Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.
Danish Cancer Society Research Center, Copenhagen, Denmark.
Lancet. 2014 Mar 1;383(9919):785-95. doi: 10.1016/S0140-6736(13)62158-3. Epub 2013 Dec 9.
Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants.
We used data from 22 European cohort studies, which created a total study population of 367,251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and between 10 μm and 2.5 μm (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOx), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buffer. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta-analysis.
The total study population consisted of 367,251 participants who contributed 5,118,039 person-years at risk (average follow-up 13.9 years), of whom 29,076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2.5 of 1.07 (95% CI 1.02-1.13) per 5 μg/m(3) was recorded. No heterogeneity was noted between individual cohort effect estimates (I(2) p value=0.95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 μg/m(3) (HR 1.06, 95% CI 1.00-1.12) or below 20 μg/m(3) (1.07, 1.01-1.13).
Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value.
European Community's Seventh Framework Program (FP7/2007-2011).
有关空气污染与死亡率之间长期暴露的研究在欧洲很少见。在欧洲多中心空气污染效应队列研究（ESCAPE）中，我们旨在调查自然原因死亡率与长期暴露于几种空气污染物之间的关联。
我们使用了来自 22 个欧洲队列研究的数据，这些研究构成了 367251 名参与者的总研究人群。所有队列均为普通人群样本，尽管有些仅限制为一种性别。我们使用严格标准化的方案，评估了细颗粒物（PM）直径小于 2.5μm（PM2.5）、小于 10μm（PM10）和 10μm 至 2.5μm（PMcoarse）、PM2.5 吸光度以及氮氧化物（NO2 和 NOx）的年度平均浓度作为居住环境暴露。我们还研究了两个交通强度变量——最近道路上的交通强度（每天车辆数）和 100 米缓冲区内所有主要道路上的总交通负荷。我们使用混杂因素模型进行了队列特异性统计分析，这些模型对混杂因素变量进行了逐步调整，并使用通用方案对 Cox 比例风险模型进行了分析。我们通过随机效应荟萃分析获得了汇总的效应估计值。
总研究人群由 367251 名参与者组成，他们在风险期间提供了 5118039 人年（平均随访 13.9 年），其中 29076 人在随访期间死于自然原因。PM2.5 每增加 5μg/m3，危险比（HR）显著增加 1.07（95%CI 1.02-1.13）。个体队列效应估计值之间没有异质性（I²p 值=0.95）。即使我们仅包括暴露于低于欧洲年平均限值 25μg/m3（HR 1.06，95%CI 1.00-1.12）或低于 20μg/m3（1.07，1.01-1.13）的污染物浓度的参与者，PM2.5 的 HR 仍然显著升高。
长期暴露于细颗粒物空气污染与自然原因死亡率有关，即使在远低于当前欧洲年平均限值的浓度范围内也是如此。
欧洲共同体第七框架计划（FP7/2007-2011）。
