SummaryBackground Long-term exposure to particulate matter air pollution has been associated with increased cardiopulmonary mortality in the USA. We aimed to assess the relation between traffic-related air pollution and mortality in participants of the Netherlands Cohort study on Diet and Cancer (NLCS), an ongoing study. MethodsWe investigated a random sample of 5000 people from the full cohort of the NLCS study (age 55-69 years) from 1986 to 1994. Long-term exposure to traffic-related air pollutants (black smoke and nitrogen dioxide) was estimated for the 1986 home address. Exposure was characterised with the measured regional and urban background concentration and an indicator variable for living near major roads. The association between exposure to air pollution and (cause specific) mortality was assessed with Cox's proportional hazards models, with adjustment for potential confounders.Findings 489 (11%) of 4492 people with data died during the follow-up period. Cardiopulmonary mortality was associated with living near a major road (relative risk 1·95, 95% CI 1·09-3·52) and, less consistently, with the estimated ambient background concentration (1·34, 0·68-2·64). The relative risk for living near a major road was 1·41 (0·94-2·12) for total deaths. Non-cardiopulmonary, non-lung cancer deaths were unrelated to air pollution (1·03, 0·54-1·96 for living near a major road).Interpretation Long-term exposure to traffic-related air pollution may shorten life expectancy.

Recent prospective cohort studies have suggested that long -term exposure to low levels of particulate matter ( PM ) air pollution is associated with increased mortality due to, especially, cardio -pulmonary disease. Exposure to ambient air pollution was estimated mostly as city average concentrations, assuming homogenous exposure within the city. We used an ongoing cohort study -The Netherlands Cohort Study ( NLCS ) on diet and cancer -to investigate the relationship between traffic -related air pollution and mortality. The baseline data collection took place in 1986. A study was conducted to develop methods for exposure assessment and evaluate the contrast in exposure to air pollution within the cohort. Assessment of long -term exposure to two traffic -related air pollutants, Black Smoke ( BS ) and Nitrogen Dioxide ( NO 2 ) , consisted of separate estimation of regional background, urban background, and local traffic contributions at the home address. Interpolation of concentration data from a routine monitoring network was used to estimate the regional background concentration. A regression model relating degree of urbanization to air pollution was used to allow for differences between different towns / neighborhoods of cities. Distance to major roads was calculated to characterize local traffic contributions, using a Geographic Information System ( GIS ) . Interpolation resulted in reasonably precise regional background estimation when distant sites were not used and distance squared was used as the weight. Cross -validation showed that prediction errors were about 15% of the range in regional background concentration. Urban and local scales contributed significantly to the contrast within the cohort. Prediction errors for estimating the urban background were about 25% of the range in background concentrations. When the developed model was applied to the study cohort, there was substantial contrast in estimated exposure to BS and NO 2 . About 90% of the study population lived 10 years or more at its 1986 home address -supporting the use of the estimated concentration at the 1986 address as a relevant exposure variable.

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Objectives In epidemiological studies, occupational exposure levels are often assigned through linkage of job histories with job-exposure matrices (JEMs). For a cohort where jobs were originally coded using a Dutch occupational coding system (CBS-84), jobs needed to be re-coded to to facilitate the application of several JEMs. The aim of this study was to investigate whether using a crosswalk to recode occupational codes would result in similar exposure estimates to those obtained when jobs were manually coded from questionnaires. Methods Crosswalks were developed and used to recode occupational codes from CBS-84 to ISCO-68 and ISCO-88. A subset of jobs (n=220) was also manually coded from questionnaires to ISCO-68 and ISCO-88. JEMs were applied to the occupational codes resulting from manual coding and from applying crosswalks. Ten occupational exposures were linked, among which chromium, asbestos, silica, pesticides, and electromagnetic fi elds. Estimated exposure levels for participants were compared between the manual coders and between coders and crosswalks. Results A moderate to high level of agreement on estimated exposures was observed between the two coders (Cohen's κ = 0.68 or higher). Estimated exposures based on the crosswalks showed a slightly lower agreement with those based on manual coding (Cohen's κ = 0.55 or higher). Conclusions Results of this study indicate that using crosswalks to recode occupational codes to the necessary occupational classifi cation results only in a limited loss in agreement of assigned exposures as compared to manual coding. Therefore, crosswalks could be an effi cient alternative to coding directly from questionnaires. on 2 May 2019 by guest. Protected by copyright.

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