Long-Term Exposure to Air Pollution and Cardiorespiratory Disease in the California Teachers Study Cohort
01 Oct 2011-American Journal of Respiratory and Critical Care Medicine (American Thoracic Society)-Vol. 184, Iss: 7, pp 828-835
TL;DR: This study provides evidence linking long-term exposure to PM2.5 and PM10 with increased risks of incident stroke as well as IHD mortality; exposure to nitrogen oxides was also related to death from cardiovascular diseases.
Abstract: Rationale: Several studies have linked long-term exposure to particulate air pollution with increased cardiopulmonary mortality; only two have also examined incident circulatory disease Objectives: To examine associations of individualized long-term exposures to particulate and gaseous air pollution with incident myocardial infarction and stroke, as well as all-cause and causespecific mortality Methods: We estimated long-term residential air pollution exposure for more than 100,000 participants in the California Teachers Study, aprospectivecohortoffemalepublicschoolprofessionalsWelinked geocoded residential addresses with inverse distance-weighted monthly pollutant surfaces for two measures of particulate matter and for several gaseous pollutants We examined associations between exposure to these pollutants and risks of incident myocardial infarction and stroke, and of all-cause and cause-specific mortality, using Cox proportional hazards models MeasurementsandMainResults:Wefoundelevatedhazardratioslinking long-term exposure to particulate matter less than 25 m mi n aerodynamic diameter (PM25), scaled to an increment of 10 mg/m 3 with mortality from ischemic heart disease (IHD) (120; 95% confidence interval [CI], 102‐141) and, particularly among postmenopausal women, incident stroke (119; 95% CI, 102‐138) Long-term exposure to particulate matter less than 10m mi n aerodynamic diameter(PM10)wasassociatedwithelevatedrisksforIHDmortality(106; 95% CI, 099‐114) and incident stroke (106; 95% CI, 100‐113), while exposure to nitrogen oxides was associated with elevated risks for IHD and all cardiovascular mortality Conclusions: This study provides evidence linking long-term exposure to PM25 and PM10 with increased risks of incident stroke as wellasIHDmortality;exposuretonitrogenoxideswasalsorelatedto
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TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
9,324 citations
TL;DR: In subjects with lower education and obese subjects a larger effect estimate for mortality related to fine PM was found, though the evidence for differences related to education has been weakened in more recent studies.
Abstract: Current day concentrations of ambient air pollution have been associated with a range of adverse health effects, particularly mortality and morbidity due to cardiovascular and respiratory diseases. In this review, we summarize the evidence from epidemiological studies on long-term exposure to fine and coarse particles, nitrogen dioxide (NO2) and elemental carbon on mortality from all-causes, cardiovascular disease and respiratory disease. We also summarize the findings on potentially susceptible subgroups across studies. We identified studies through a search in the databases Medline and Scopus and previous reviews until January 2013 and performed a meta-analysis if more than five studies were available for the same exposure metric.
1,480 citations
Cites background from "Long-Term Exposure to Air Pollution..."
...Rome cohort [38] California teachers [36] ACS Los Angeles [19] Nurses Health [25]...
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...5 16 (3–28) Address (Inter) 1 (−5, 9) 7 (−5, 19) [36]...
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...female teachers [27,36] or male truck drivers [32]....
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Health Canada1, Brigham Young University2, Imperial College London3, University of Washington4, Institute for Health Metrics and Evaluation5, Harvard University6, Research Triangle Park7, University of British Columbia8, King's College London9, University of California, Berkeley10, University of California, San Francisco11, University of Liverpool12, Fudan University13, World Health Organization14, University of Ottawa15, American Cancer Society16, Health Effects Institute17
TL;DR: A fine particulate mass–based RR model that covered the global range of exposure by integrating RR information from different combustion types that generate emissions of particulate matter is developed.
Abstract: Background: Estimating the burden of disease attributable to long-term exposure to fine particulate matter (PM2.5) in ambient air requires knowledge of both the shape and magnitude of the relative ...
1,468 citations
Health Canada1, United States Environmental Protection Agency2, Brigham Young University3, University of Texas at Austin4, University of British Columbia5, Health Effects Institute6, McGill University7, University of Minnesota8, Harvard University9, Utrecht University10, University of Washington11, Fudan University12, New York University13, University of California, Los Angeles14, University of Ottawa15, American Cancer Society16, University of California, Davis17, Cancer Prevention Institute of California18, University of New Brunswick19, Dalhousie University20, Carleton University21, Statistics Canada22, University of Toronto23, Chinese Center for Disease Control and Prevention24, St George's, University of London25, University of Hong Kong26, University of Ulm27, SERC Reliability Corporation28
TL;DR: PM2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.
Abstract: Exposure to ambient fine particulate matter (PM2.5) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM2.5 sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM2.5-mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range. We modeled the shape of the association between PM2.5 and nonaccidental mortality using data from 41 cohorts from 16 countries-the Global Exposure Mortality Model (GEMM). We then constructed GEMMs for five specific causes of death examined by the global burden of disease (GBD). The GEMM predicts 8.9 million [95% confidence interval (CI): 7.5-10.3] deaths in 2015, a figure 30% larger than that predicted by the sum of deaths among the five specific causes (6.9; 95% CI: 4.9-8.5) and 120% larger than the risk function used in the GBD (4.0; 95% CI: 3.3-4.8). Differences between the GEMM and GBD risk functions are larger for a 20% reduction in concentrations, with the GEMM predicting 220% higher excess deaths. These results suggest that PM2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.
1,283 citations
University of Leicester1, University of Cambridge2, Cooperative Institute for Research in Environmental Sciences3, Newbury College4, University of Paris5, Earth System Research Laboratory6, University of Edinburgh7, Paul Sabatier University8, Potsdam Institute for Climate Impact Research9, Lancaster University10, King's College London11
TL;DR: In this paper, a review examines current understanding of the processes regulating tropospheric ozone at global to local scales from both measurements and models and takes the view that knowledge across the scales is important for dealing with air quality and climate change in a synergistic manner.
Abstract: Ozone holds a certain fascination in atmospheric science. It is ubiquitous in the atmosphere, central to tropospheric oxidation chemistry, yet harmful to human and ecosystem health as well as being an important greenhouse gas. It is not emitted into the atmosphere but is a by-product of the very oxidation chemistry it largely initiates. Much effort is focussed on the reduction of surface levels of ozone owing to its health impacts but recent efforts to achieve reductions in exposure at a country scale have proved difficult to achieve due to increases in background ozone at the zonal hemispheric scale. There is also a growing realisation that the role of ozone as a short-lived climate pollutant could be important in integrated air quality climate-change mitigation. This review examines current understanding of the processes regulating tropospheric ozone at global to local scales from both measurements and models. It takes the view that knowledge across the scales is important for dealing with air quality and climate change in a synergistic manner.
877 citations
References
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TL;DR: Fine particulate and sulfur oxide--related pollution were associated with all-cause, lung cancer, and cardiopulmonary mortality and long-term exposure to combustion-related fine particulate air pollution is an important environmental risk factor for cardiopULmonary and lung cancer mortality.
Abstract: ContextAssociations have been found between day-to-day particulate air pollution
and increased risk of various adverse health outcomes, including cardiopulmonary
mortality. However, studies of health effects of long-term particulate air
pollution have been less conclusive.ObjectiveTo assess the relationship between long-term exposure to fine particulate
air pollution and all-cause, lung cancer, and cardiopulmonary mortality.Design, Setting, and ParticipantsVital status and cause of death data were collected by the American
Cancer Society as part of the Cancer Prevention II study, an ongoing prospective
mortality study, which enrolled approximately 1.2 million adults in 1982.
Participants completed a questionnaire detailing individual risk factor data
(age, sex, race, weight, height, smoking history, education, marital status,
diet, alcohol consumption, and occupational exposures). The risk factor data
for approximately 500 000 adults were linked with air pollution data
for metropolitan areas throughout the United States and combined with vital
status and cause of death data through December 31, 1998.Main Outcome MeasureAll-cause, lung cancer, and cardiopulmonary mortality.ResultsFine particulate and sulfur oxide–related pollution were associated
with all-cause, lung cancer, and cardiopulmonary mortality. Each 10-µg/m3 elevation in fine particulate air pollution was associated with approximately
a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer
mortality, respectively. Measures of coarse particle fraction and total suspended
particles were not consistently associated with mortality.ConclusionLong-term exposure to combustion-related fine particulate air pollution
is an important environmental risk factor for cardiopulmonary and lung cancer
mortality.
7,803 citations
"Long-Term Exposure to Air Pollution..." refers background or methods in this paper
...5, March 1, 2000) and (1) the date of death (for mortality analyses), (2) the date of hospitalization or death (for MI and stroke incidence analyses), (3) the end of the follow-up period (December 31, 2005), or (4) the date of first relocation to a non-California address for women who moved out of state for at least 4 months before any of events 1–3 occurred....
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...We selected individual-level predictor variables based on risk factors identified in previous observational studies of cardiovascular disease, especially investigations of air pollution and cardiopulmonary mortality (1, 4, 6)....
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...In several prior cohort studies, when ozone has been included in the models of long-term exposure, no associations with cardiopulmonary mortality have been observed (1, 4, 6)....
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TL;DR: It is suggested that fine-particulate air pollution, or a more complex pollution mixture associated with fine particulate matter, contributes to excess mortality in certain U.S. cities.
Abstract: Background Recent studies have reported associations between particulate air pollution and daily mortality rates. Population-based, cross-sectional studies of metropolitan areas in the United States have also found associations between particulate air pollution and annual mortality rates, but these studies have been criticized, in part because they did not directly control for cigarette smoking and other health risks. Methods In this prospective cohort study, we estimated the effects of air pollution on mortality, while controlling for individual risk factors. Survival analysis, including Cox proportional-hazards regression modeling, was conducted with data from a 14-to-16-year mortality follow-up of 8111 adults in six U.S. cities. Results Mortality rates were most strongly associated with cigarette smoking. After adjusting for smoking and other risk factors, we observed statistically significant and robust associations between air pollution and mortality. The adjusted mortality-rate ratio for the most po...
7,194 citations
TL;DR: It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM2.5 exposure and cardiovascular morbidity and mortality.
Abstract: In 2004, the first American Heart Association scientific statement on “Air Pollution and Cardiovascular Disease” concluded that exposure to particulate matter (PM) air pollution contributes to card...
5,227 citations
TL;DR: Fine particulate air pollution is a risk factor for cause-specific cardiovascular disease mortality via mechanisms that likely include pulmonary and systemic inflammation, accelerated atherosclerosis, and altered cardiac autonomic function.
Abstract: Background— Epidemiologic studies have linked long-term exposure to fine particulate matter air pollution (PM) to broad cause-of-death mortality. Associations with specific cardiopulmonary diseases might be useful in exploring potential mechanistic pathways linking exposure and mortality. Methods and Results— General pathophysiological pathways linking long-term PM exposure with mortality and expected patterns of PM mortality with specific causes of death were proposed a priori. Vital status, risk factor, and cause-of-death data, collected by the American Cancer Society as part of the Cancer Prevention II study, were linked with air pollution data from United States metropolitan areas. Cox Proportional Hazard regression models were used to estimate PM-mortality associations with specific causes of death. Long-term PM exposures were most strongly associated with mortality attributable to ischemic heart disease, dysrhythmias, heart failure, and cardiac arrest. For these cardiovascular causes of death, a 10-...
2,530 citations
"Long-Term Exposure to Air Pollution..." refers background in this paper
...5, March 1, 2000) and (1) the date of death (for mortality analyses), (2) the date of hospitalization or death (for MI and stroke incidence analyses), (3) the end of the follow-up period (December 31, 2005), or (4) the date of first relocation to a non-California address for women who moved out of state for at least 4 months before any of events 1–3 occurred....
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...This investigation represents one of the largest prospective air pollution studies undertaken to date (1, 3, 5, 12)....
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TL;DR: Long-term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women and the between-city effect appeared to be smaller than the within- city effect.
Abstract: A total of 1816 women had one or more fatal or nonfatal cardiovascular events, as confirmed by a review of medical records, including death from coronary heart disease or cerebrovascular disease, coronary revascularization, myocardial infarction, and stroke. In 2000, levels of PM2.5 exposure varied from 3.4 to 28.3 μg per cubic meter (mean, 13.5). Each increase of 10 μg per cubic meter was associated with a 24% increase in the risk of a cardiovascular event (hazard ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41) and a 76% increase in the risk of death from cardiovascular disease (hazard ratio, 1.76; 95% CI, 1.25 to 2.47). For cardiovascular events, the between-city effect appeared to be smaller than the within-city effect. The risk of cerebrovascular events was also associated with increased levels of PM2.5 (hazard ratio, 1.35; 95% CI, 1.08 to 1.68). Conclusions Long-term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women. Exposure differences within cities are associated with the risk of cardiovascular disease.
1,704 citations
"Long-Term Exposure to Air Pollution..." refers background in this paper
...This investigation represents one of the largest prospective air pollution studies undertaken to date (1, 3, 5, 12)....
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...Miller and colleagues (5) identified significantly increased risks of incident and fatal cardiovascular events associated with elevated PM2....
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...5 has reported associations with incident MI and stroke (5)....
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