Lung Cancer, Cardiopulmonary
Mortality, and Long-term Exposure to Fine Particulate Air
Pollution
C. Arden
Pope III, PhD; Richard T. Burnett, PhD; Michael J. Thun, MD; Eugenia E. Calle,
PhD; Daniel Krewski, PhD; Kazuhiko Ito, PhD; George D. Thurston, ScD
Context Associations have been found
between day-to-day particulate air pollution and increased risk of various
adverse health outcomes, including cardiopulmonary mortality. However, studies
of health effects of long-term particulate air pollution have been less
conclusive.
Objective To assess the relationship between
long-term exposure to fine particulate air pollution and all-cause, lung
cancer, and cardiopulmonary mortality.
Design, Setting, and
Participants Vital status and cause of death
data were collected by the American Cancer Society as part of the Cancer
Prevention II study, an ongoing prospective mortality study, which enrolled
approximately 1.2 million adults in 1982. Participants completed a
questionnaire detailing individual risk factor data (age, sex, race, weight,
height, smoking history, education, marital status, diet, alcohol consumption,
and occupational exposures). The risk factor data for approximately
500 000 adults were linked with air pollution data for metropolitan areas
throughout the United States and combined with vital status and cause of death
data through December 31, 1998.
Main Outcome
Measure All-cause, lung cancer, and
cardiopulmonary mortality.
Results Fine particulate and sulfur
oxide–related pollution were associated with all-cause, lung cancer, and
cardiopulmonary mortality. Each 10-µg/m3 elevation in fine
particulate air pollution was associated with approximately a 4%, 6%, and 8%
increased risk of all-cause, cardiopulmonary, and lung cancer mortality,
respectively. Measures of coarse particle fraction and total suspended
particles were not consistently associated with
mortality.
Conclusion Long-term exposure to
combustion-related fine particulate air pollution is an important
environmental risk factor for cardiopulmonary and lung cancer
mortality.
JAMA.
2002;287:1132-1141