Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden

Objectives To estimate concentration–response relationships for particulate matter (PM) and black carbon (BC) in relation to mortality in cohorts from three Swedish cities with comparatively low pollutant levels.Setting Cohorts from Gothenburg, Stockholm and Umeå, Sweden.Design High-resolution dispe...

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Main Authors: Annika Rosengren, Bertil Forsberg, Niklas Andersson, Debora Rizzuto, Göran Pershagen, Lars Barregard, Patrik Wennberg, Johan Nilsson Sommar, Gerd Sallsten, Anton Lager, David Segersson, Tom Bellander, Karin Leander, Kristina Eneroth, Eva M Andersson, Leonard Stockfelt, Petter LS Ljungman, Lars Gidhagen, Peter Molnar, Patrik KE Magnusson, Christer Johansson
Format: Article
Language:English
Published: BMJ Publishing Group 2021-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/9/e046040.full
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author Annika Rosengren
Bertil Forsberg
Niklas Andersson
Debora Rizzuto
Göran Pershagen
Lars Barregard
Patrik Wennberg
Johan Nilsson Sommar
Gerd Sallsten
Anton Lager
David Segersson
Tom Bellander
Karin Leander
Kristina Eneroth
Eva M Andersson
Leonard Stockfelt
Petter LS Ljungman
Lars Gidhagen
Peter Molnar
Patrik KE Magnusson
Christer Johansson
author_facet Annika Rosengren
Bertil Forsberg
Niklas Andersson
Debora Rizzuto
Göran Pershagen
Lars Barregard
Patrik Wennberg
Johan Nilsson Sommar
Gerd Sallsten
Anton Lager
David Segersson
Tom Bellander
Karin Leander
Kristina Eneroth
Eva M Andersson
Leonard Stockfelt
Petter LS Ljungman
Lars Gidhagen
Peter Molnar
Patrik KE Magnusson
Christer Johansson
author_sort Annika Rosengren
collection DOAJ
description Objectives To estimate concentration–response relationships for particulate matter (PM) and black carbon (BC) in relation to mortality in cohorts from three Swedish cities with comparatively low pollutant levels.Setting Cohorts from Gothenburg, Stockholm and Umeå, Sweden.Design High-resolution dispersion models were used to estimate annual mean concentrations of PM with aerodynamic diameter ≤10 µm (PM10) and ≤2.5 µm (PM2.5), and BC, at individual addresses during each year of follow-up, 1990–2011. Moving averages were calculated for the time windows 1–5 years (lag1–5) and 6–10 years (lag6–10) preceding the outcome. Cause-specific mortality data were obtained from the national cause of death registry. Cohort-specific HRs were estimated using Cox regression models and then meta-analysed including a random effect of cohort.Participants During the study period, 7 340 cases of natural mortality, 2 755 cases of cardiovascular disease (CVD) mortality and 817 cases of respiratory and lung cancer mortality were observed among in total 68 679 individuals and 689 813 person-years of follow-up.Results Both PM10 (range: 6.3–41.9 µg/m3) and BC (range: 0.2–6.8 µg/m3) were associated with natural mortality showing 17% (95% CI 6% to 31%) and 9% (95% CI 0% to 18%) increased risks per 10 µg/m3 and 1 µg/m3 of lag1-5 exposure, respectively. For PM2.5 (range: 4.0–22.4 µg/m3), the estimated increase was 13% per 5 µg/m3, but less precise (95% CI −9% to 40%). Estimates for CVD mortality appeared higher for both PM10 and PM2.5. No association was observed with respiratory mortality.Conclusion The results support an effect of long-term air pollution on natural mortality and mortality in CVD with high relative risks also at low exposure levels. These findings are relevant for future decisions concerning air quality policies.
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spelling doaj-art-2bb3a9fcd98441198075de557b2177a62025-08-20T02:18:35ZengBMJ Publishing GroupBMJ Open2044-60552021-09-0111910.1136/bmjopen-2020-046040Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in SwedenAnnika Rosengren0Bertil Forsberg1Niklas Andersson2Debora Rizzuto3Göran Pershagen4Lars Barregard5Patrik Wennberg6Johan Nilsson Sommar7Gerd Sallsten8Anton Lager9David Segersson10Tom Bellander11Karin Leander12Kristina Eneroth13Eva M Andersson14Leonard Stockfelt15Petter LS Ljungman16Lars Gidhagen17Peter Molnar18Patrik KE Magnusson19Christer Johansson20Department of Medicine Geriatrics and Emergency Medicine/Östra, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, SwedenprofessorInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenAgeing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenSchool of Public Health and Community Medicine, University of Gothenburg, Goteborg, SwedenFamily Medicine, Public Health and Clinical Medicine, Umeå University, Umeå, SwedenSection of Sustainable Health, Department of Public Health and Clinical Medicine, Umea University, Umeå, SwedenOccupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Gothenburg, SwedenPhD studentSwedish Meteorological and Hydrological Institute, Norrkoping, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenSLB-analys, Environment and Health Administration, Stockholm, SwedenSchool of Public Health and Community Medicine, University of Gothenburg, Goteborg, SwedenOccupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Gothenburg, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenSwedish Meteorological and Hydrological Institute, Norrkoping, SwedenOccupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenSLB-analys, Environment and Health Administration, Stockholm, SwedenObjectives To estimate concentration–response relationships for particulate matter (PM) and black carbon (BC) in relation to mortality in cohorts from three Swedish cities with comparatively low pollutant levels.Setting Cohorts from Gothenburg, Stockholm and Umeå, Sweden.Design High-resolution dispersion models were used to estimate annual mean concentrations of PM with aerodynamic diameter ≤10 µm (PM10) and ≤2.5 µm (PM2.5), and BC, at individual addresses during each year of follow-up, 1990–2011. Moving averages were calculated for the time windows 1–5 years (lag1–5) and 6–10 years (lag6–10) preceding the outcome. Cause-specific mortality data were obtained from the national cause of death registry. Cohort-specific HRs were estimated using Cox regression models and then meta-analysed including a random effect of cohort.Participants During the study period, 7 340 cases of natural mortality, 2 755 cases of cardiovascular disease (CVD) mortality and 817 cases of respiratory and lung cancer mortality were observed among in total 68 679 individuals and 689 813 person-years of follow-up.Results Both PM10 (range: 6.3–41.9 µg/m3) and BC (range: 0.2–6.8 µg/m3) were associated with natural mortality showing 17% (95% CI 6% to 31%) and 9% (95% CI 0% to 18%) increased risks per 10 µg/m3 and 1 µg/m3 of lag1-5 exposure, respectively. For PM2.5 (range: 4.0–22.4 µg/m3), the estimated increase was 13% per 5 µg/m3, but less precise (95% CI −9% to 40%). Estimates for CVD mortality appeared higher for both PM10 and PM2.5. No association was observed with respiratory mortality.Conclusion The results support an effect of long-term air pollution on natural mortality and mortality in CVD with high relative risks also at low exposure levels. These findings are relevant for future decisions concerning air quality policies.https://bmjopen.bmj.com/content/11/9/e046040.full
spellingShingle Annika Rosengren
Bertil Forsberg
Niklas Andersson
Debora Rizzuto
Göran Pershagen
Lars Barregard
Patrik Wennberg
Johan Nilsson Sommar
Gerd Sallsten
Anton Lager
David Segersson
Tom Bellander
Karin Leander
Kristina Eneroth
Eva M Andersson
Leonard Stockfelt
Petter LS Ljungman
Lars Gidhagen
Peter Molnar
Patrik KE Magnusson
Christer Johansson
Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
BMJ Open
title Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
title_full Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
title_fullStr Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
title_full_unstemmed Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
title_short Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
title_sort long term exposure to particulate air pollution and black carbon in relation to natural and cause specific mortality a multicohort study in sweden
url https://bmjopen.bmj.com/content/11/9/e046040.full
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