Dataset Information

Fine Particulate Matter Air Pollution and Mortality Risk Among US Cancer Patients and Survivors.

ABSTRACT:

Background

Exposure to fine particulate matter (PM_2.5) air pollution has been linked to increased risk of mortality, especially cardiopulmonary and lung cancer mortality. It is unknown if cancer patients and survivors are especially vulnerable to PM_2.5 air pollution exposure. This study evaluates PM_2.5 exposure and risk for cancer and cardiopulmonary mortality in cohorts of US cancer patients and survivors.

Methods

A primary cohort of 5 591 168 of cancer patients and a 5-year survivor cohort of 2 318 068 was constructed using Surveillance, Epidemiology, and End Results Program data from 2000 to 2016, linked with county-level estimates of long-term average concentrations of PM_2.5. Cox proportional hazards models were used to estimate PM_2.5-mortality hazard ratios controlling for age-sex-race combinations and individual and county-level covariables.

Results

Of those who died, 26% died of noncancer causes, mostly from cardiopulmonary disease. Minimal PM_2.5-mortality associations were observed for all-cause mortality (hazard ratio [HR] = 1.01, 95% confidence interval [CI] = 1.00 to 1.03) per 10?µg/m³ increase in PM_2.5. Substantial adverse PM_2.5-mortality associations were observed for cardiovascular (HR?=?1.32, 95% CI = 1.26 to 1.39), chronic obstructive pulmonary disease (HR?=?1.10, 95% CI = 1.01 to 1.20), influenza and pneumonia (HR?=?1.55, 95% CI = 1.33 to 1.80), and cardiopulmonary mortality combined (HR?=?1.25, 95% CI = 1.21 to 1.30). PM_2.5-cardiopulmonary mortality hazard ratio was higher for cancer patients who received chemotherapy or radiation treatments.

Conclusions

Air pollution is adversely associated with cardiopulmonary mortality for cancer patients and survivors, especially those who received chemotherapy or radiation treatment. Given ubiquitous and involuntary air pollution exposures and large numbers of cancer patients and survivors, these results are of substantial clinical and public health importance.

SUBMITTER: Coleman NC

PROVIDER: S-EPMC7898081 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Fine Particulate Matter Air Pollution and Mortality Risk Among US Cancer Patients and Survivors.

Coleman Nathan C NC Ezzati Majid M Marshall Julian D JD Robinson Allen L AL Burnett Richard T RT Pope C Arden CA

JNCI cancer spectrum 20210221 1

<h4>Background</h4>Exposure to fine particulate matter (PM<sub>2.5</sub>) air pollution has been linked to increased risk of mortality, especially cardiopulmonary and lung cancer mortality. It is unknown if cancer patients and survivors are especially vulnerable to PM<sub>2.5</sub> air pollution exposure. This study evaluates PM<sub>2.5</sub> exposure and risk for cancer and cardiopulmonary mortality in cohorts of US cancer patients and survivors.<h4>Methods</h4>A primary cohort of 5 591 168 of ...[more]

PMID: 33644681

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Project description:Using daily fine particulate matter (PM2.5) composition data from the 2000-2005 U.S. EPA Chemical Speciation Network (CSN) for over 200 sites, we applied multivariate methods to identify and quantify the major fine particulate matter (PM2.5) source components in the U.S. Novel aspects of this work were: (1) the application of factor analysis (FA) to multi-city daily data, drawing upon both spatial and temporal variations of chemical species; and, (2) the exclusion of secondary components (sulfates, nitrates and organic carbon) from the source identification FA to more clearly discern and apportion the PM2.5 mass to primary emission source categories. For the quantification of source-related mass, we considered two approaches based upon the FA results: 1) using single key tracers for sources identified by FA in a mass regression; and, 2) applying Absolute Principal Component Analysis (APCA). In each case, we followed a two-stage mass regression approach, in which secondary components were first apportioned among the identified sources, and then mass was apportioned to the sources and to other secondary mass not explained by the individual sources. The major U.S. PM2.5 source categories identified via FA (and their key elements) were: Metals Industry (Pb, Zn); Crustal/Soil Particles (Ca, Si); Motor Vehicle Traffic (EC, NO2); Steel Industry (Fe, Mn); Coal Combustion (As, Se); Oil Combustion (V, Ni); Salt Particles (Na, Cl) and Biomass Burning (K). Nationwide spatial plots of the source-related PM2.5 impacts were confirmatory of the factor interpretations: ubiquitous sources, such as Traffic and Soil, were found to be spread across the nation, more unique sources (such as Steel and Metals Processing) being highest in select industrialized cities, Biomass Burning was highest in the U.S. Northwest, while Residual Oil combustion was highest in cities in the Northeastern U.S. and in cities with major seaports. The sum of these source contributions and the secondary PM2.5 components agreed well with the U.S. PM2.5 observed during the study period (mean=14.3 ug/m3; R2= 0.91). Apportionment regression analyses using single-element tracers for each source category gave results consistent with the APCA estimates. Comparisons of nearby sites indicated that the PM2.5 mass and the secondary aerosols were most homogenous spatially, while traffic PM2.5 and its tracer, EC, were among the most spatially representative of the source-related components. Comparison of apportionment results to a previous analysis of the 1979-1982 IP Network revealed similar and correlated major U.S. source category factors, albeit at lower levels than in the earlier period, suggesting a consistency in the U.S. spatial patterns of these source-related exposures over time, as well. These results indicate that applying source apportionment methods to the nationwide CSN can be an informative avenue for identifying and quantifying source components for the subsequent estimation of source-specific health effects, potentially contributing to more efficient regulation of PM2.5.

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Dataset Information

Fine Particulate Matter Air Pollution and Mortality Risk Among US Cancer Patients and Survivors.

Background

Methods

Results

Conclusions

Publications

Fine Particulate Matter Air Pollution and Mortality Risk Among US Cancer Patients and Survivors.

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