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Air pollution and cardiovascular mortality with over 25years follow-up: A combined analysis of two British cohorts.

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journal contribution
posted on 16.08.2019, 13:49 by H-M Dehbi, M Blangiardo, J Gulliver, D Fecht, K de Hoogh, Z Al-Kanaani, T Tillin, R Hardy, N Chaturvedi, AL Hansell
BACKGROUND: Adverse effects of air pollution on cardiovascular disease (CVD) mortality are well established. There are comparatively fewer studies in Europe, and in the UK particularly, than in North America. We examined associations in two British cohorts with >25years of follow-up. METHODS: Annual average NO2, SO2 and black smoke (BS) air pollution exposure estimates for 1991 were obtained from land use regression models using contemporaneous monitoring data. From the European Study of Cohorts and Air Pollution (ESCAPE), air pollution estimates in 2010-11 were obtained for NO2, NOx, PM10, PMcoarse and PM2.5. The exposure estimates were assigned to place of residence 1989 for participants in a national birth cohort born in 1946, the MRC National Study of Health and Development (NSHD), and an adult multi-ethnic London cohort, Southall and Brent Revisited (SABRE) recruited 1988-91. The combined median follow-up was 26years. Single-pollutant competing risk models were employed, adjusting for individual risk factors. RESULTS: Elevated non-significant hazard ratios for CVD mortality were seen with 1991 BS and SO2 and with ESCAPE PM10 and PM2.5 in fully adjusted linear models. Per 10μg/m3 increase HRs were 1.11 [95% CI: 0.76-1.61] for BS, 1.05 [95% CI: 0.91-1.22] for SO2, 1.16 [95% CI: 0.70-1.92] for PM10 and 1.30 [95% CI: 0.39-4.34] for PM2.5, with largest effects seen in the fourth quartile of BS and PM2.5 compared to the first with HR 1.24 [95% CI: 0.91-1.61] and 1.21 [95% CI: 0.88-1.66] respectively. There were no consistent associations with other ESCAPE pollutants, or with 1991 NO2. Modelling using Cox regression led to similar results. CONCLUSION: Our results support a detrimental long-term effect for air pollutants on cardiovascular mortality.


The SABRE Study was funded at baseline by the UK Medical Research Council, Diabetes UK and the British Heart Foundation, and at follow-up by the Wellcome Trust and British Heart Foundation. The Medical Research Council provides core funding for the MRC National Survey of Health and Development and supports RH (MC_UU_12019/1, MC_UU_12019/2). The first author was supported by the British Heart Foundation for this work.



Environment International, 2017, 99, pp. 275-281

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/Organisation/COLLEGE OF SCIENCE AND ENGINEERING/School of Geography, Geology and the Environment


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Environment International


Elsevier for Pergamon



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Supplementary data to this article can be found online at http://dx.doi.org/10.1016/j.envint.2016.12.004.