Publication related to RSI or an RSI staff member
Long-Term Ozone Exposure and Mortality in a Large Prospective Study.
RATIONALE: Tropospheric ozone (O3) is potentially associated with cardiovascular disease risk and premature death. Results from long-term epidemiological studies on O3 are scarce and inconclusive. OBJECTIVES: In this study, we examined associations between chronic ambient O3 exposure and all-cause and cause-specific mortality in a large cohort of U.S. adults. METHODS: Cancer Prevention Study II participants were enrolled in 1982. A total of 669,046 participants were analyzed, among whom 237,201 deaths occurred through 2004. We obtained estimates of O3 concentrations at the participant’s residence from a hierarchical Bayesian space-time model. Estimates of fine particulate matter (particulate matter with an aerodynamic diameter of up to 2.5 mum [PM2.5]) and NO2 concentrations were obtained from land use regression. Cox proportional hazards regression models were used to examine mortality associations adjusted for individual- and ecological-level covariates. MEASUREMENTS AND MAIN RESULTS: In single-pollutant models, we observed significant positive associations between O3, PM2.5, and NO2 concentrations and all-cause and cause-specific mortality. In two-pollutant models adjusted for PM2.5, significant positive associations remained between O3 and all-cause (hazard ratio [HR] per 10 ppb, 1.02; 95% confidence interval [CI], 1.01-1.04), circulatory (HR, 1.03; 95% CI, 1.01-1.05), and respiratory mortality (HR, 1.12; 95% CI, 1.08-1.16) that were unchanged with further adjustment for NO2. We also observed positive mortality associations with both PM2.5 (both near source and regional) and NO2 in multipollutant models. CONCLUSIONS: Findings derived from this large-scale prospective study suggest that long-term ambient O3 contributes to risk of respiratory and circulatory mortality. Substantial health and environmental benefits may be achieved by implementing further measures aimed at controlling O3 concentrations.
Authors
- Turner, Michelle C, Turner MC, 1 McLaughlin Centre for Population Health Risk Assessment and.; 2 Centre for Research in Environmental Epidemiology, Barcelona, Spain.; 3 Universitat Pompeu Fabra, Barcelona, Spain.; 4 CIBER Epidemiología y Salud Pública, Madrid, Spain.
- Jerrett, Michael, Jerrett M, 5 Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California.
- Pope, C Arden 3rd, Pope CA 3rd, 6 Department of Economics, Brigham Young University, Provo, Utah.
- Krewski, Daniel, Krewski D, 1 McLaughlin Centre for Population Health Risk Assessment and.; 7 School of Epidemiology, Public Health and Disease Prevention, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Gapstur, Susan M, Gapstur SM, 8 Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
- Diver, W Ryan, Diver WR, 8 Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
- Beckerman, Bernardo S, Beckerman BS, 5 Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California.
- Marshall, Julian D, Marshall JD, 9 Department of Civil and Environmental Engineering, University of Washington, Seattle, Washington.
- Su, Jason, Su J, 5 Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California.
- Crouse, Daniel L, Crouse DL, 10 Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada; and.
- Burnett, Richard T, Burnett RT, 11 Population Studies Division, Health Canada, Ottawa, Ontario, Canada.
RATIONALE: Tropospheric ozone (O3) is potentially associated with cardiovascular disease risk and premature death. Results from long-term epidemiological studies on O3 are scarce and inconclusive. OBJECTIVES: In this study, we examined associations between chronic ambient O3 exposure and all-cause and cause-specific mortality in a large cohort of U.S. adults. METHODS: Cancer Prevention Study II participants were enrolled in 1982. A total of 669,046 participants were analyzed, among whom 237,201 deaths occurred through 2004. We obtained estimates of O3 concentrations at the participant's residence from a hierarchical Bayesian space-time model. Estimates of fine particulate matter (particulate matter with an aerodynamic diameter of up to 2.5 mum [PM2.5]) and NO2 concentrations were obtained from land use regression. Cox proportional hazards regression models were used to examine mortality associations adjusted for individual- and ecological-level covariates. MEASUREMENTS AND MAIN RESULTS: In single-pollutant models, we observed significant positive associations between O3, PM2.5, and NO2 concentrations and all-cause and cause-specific mortality. In two-pollutant models adjusted for PM2.5, significant positive associations remained between O3 and all-cause (hazard ratio [HR] per 10 ppb, 1.02; 95% confidence interval [CI], 1.01-1.04), circulatory (HR, 1.03; 95% CI, 1.01-1.05), and respiratory mortality (HR, 1.12; 95% CI, 1.08-1.16) that were unchanged with further adjustment for NO2. We also observed positive mortality associations with both PM2.5 (both near source and regional) and NO2 in multipollutant models. CONCLUSIONS: Findings derived from this large-scale prospective study suggest that long-term ambient O3 contributes to risk of respiratory and circulatory mortality. Substantial health and environmental benefits may be achieved by implementing further measures aimed at controlling O3 concentrations.
