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Long-term exposure to urban air pollution and mortality in a cohort of more than a million adults in Rome.


ABSTRACT:

Background

Few European studies have investigated the effects of long-term exposure to both fine particulate matter (? 2.5 µm; PM2.5) and nitrogen dioxide (NO2) on mortality.

Objectives

We studied the association of exposure to NO2, PM2.5, and traffic indicators on cause-specific mortality to evaluate the form of the concentration-response relationship.

Methods

We analyzed a population-based cohort enrolled at the 2001 Italian census with 9 years of follow-up. We selected all 1,265,058 subjects ? 30 years of age who had been living in Rome for at least 5 years at baseline. Residential exposures included annual NO2 (from a land use regression model) and annual PM2.5 (from a Eulerian dispersion model), as well as distance to roads with > 10,000 vehicles/day and traffic intensity. We used Cox regression models to estimate associations with cause-specific mortality adjusted for individual (sex, age, place of birth, residential history, marital status, education, occupation) and area (socioeconomic status, clustering) characteristics.

Results

Long-term exposures to both NO2 and PM2.5 were associated with an increase in nonaccidental mortality [hazard ratio (HR) = 1.03 (95% CI: 1.02, 1.03) per 10-µg/m3 NO2; HR = 1.04 (95% CI: 1.03, 1.05) per 10-µg/m3 PM2.5]. The strongest association was found for ischemic heart diseases (IHD) [HR = 1.10 (95% CI: 1.06, 1.13) per 10-µg/m3 PM2.5], followed by cardiovascular diseases and lung cancer. The only association showing some deviation from linearity was that between NO2 and IHD. In a bi-pollutant model, the estimated effect of NO2 on mortality was independent of PM2.5.

Conclusions

This large study strongly supports an effect of long-term exposure to NO2 and PM2.5 on mortality, especially from cardiovascular causes. The results are relevant for the next European policy decisions regarding air quality.

SUBMITTER: Cesaroni G 

PROVIDER: S-EPMC3621202 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

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Long-term exposure to urban air pollution and mortality in a cohort of more than a million adults in Rome.

Cesaroni Giulia G   Badaloni Chiara C   Gariazzo Claudio C   Stafoggia Massimo M   Sozzi Roberto R   Davoli Marina M   Forastiere Francesco F  

Environmental health perspectives 20130108 3


<h4>Background</h4>Few European studies have investigated the effects of long-term exposure to both fine particulate matter (≤ 2.5 µm; PM2.5) and nitrogen dioxide (NO2) on mortality.<h4>Objectives</h4>We studied the association of exposure to NO2, PM2.5, and traffic indicators on cause-specific mortality to evaluate the form of the concentration-response relationship.<h4>Methods</h4>We analyzed a population-based cohort enrolled at the 2001 Italian census with 9 years of follow-up. We selected a  ...[more]

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