All-cause mortality and long-term exposure to low level air pollution in the ‘45 and up study’ cohort, Sydney, Australia, 2006–2015

Ivan C. Hanigan, Margaret I. Rolfe, Luke D. Knibbs, Farhad Salimi, Christine T. Cowie, Jane Heyworth, Guy B. Marks, Yuming Guo, Martin Cope, Adrian Bauman, Bin Jalaludin, Geoffrey G. Morgan

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Abstract

Background: Epidemiological studies show that long-term exposure to ambient air pollution reduces life expectancy. Most studies have been in environments with relatively high concentrations such as North America, Europe and Asia. Associations at the lower end of the concentration-response function are not well defined. Objectives: We assessed associations between all-cause mortality and exposure to annual average particulate matter <2.5 μm (PM 2.5 ) and nitrogen dioxide (NO 2 ) in Sydney, Australia, where concentrations are relatively low. Methods: The ‘45 and Up Study’ comprises a prospective longitudinal cohort from the state of New South Wales, Australia with 266,969 participants linked to death registry data. We analyzed data for the participants who resided in Sydney at baseline questionnaire (n = 75,268). Exposures to long-term pollution were estimated using annual averages from a chemical transport model (PM 2.5 ), and a satellite-based land-use regression model (NO 2 ). Socio-demographic information was extracted from the baseline questionnaire. Cox proportional hazard models were applied to estimate associations, while adjusting for covariates. Results: In our cohort mean annual PM 2.5 was 4.5 μg/m 3 and mean NO 2 was 17.8 μg/m 3 . The mortality rate was 4.4% over the 7 years of follow up. Models that adjusted for individual-level and area-level risk factors resulted in a detrimental non statistically significant hazard ratio (HR) of 1.05 (95% CI: 0.98–1.12) per 1 μg/m 3 increase in PM 2.5 , and 1.03 (95% CI: 0.98–1.07) per 5 μg/m 3 increase in NO 2 . Conclusions: We found evidence that low-level air pollution exposure was associated with increased risk of mortality in this cohort of adults aged 45 years and over, even at the relatively low concentrations seen in Sydney. However, a clear determination of the association with mortality is difficult because the results were sensitive to some covariates. Our findings are supportive of emerging evidence that exposure to low levels of air pollution reduces life expectancy.

Original languageEnglish
Pages (from-to)762-770
Number of pages9
JournalEnvironment International
Volume126
DOIs
Publication statusPublished - May 2019

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atmospheric pollution
mortality
life expectancy
hazard
pollution exposure
nitrogen dioxide
risk factor
ambient air
particulate matter
land use
pollution
exposure

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Hanigan, Ivan C. ; Rolfe, Margaret I. ; Knibbs, Luke D. ; Salimi, Farhad ; Cowie, Christine T. ; Heyworth, Jane ; Marks, Guy B. ; Guo, Yuming ; Cope, Martin ; Bauman, Adrian ; Jalaludin, Bin ; Morgan, Geoffrey G. / All-cause mortality and long-term exposure to low level air pollution in the ‘45 and up study’ cohort, Sydney, Australia, 2006–2015. In: Environment International. 2019 ; Vol. 126. pp. 762-770.
@article{de99cd691c764f70bf6c1721e76b45dd,
title = "All-cause mortality and long-term exposure to low level air pollution in the ‘45 and up study’ cohort, Sydney, Australia, 2006–2015",
abstract = "Background: Epidemiological studies show that long-term exposure to ambient air pollution reduces life expectancy. Most studies have been in environments with relatively high concentrations such as North America, Europe and Asia. Associations at the lower end of the concentration-response function are not well defined. Objectives: We assessed associations between all-cause mortality and exposure to annual average particulate matter <2.5 μm (PM 2.5 ) and nitrogen dioxide (NO 2 ) in Sydney, Australia, where concentrations are relatively low. Methods: The ‘45 and Up Study’ comprises a prospective longitudinal cohort from the state of New South Wales, Australia with 266,969 participants linked to death registry data. We analyzed data for the participants who resided in Sydney at baseline questionnaire (n = 75,268). Exposures to long-term pollution were estimated using annual averages from a chemical transport model (PM 2.5 ), and a satellite-based land-use regression model (NO 2 ). Socio-demographic information was extracted from the baseline questionnaire. Cox proportional hazard models were applied to estimate associations, while adjusting for covariates. Results: In our cohort mean annual PM 2.5 was 4.5 μg/m 3 and mean NO 2 was 17.8 μg/m 3 . The mortality rate was 4.4{\%} over the 7 years of follow up. Models that adjusted for individual-level and area-level risk factors resulted in a detrimental non statistically significant hazard ratio (HR) of 1.05 (95{\%} CI: 0.98–1.12) per 1 μg/m 3 increase in PM 2.5 , and 1.03 (95{\%} CI: 0.98–1.07) per 5 μg/m 3 increase in NO 2 . Conclusions: We found evidence that low-level air pollution exposure was associated with increased risk of mortality in this cohort of adults aged 45 years and over, even at the relatively low concentrations seen in Sydney. However, a clear determination of the association with mortality is difficult because the results were sensitive to some covariates. Our findings are supportive of emerging evidence that exposure to low levels of air pollution reduces life expectancy.",
keywords = "All-cause mortality, Fine particulate matter, Gaseous pollutants, Low concentration, Survival model",
author = "Hanigan, {Ivan C.} and Rolfe, {Margaret I.} and Knibbs, {Luke D.} and Farhad Salimi and Cowie, {Christine T.} and Jane Heyworth and Marks, {Guy B.} and Yuming Guo and Martin Cope and Adrian Bauman and Bin Jalaludin and Morgan, {Geoffrey G.}",
year = "2019",
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Hanigan, IC, Rolfe, MI, Knibbs, LD, Salimi, F, Cowie, CT, Heyworth, J, Marks, GB, Guo, Y, Cope, M, Bauman, A, Jalaludin, B & Morgan, GG 2019, 'All-cause mortality and long-term exposure to low level air pollution in the ‘45 and up study’ cohort, Sydney, Australia, 2006–2015', Environment International, vol. 126, pp. 762-770. https://doi.org/10.1016/j.envint.2019.02.044

All-cause mortality and long-term exposure to low level air pollution in the ‘45 and up study’ cohort, Sydney, Australia, 2006–2015. / Hanigan, Ivan C.; Rolfe, Margaret I.; Knibbs, Luke D.; Salimi, Farhad; Cowie, Christine T.; Heyworth, Jane; Marks, Guy B.; Guo, Yuming; Cope, Martin; Bauman, Adrian; Jalaludin, Bin; Morgan, Geoffrey G.

In: Environment International, Vol. 126, 05.2019, p. 762-770.

Research output: Contribution to journalArticle

TY - JOUR

T1 - All-cause mortality and long-term exposure to low level air pollution in the ‘45 and up study’ cohort, Sydney, Australia, 2006–2015

AU - Hanigan, Ivan C.

AU - Rolfe, Margaret I.

AU - Knibbs, Luke D.

AU - Salimi, Farhad

AU - Cowie, Christine T.

AU - Heyworth, Jane

AU - Marks, Guy B.

AU - Guo, Yuming

AU - Cope, Martin

AU - Bauman, Adrian

AU - Jalaludin, Bin

AU - Morgan, Geoffrey G.

PY - 2019/5

Y1 - 2019/5

N2 - Background: Epidemiological studies show that long-term exposure to ambient air pollution reduces life expectancy. Most studies have been in environments with relatively high concentrations such as North America, Europe and Asia. Associations at the lower end of the concentration-response function are not well defined. Objectives: We assessed associations between all-cause mortality and exposure to annual average particulate matter <2.5 μm (PM 2.5 ) and nitrogen dioxide (NO 2 ) in Sydney, Australia, where concentrations are relatively low. Methods: The ‘45 and Up Study’ comprises a prospective longitudinal cohort from the state of New South Wales, Australia with 266,969 participants linked to death registry data. We analyzed data for the participants who resided in Sydney at baseline questionnaire (n = 75,268). Exposures to long-term pollution were estimated using annual averages from a chemical transport model (PM 2.5 ), and a satellite-based land-use regression model (NO 2 ). Socio-demographic information was extracted from the baseline questionnaire. Cox proportional hazard models were applied to estimate associations, while adjusting for covariates. Results: In our cohort mean annual PM 2.5 was 4.5 μg/m 3 and mean NO 2 was 17.8 μg/m 3 . The mortality rate was 4.4% over the 7 years of follow up. Models that adjusted for individual-level and area-level risk factors resulted in a detrimental non statistically significant hazard ratio (HR) of 1.05 (95% CI: 0.98–1.12) per 1 μg/m 3 increase in PM 2.5 , and 1.03 (95% CI: 0.98–1.07) per 5 μg/m 3 increase in NO 2 . Conclusions: We found evidence that low-level air pollution exposure was associated with increased risk of mortality in this cohort of adults aged 45 years and over, even at the relatively low concentrations seen in Sydney. However, a clear determination of the association with mortality is difficult because the results were sensitive to some covariates. Our findings are supportive of emerging evidence that exposure to low levels of air pollution reduces life expectancy.

AB - Background: Epidemiological studies show that long-term exposure to ambient air pollution reduces life expectancy. Most studies have been in environments with relatively high concentrations such as North America, Europe and Asia. Associations at the lower end of the concentration-response function are not well defined. Objectives: We assessed associations between all-cause mortality and exposure to annual average particulate matter <2.5 μm (PM 2.5 ) and nitrogen dioxide (NO 2 ) in Sydney, Australia, where concentrations are relatively low. Methods: The ‘45 and Up Study’ comprises a prospective longitudinal cohort from the state of New South Wales, Australia with 266,969 participants linked to death registry data. We analyzed data for the participants who resided in Sydney at baseline questionnaire (n = 75,268). Exposures to long-term pollution were estimated using annual averages from a chemical transport model (PM 2.5 ), and a satellite-based land-use regression model (NO 2 ). Socio-demographic information was extracted from the baseline questionnaire. Cox proportional hazard models were applied to estimate associations, while adjusting for covariates. Results: In our cohort mean annual PM 2.5 was 4.5 μg/m 3 and mean NO 2 was 17.8 μg/m 3 . The mortality rate was 4.4% over the 7 years of follow up. Models that adjusted for individual-level and area-level risk factors resulted in a detrimental non statistically significant hazard ratio (HR) of 1.05 (95% CI: 0.98–1.12) per 1 μg/m 3 increase in PM 2.5 , and 1.03 (95% CI: 0.98–1.07) per 5 μg/m 3 increase in NO 2 . Conclusions: We found evidence that low-level air pollution exposure was associated with increased risk of mortality in this cohort of adults aged 45 years and over, even at the relatively low concentrations seen in Sydney. However, a clear determination of the association with mortality is difficult because the results were sensitive to some covariates. Our findings are supportive of emerging evidence that exposure to low levels of air pollution reduces life expectancy.

KW - All-cause mortality

KW - Fine particulate matter

KW - Gaseous pollutants

KW - Low concentration

KW - Survival model

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UR - http://www.mendeley.com/research/allcause-mortality-longterm-exposure-low-level-air-pollution-45-up-study-cohort-sydney-australia-200

U2 - 10.1016/j.envint.2019.02.044

DO - 10.1016/j.envint.2019.02.044

M3 - Article

VL - 126

SP - 762

EP - 770

JO - Environmental International

JF - Environmental International

SN - 0160-4120

ER -