Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project

作者：Massimo Stafoggia, Bente Oftedal, Jie Chen, Sophia Rodopoulou, Matteo Renzi, Richard Atkinson, Mariska Bauwelinck, Jochem O. Klompmaker, Amar Mehta, Danielle Vienneau, Zorana Jovanovic Andersen, Tom Bellander, Jørgen Brandt, Giulia Cesaroni, Kees de Hoogh, Daniela Fecht, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, Karl‐Heinz Jöckel, Jeanette T. Jørgensen, Klea Katsouyanni, Matthias Ketzel, Doris Tove Kristoffersen, Anton Lager, Karin Leander, Shuo Liu, Petter Ljungman, Gabriele Nagel, Göran Pershagen, Annette Peters, Ole Raaschou‐Nielsen, Debora Rizzuto, Sara Schramm, Per E. Schwarze, Gianluca Severi, Torben Sigsgaard, Maciej Strak, Yvonne T. van der Schouw, W. M. Monique Verschuren, Gudrun Weinmayr, Kathrin Wolf, Emanuel Zitt, Evangelia Samoli, Francesco Forastiere, Bert Brunekreef, Gerard Hoek, Nicole Janssen · 发表于：The Lancet Planetary Health · 年份：2022 · DOI：10.1016/s2542-5196(21)00277-1 · 被引用次数：357 · 研究领域：Air Quality and Health Impacts、Environmental Justice and Health Disparities、Health, Environment, Cognitive Aging

Background Long-term exposure to ambient air pollution has been associated with premature mortality, but associations at concentrations lower than current annual limit values are uncertain. We analysed associations between low-level air pollution and mortality within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE). Methods In this multicentre longitudinal study, we analysed seven population-based cohorts of adults (age ≥30 years) within ELAPSE, from Belgium, Denmark, England, the Netherlands, Norway, Rome (Italy), and Switzerland (enrolled in 2000–11; follow-up until 2011–17). Mortality registries were used to extract the underlying cause of death for deceased individuals. Annual average concentrations of fine particulate matter (PM 2·5 ), nitrogen dioxide (NO 2 ), black carbon, and tropospheric warm-season ozone (O 3 ) from Europe-wide land use regression models at 100 m spatial resolution were assigned to baseline residential addresses. We applied cohort-specific Cox proportional hazard models with adjustment for area-level and individual-level covariates to evaluate associations with non-accidental mortality, as the main outcome, and with cardiovascular, non-malignant respiratory, and lung cancer mortality. Subset analyses of participants living at low pollutant concentrations (as per predefined values) and natural splines were used to investigate the concentration-response function. Cohort-specific effect estimates were pooled in a ran...