An Association Between Long-Term Exposure to Ambient Air Pollution and Mortality From Lung Cancer and Respiratory Diseases in Japan

Abstract

BackgroundEvidence for a link between long-term exposure to air pollution and lung cancer is limited to Western populations. In this prospective cohort study, we examined this association in a Japanese population.MethodsThe study comprised 63 520 participants living in 6 areas in 3 Japanese prefectures who were enrolled between 1983 and 1985. Exposure to particulate matter less than 2.5 µm in aerodynamic diameter (PM2.5), sulfur dioxide (SO2), and nitrogen dioxide (NO2) was assessed using data from monitoring stations located in or nearby each area. The Cox proportional hazards model was used to calculate the hazard ratios associated with the average concentrations of these air pollutants.ResultsThe 10-year average concentrations of PM2.5, SO2, and NO2 before recruitment (1974–1983) were 16.8 to 41.9 µg/m3, 2.4 to 19.0 ppb, and 1.2 to 33.7 ppb, respectively (inter-area range). During an average follow-up of 8.7 years, there were 6687 deaths, including 518 deaths from lung cancer. The hazard ratios for lung cancer mortality associated with a 10-unit increase in PM2.5 (µg/m3), SO2 (ppb), and NO2 (ppb) were 1.24 (95% confidence interval: 1.12–1.37), 1.26 (1.07–1.48), and 1.17 (1.10–1.26), respectively, after adjustment for tobacco smoking and other confounding factors. In addition, a significant increase in risk was observed for male smokers and female never smokers. Respiratory diseases, particularly pneumonia, were also significantly associated with all the air pollutants.ConclusionsLong-term exposure to air pollution is associated with lung cancer and respiratory diseases in Japan.

Outdoor Particulate Matter Exposure and Lung Cancer: A Systematic Review and Meta-Analysis

“…We identified 17 cohort studies Beeson et al 1998;Cao et al 2011;Carey et al 2013;Cesaroni et al 2013;Hales et al 2012;Hart et al 2011;Heinrich et al 2013;Jerrett et al 2013;Katanoda et al 2011;Krewski et al 2009;Lepeule et al 2012;Lipsett et al 2011;McDonnell et al 2000;Naess et al 2007;Pope et al 2002;Raaschou-Nielsen et al 2013) and one case-control study (Hystad et al 2013) of lung cancer that provided estimates of the quantitative relationships between the risk of lung cancer and exposure to PM 2.5 or PM 10 that could be expressed per 10-μg/m 3 change in PM. Estimates from one cohort study (Naess et al 2007) could not be converted to units of 10-μg/m 3 , and thus, this study did not contribute to the meta-estimates.…”

Exposure to Particulate Matter and Long-term Risk of Cardiovascular Mortality in Japan: NIPPON DATA80

“…Permission to use the National Vital Statistics was obtained from the Management and Coordination Agency, Government of Japan. Approval for this study was obtained from the Institutional Review Board of Shiga University of Medical Science (number [12][13][14][15][16][17][18]2000).…”

“…In Japan, one study examined the association between long-term PM and cardiovascular mortality and found a higher cardiovascular mortality in less polluted areas than more heavily polluted areas 11) . The study did not adjust for several cardiovascular risk factors, such as blood pressure level and serum lipid level, because the main goal at the baseline survey of the study was to examine the association between air pollution and lung cancer mortality 11,12) . It remains uncertain whether chronic exposure to PM is associated with increased cardiovascular mortality in Japan for the following reasons.…”

Air Pollution, Reactive Oxygen Species (ROS), and Autonomic Nervous System Interactions Modulate Cardiac Oxidative Stress and Electrophysiological Changes

“…As an example, data from Tokyo showed that sulfur dioxide, one of the main pollutants in urban areas, had and annual average concentration below 10 g/m 3 , for the years 2000-2005 which corresponds to concentrations recorded in the least polluted cities in Europe such as Copenhagen and Barcelona. On the other hand the annual average ambient nitrogen dioxide concentration in Tokyo was 60 g/m 3 , a value higher than those in the most polluted cities in Europe such as Paris and Athens [Katanoda et al, 2011].…”