preprints.org > public health and healthcare > public, environmental and occupational health > doi: 10.20944/preprints202308.1605.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 22 August 2023 / Approved: 22 August 2023 / Online: 23 August 2023 (09:12:45 CEST)

In this study, long-term mortality effects associated with exposure to PM10, PM2.5, BC (black carbon), and NOx were analyzed in a cohort in southern Sweden during the period from 1991‒2016. Participants (those residing in Malmö, Sweden, born between 1923‒1950) were randomly recruited from 1991‒1996. At enrollment, 30,438 participants underwent a health screening, which consisted of questionnaires about lifestyle and diet, a clinical examination, and blood sampling. Mortality data were retrieved from the Swedish national cause of death register. The modeled concentrations of PM10 (particles with an aerodynamic diameter smaller than or equal to 10 µm), PM2.5 (particles with an aerodynamic diameter smaller than or equal to 2.5 µm), BC (black carbon), and NOx (nitrogen oxides) at the cohort participants' home addresses were used to assess air pollution exposure. Cox proportional hazard models were used to estimate the associations between long-term exposure to PM10, PM2.5, BC, and NOx and the time until death among the participants during the period from 1991‒2016. The hazard ratios (HRs) associated with an interquartile range (IQR) increase in each air pollutant were calculated based on the exposure lag windows of the same year (lag0), 1‒5 years (lag1‒5), and 6‒10 years (lag6‒10). Three models were used with varying adjustments for possible confounders including both single-pollutant estimates and two-pollutant estimates. With adjustments for all covariates, the HRs for PM10, PM2.5, BC, and NOx in the single-pollutant models at lag1‒5 were 1.06 (95% CI: 1.02‒1.11), 1.01 (95% CI: 0.95‒1.08), 1.07 (95% CI: 1.04‒1.11), and 1.11 (95% CI: 1.07‒1.16) per IQR increase, respectively. The HRs were in most cases decreased by the inclusion of a larger number of covariates in the models. The most robust associations were shown for NOx, with statistically significant positive HRs in all models. An overall conclusion is that road traffic-related pollutants had a significant association with mortality in the cohort.

air pollution; long-term exposure; particles; nitrogen oxides; Cox regression; proportional hazard; hazard ratio

Public Health and Healthcare, Public, Environmental and Occupational Health

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