Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Hvidtfeldt, Ulla Arthur; Severi, Gianluca; Andersen, Zorana Jovanovic; Atkinson, Richard; Bauwelinck, Mariska; Bellander, Tom; Boutron-Ruault, Marie Christine; Brandt, Jørgen; Brunekreef, Bert; Cesaroni, Giulia; Chen, Jie; Concin, Hans; Forastiére, Francesco; Gils, Carla H. van; Gulliver, John; Hertel, Ole; Hoek, Gerard; Hoffmann, Barbara; Hoogh, Kees de; Janssen, Nicole; Jöckel, Karl Heinz; Jørgensen, Jeanette Therming; Katsouyanni, Klea; Ketzel, Matthias; Klompmaker, Jochem O.; Krog, Norun Hjertager; Lang, Alois; Leander, Karin; Liu, Shuo; Ljungman, Petter; Magnusson, Patrik K. E.; Mehta, Amar; Nagel, Gabriële; Oftedal, Bente; Pershagen, Göran; Peter, Raphael Simon; Peters, Annette; Renzi, Matteo; Rizzuto, Debora; Rodopoulou, Sophia; Samoli, Evangelia; Schwarze, Per E.; Sigsgaard, Torben; Simonsen, Mette Kildevæld; Stafoggia, Massimo; Strak, Maciek; Vienneau, Danielle; Weinmayr, Gudrun; Wolf, Kathrin; Raaschou-Nielsen, Ole; Fecht, Daniela

doi:10.1016/j.envint.2020.106249

Cited by 88 publications

(78 citation statements)

References 36 publications

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“…68 The Effects of Low-level Air Pollution: A Study in Europe (ELAPSE), a large pooled cohort analysis, also suggested a linear to supralinear shape of the PM 2.5 concentration-response function with no evidence of a threshold. 69 For breast cancer, we did not find a statistically significant effect of PM exposure. The studies were too limited in number to analyze subgroups.…”

Section: Discussioncontrasting

confidence: 62%

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Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis

Pei

Guo

et al. 2021

The Innovation

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Robust evidence is needed for the hazardous effects of outdoor particulate matter (PM) on mortality and morbidity from all types of cancers. To summarize and meta-analyze the association between PM and cancer, published articles reporting associations between outdoor PM exposure and any type of cancer with individual outcome assessment that provided a risk estimate in cohort studies were identified via systematic searches. Of 3,256 records, 47 studies covering 13 cancer sites (30 for lung cancer, 12 for breast cancer, 11 for other cancers) were included in the quantitative evaluation. The pooled relative risks (RRs) for lung cancer incidence or mortality associated with every 10-μg/m 3 PM 2.5 or PM 10 were 1.16 (95% confidence interval [CI], 1.10–1.23; I 2 = 81%) or 1.22 (95% CI, 1.02–1.45; I 2 = 96%), respectively. Increased but non-significant risks were found for breast cancer. Other cancers were shown to be associated with PM exposure in some studies but not consistently and thus warrant further investigation.

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Section: Discussioncontrasting

confidence: 62%

“…68 The Effects of Low-level Air Pollution: A Study in Europe (ELAPSE), a large pooled cohort analysis, also suggested a linear to supra-linear shape of the PM 2.5 concentration-response function with no evidence of a threshold. 69 …”

Section: Discussionmentioning

confidence: 99%

Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis

Pei

Guo

et al. 2021

The Innovation

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“…The discrepancy in distributions of air pollution exposure concentrations between two exposure assessment methods can be checked elsewhere. 25 In conclusion, our study suggests that long-term exposure to air pollution may increase the risk of liver cancer, even at concentrations below current EU standards, and adds evidence of detrimental health effects of air pollution on cancers other than lung cancer.…”

Section: Discussionsupporting

confidence: 54%

Long‐term exposure to air pollution and liver cancer incidence in six European cohorts

Chen

Mehta

et al. 2021

Intl Journal of Cancer

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Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the "Effects of low-level air pollution: A study in Europe" (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015.The annual average exposure to nitrogen dioxide (NO 2 ), particulate matter with diameter <2.5 μm (PM 2.5 ), black carbon (BC), warm-season ozone (O 3 ), and eight elemental components of PM 2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330 064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO 2 (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 μg/m 3 ), PM 2.5 (1.12, 0.92-1.36 per 5 μg/m 3 ), and BC (1.15, 1.00-1.33 per 0.5 10 À5 /m) and liver cancer incidence. Associations with NO 2 and BC persisted in two-pollutant models with PM 2.5 . Most components of PM 2.5 were associated with the risk of liver 1888 SO ET AL.

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“…Main analyses. To estimate HRs and 95% CIs for associations of the PM 2:5 component exposure with natural and cause-specific mortality, we applied Cox proportional hazards models following the general ELAPSE analytical framework (Hvidtfeldt et al 2021b;Liu et al 2021Liu et al , 2020Samoli et al 2021). We used strata for subcohorts contributing to the pooled cohort to account for differences in baseline hazard between the subcohorts unexplained by the available covariates.…”

Section: Statistical Analysesmentioning

confidence: 99%

Long-Term Exposure to Fine Particle Elemental Components and Natural and Cause-Specific Mortality—a Pooled Analysis of Eight European Cohorts within the ELAPSE Project

Chen

Rodopoulou

Hoogh

et al. 2021

Environ Health Perspect

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Background: Inconsistent associations between long-term exposure to particles with an aerodynamic diameter [fine particulate matter ( )] components and mortality have been reported, partly related to challenges in exposure assessment. Objectives: We investigated the associations between long-term exposure to elemental components and mortality in a large pooled European cohort; to compare health effects of components estimated with two exposure modeling approaches, namely, supervised linear regression (SLR) and random forest (RF) algorithms. Methods: We pooled data from eight European cohorts with 323,782 participants, average age 49 y at baseline (1985–2005). Residential exposure to 2010 annual average concentration of eight components [copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V), and zinc (Zn)] was estimated with Europe-wide SLR and RF models at a scale. We applied Cox proportional hazards models to investigate the associations between components and natural and cause-specific mortality. In addition, two-pollutant analyses were conducted by adjusting each component for mass and nitrogen dioxide ( ) separately. Results: We observed 46,640 natural-cause deaths with 6,317,235 person-years and an average follow-up of 19.5 y. All SLR-modeled components were statistically significantly associated with natural-cause mortality in single-pollutant models with hazard ratios (HRs) from 1.05 to 1.27. Similar HRs were observed for RF-modeled Cu, Fe, K, S, V, and Zn with wider confidence intervals (CIs). HRs for SLR-modeled Ni, S, Si, V, and Zn remained above unity and (almost) significant after adjustment for both and . HRs only remained (almost) significant for RF-modeled K and V in two-pollutant models. The HRs for V were 1.03 (95% CI: 1.02, 1.05) and 1.06 (95% CI: 1.02, 1.10) for SLR- and RF-modeled exposures, respectively, per , adjusting for mass. Associations with cause-specific mortality were less consistent in two-pollutant models. Conclusion: Long-term exposure to V in was most consistently associated with increased mortality. Associations for the other components were weaker for exposure modeled with RF than SLR in two-pollutant models. https://doi.org/10.1289/EHP8368

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Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Cited by 88 publications

References 36 publications

Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis

Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis

Long‐term exposure to air pollution and liver cancer incidence in six European cohorts

Long-Term Exposure to Fine Particle Elemental Components and Natural and Cause-Specific Mortality—a Pooled Analysis of Eight European Cohorts within the ELAPSE Project

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