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

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Abstract

BACKGROUND: Few European studies have investigated the effects of long-term exposure to both fine particulate matter (/= 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-microg/m3 NO2; HR = 1.04 (95% CI: 1.03, 1.05) per 10-microg/m3 PM2.5]. The strongest association was found for ischemic heart diseases (IHD) [HR = 1.10 (95% CI: 1.06, 1.13) per 10-microg/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.

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APA

Cesaroni, G., Badaloni, C., Gariazzo, C., Stafoggia, M., Sozzi, R., Davoli, M., & Forastiere, F. (2013). Long-term exposure to urban air pollution and mortality in a cohort of more than a million adults in Rome. Environmental Health Perspectives, 121(3), 324–331. https://doi.org/10.1289/ehp.1205862

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