Associations between long-term PM2.5 and ozone exposure and mortality in the Canadian Census Health and Environment Cohort (CANCHEC), by spatial synoptic classification zone

• Published in: Environment international Vol. 111; pp. 200 - 211
• Main Authors: Cakmak, Sabit, Hebbern, Chris, Pinault, Lauren, Lavigne, Eric, Vanos, Jennifer, Crouse, Dan Lawson, Tjepkema, Michael
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.02.2018; Elsevier
• Subjects: Air pollution; Canada; chronic exposure; Climate; climatic zones; death; Environmental health; Lung cancer; lung neoplasms; Mortality; myocardial ischemia; ozone; particulates; risk; risk estimate; socioeconomic status; weather; Canada; Air pollution; Climate; Lung cancer; Mortality; Environmental health
• ISSN: 0160-4120; 1873-6750; 1873-6750
• DOI: 10.1016/j.envint.2017.11.030

Studies suggest that long-term chronic exposure to fine particulate matter air pollution can increase lung cancer mortality. We analyzed the association between long term PM2.5 and ozone exposure and mortality due to lung cancer, ischemic heart disease, and chronic obstructive pulmonary disease, accounting for geographic location, socioeconomic status, and residential mobility. Subjects in the 1991 Canadian Census Health and Environment Cohort (CanCHEC) were followed for 20years, and assigned to regions across Canada based on spatial synoptic classification weather types. Hazard ratios (HR) for mortality, were related to PM2.5 and ozone using Cox proportional hazards survival models, adjusting for socioeconomic characteristics and individual confounders. An increase of 10μg/m3 in long term PM2.5 exposure resulted in an HR for lung cancer mortality of 1.26 (95% CI 1.04, 1.53); the inclusion in the model of SSC zone as a stratum increased the risk estimate to HR 1.29 (95% CI 1.06, 1.57). After adjusting for ozone, HRs increased to 1.49 (95% CI 1.23, 1.88), and HR 1.54 (95% CI 1.27, 1.87), with and without zone as a model stratum. HRs for ischemic heart disease fell from 1.25 (95% CI 1.21, 1.29) for exposure to PM2.5, to 1.13 (95% CI 1.08, 1.19) when PM2.5 was adjusted for ozone. For COPD, the 95% confidence limits included 1.0 when climate zone was included in the model. HRs for all causes of death showed spatial differences when compared to zone 3, the most populated climate zone. Exposure to PM2.5 was related to an increased risk of mortality from lung cancer, and both ozone and PM2.5 exposure were related to risk of mortality from ischemic heart disease, and the risk varied spatially by climate zone. •We assign geographic zones in Canada based on SSC and identified 7 climate zones.•Lung cancer-related mortality risk due to long term exposure to PM2.5 varies by each climate zone in Canada.•PM2.5 risk on lung cancer-related mortality remains significant after adjustment for ozone.•The effect of ozone on lung cancer-related mortality was statistically non-significant.