Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project.
Stafoggia, Massimo; Oftedal, Bente; Chen, Jie; Rodopoulou, Sophia; Renzi, Matteo; Atkinson, Richard W; Bauwelinck, Mariska; Klompmaker, Jochem O; Mehta, Amar; Vienneau, Danielle; Andersen, Zorana J; Bellander, Tom; Brandt, Jørgen; Cesaroni, Giulia; de Hoogh, Kees; Fecht, Daniela; Gulliver, John; Hertel, Ole; Hoffmann, Barbara; Hvidtfeldt, Ulla A; Jöckel, Karl-Heinz; Jørgensen, Jeanette T; Katsouyanni, Klea; Ketzel, Matthias; Kristoffersen, Doris Tove; Lager, Anton; Leander, Karin; Liu, Shuo; Ljungman, Petter L S; Nagel, Gabriele; Pershagen, Göran; Peters, Annette; Raaschou-Nielsen, Ole; Rizzuto, Debora; Schramm, Sara; Schwarze, Per E; Severi, Gianluca; Sigsgaard, Torben; Strak, Maciek; van der Schouw, Yvonne T; Verschuren, Monique; Weinmayr, Gudrun; Wolf, Kathrin; Zitt, Emanuel; Samoli, Evangelia; Forastiere, Francesco; Brunekreef, Bert; Hoek, Gerard; Janssen, Nicole A H
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Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project.
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Lancet Planet Health 2022;6(1):e9-18
Abstract
In this multicentre longitudinal study, we analysed seven population-based cohorts of adults (age ≥30 years) within ELAPSE, from Belgium, Denmark, England, the Netherlands, Norway, Rome (Italy), and Switzerland (enrolled in 2000-11; follow-up until 2011-17). Mortality registries were used to extract the underlying cause of death for deceased individuals. Annual average concentrations of fine particulate matter (PM2·5), nitrogen dioxide (NO2), black carbon, and tropospheric warm-season ozone (O3) from Europe-wide land use regression models at 100 m spatial resolution were assigned to baseline residential addresses. We applied cohort-specific Cox proportional hazard models with adjustment for area-level and individual-level covariates to evaluate associations with non-accidental mortality, as the main outcome, and with cardiovascular, non-malignant respiratory, and lung cancer mortality. Subset analyses of participants living at low pollutant concentrations (as per predefined values) and natural splines were used to investigate the concentration-response function. Cohort-specific effect estimates were pooled in a random-effects meta-analysis.