Long-term exposure to traffic-related air pollution and the risk of death from hemorrhagic stroke and lung cancer in Shizuoka, Japan

• Published in: The Science of the total environment Vol. 443; no. 15; pp. 397 - 402
• Main Authors: Yorifuji, Takashi, Kashima, Saori, Tsuda, Toshihide, Ishikawa-Takata, Kazuko, Ohta, Toshiki, Tsuruta, Ken-ichi, Doi, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier B.V 15.01.2013; Elsevier
• Subjects: adverse effects; Aged; Air; Air Pollution; Air. Soil. Water. Waste. Feeding; Biological and medical sciences; Cancer; chronic exposure; cohort studies; confidence interval; death; Environment. Living conditions; Environmental exposure; Environmental pollutants toxicology; Hazards; hemorrhage; Hemorrhages; Humans; Intracranial Hemorrhages - chemically induced; Intracranial Hemorrhages - mortality; Japan - epidemiology; land use; Lung neoplasms; Lung Neoplasms - chemically induced; Lung Neoplasms - mortality; Medical sciences; Mortality; myocardial ischemia; Nitrogen dioxide; Public health. Hygiene; Public health. Hygiene-occupational medicine; regression analysis; Risk; Risk Factors; Stroke; Stroke - chemically induced; Stroke - mortality; Strokes; Toxicology; Vehicle Emissions - toxicity; Asia; Honshu; Japan; Environmental exposure; Stroke; IHD; CI; LUR; HR; ICD; GIS; NO2; LC; Air pollution; Nitrogen dioxide; BMI; COPD; Lung neoplasms; Lung disease; Respiratory disease; Toxicity; Lung cancer; Mortality; Nitrogen compounds; Cardiovascular disease; Motor vehicle; Malignant tumor; Hemorrhage; Long term; Cerebral disorder; Health and environment; Central nervous system disease; Road traffic; Public health; Cancer
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2012.10.088

A number of studies have linked exposure to long-term outdoor air pollution with cardiopulmonary disease; however, the evidence for stroke is limited. Furthermore, evidence with the risk for lung cancer (LC) is still inconsistent. We, therefore, evaluated the association between long-term exposure to traffic-related air pollution and cause-specific mortality. Individual data were extracted from participants of an ongoing cohort study in Shizuoka, Japan. A total of 14,001 elderly residents completed questionnaires and were followed from December 1999 to January 2009. Annual individual nitrogen dioxide (NO2) exposure data, as an index for traffic-related exposure, were modeled using a Land Use Regression model and assigned to the participants. We then estimated the adjusted hazard ratios (HRs) and their confidence intervals (CIs) associated with a 10μg/m3 elevation in NO2 for all-cause or cause-specific mortality using time-varying Cox proportional hazards models. We found positive associations of NO2 levels with all-cause (HR=1.12, 95% CI: 1.07–1.18), cardiopulmonary disease (HR=1.22, 95% CI: 1.15–1.30), and LC mortality (HR=1.20, 95% CI: 1.03–1.40). Among cardiopulmonary disease mortality, not only the risk for ischemic heart disease (HR=1.27, 95% CI: 1.11–1.47) but also the risks for stroke were elevated: intracerebral hemorrhage (HR=1.28, 95% CI: 1.05–1.57) and ischemic stroke (HR=1.20, 95% CI: 1.04–1.39). The present study supports the existing evidence that long-term exposure to traffic-related air pollution increases the risk of cardiopulmonary as well as LC mortality, and provides additional evidence for adverse effects on intracerebral hemorrhage as well as ischemic stroke. ► We evaluated the effect of long-term exposure to air pollution and mortality. ► Air pollution increased the risk of cardiopulmonary and lung cancer mortality. ► Air pollution had adverse effects on intracerebral hemorrhage and ischemic stroke.