPOSITORIES: biostudies-literature

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Publications

Long-term associations of outdoor air pollution with mortality in Great Britain.

Elliott Paul P Shaddick Gavin G Wakefield Jonathan C JC de Hoogh Cornelis C Briggs David J DJ

Thorax 20070731 12

<h4>Background</h4>Recent studies have indicated long-term effects on mortality of particulate and sulphur dioxide (SO(2)) pollution, but uncertainties remain over the size of any effects, potential latency and generalisability.<h4>Methods</h4>A small area study was performed across electoral wards in Great Britain of mean annual black smoke (BS) and SO(2) concentrations (from 1966) and subsequent all-cause and cause-specific mortality using random effect models within a Bayesian framework adjus ...[more]

PMID: 17666438

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Project description:Increased risks of cardiac morbidity and mortality among childhood cancer survivors have been described previously. However, little is known about the very long-term risks of cardiac mortality and whether the risk has decreased among those more recently diagnosed. We investigated the risk of long-term cardiac mortality among survivors within the recently extended British Childhood Cancer Survivor Study.The British Childhood Cancer Survivor Study is a population-based cohort of 34?489 five-year survivors of childhood cancer diagnosed from 1940 to 2006 and followed up until February 28, 2014, and is the largest cohort to date to assess late cardiac mortality. Standardized mortality ratios and absolute excess risks were used to quantify cardiac mortality excess risk. Multivariable Poisson regression models were used to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity and trends.Overall, 181 cardiac deaths were observed, which was 3.4 times that expected. Survivors were 2.5 times and 5.9 times more at risk of ischemic heart disease and cardiomyopathy/heart failure death, respectively, than expected. Among those >60 years of age, subsequent primary neoplasms, cardiac disease, and other circulatory conditions accounted for 31%, 22%, and 15% of all excess deaths, respectively, providing clear focus for preventive interventions. The risk of both overall cardiac and cardiomyopathy/heart failure mortality was greatest among those diagnosed from 1980 to 1989. Specifically, for cardiomyopathy/heart failure deaths, survivors diagnosed from 1980 to 1989 had 28.9 times the excess number of deaths observed for survivors diagnosed either before 1970 or from 1990 on.Excess cardiac mortality among 5-year survivors of childhood cancer remains increased beyond 50 years of age and has clear messages in terms of prevention strategies. However, the fact that the risk was greatest in those diagnosed from 1980 to 1989 suggests that initiatives to reduce cardiotoxicity among those treated more recently may be having a measurable impact.

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Dataset Information

Long-term associations of outdoor air pollution with mortality in Great Britain.

Background

Methods

Results

Conclusions

Publications

Long-term associations of outdoor air pollution with mortality in Great Britain.

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