Long-term exposure to low air pollutant concentrations and the relationship with all-cause mortality and stroke in older men

Mila Dirgawati, Andrea Hinwood, Lee Nedkoff, Graeme J Hankey, Bu B Yeap, Leon Flicker, Mark Nieuwenhuijsen, Bert Brunekreef, Jane Heyworth

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Long-term air pollution exposure has been associated with increased risk of mortality and stroke. Less is known about the risk at lower concentrations. The association of long-term exposure to PM2.5, PM2.5 absorbance, NO2, and NOx with all-cause mortality and stroke was investigated in a cohort of men aged ≥ 65 years who lived in metropolitan Perth, Western Australia.

METHODS: Land use regression models were used to estimate long-term exposure to air pollutants at participant's home address (n = 11,627) over 16 years. Different metrics of exposure were assigned: baseline; year before the outcome event; and average exposure across follow-up period. The Mortality Register and Hospital Morbidity Data from the Western Australia Data Linkage System were used to ascertain mortality and stroke cases. Hazard ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazard models, adjusting for age, smoking, education, and body mass index for all-cause mortality. For fatal and hospitalized stroke, the models included variables controlled for all-cause mortality plus hypertension.

RESULTS: Fifty-four percent of all-participants died, 3% suffered a fatal stroke, and 14% were hospitalized stroke cases. PM2.5 absorbance increased the risk of all-cause mortality with adjusted HR of 1.12 (1.02-1.23) for baseline and average exposures, and 1.14 (1.02-1.24) for past-year exposure. There were no associations between PM2.5 absorbance, NO2, and NOx and stroke outcomes. However, PM2.5 was associated with reduced risks of fatal stroke.

CONCLUSION: Long-term exposure to PM2.5 absorbance was associated with all-cause mortality among older men exposed to low concentrations; and exposure to PM2.5 was associated with reduced risk of fatal stroke.

Original languageEnglish
Pages (from-to)S82-S89
Number of pages8
JournalEpidemiology
Volume30
Issue numberSupplement 1
DOIs
Publication statusPublished - Jul 2019

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