Long-term exposure to ultrafine particles and natural and cause-specific mortality

Femke Bouma; Nicole Ah Janssen; Joost Wesseling; Sjoerd van Ratingen; Maciek Strak; Jules Kerckhoffs; Ulrike Gehring; Wouter Hendricx; Kees de Hoogh; Roel Vermeulen; Gerard Hoek

doi:10.1016/j.envint.2023.107960

Long-term exposure to ultrafine particles and natural and cause-specific mortality

Environ Int. 2023 May:175:107960. doi: 10.1016/j.envint.2023.107960. Epub 2023 May 8.

Authors

Affiliations

¹ Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands. Electronic address: f.l.bouma@uu.nl.
² National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
³ Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
⁴ Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
⁵ Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.

PMID: 37178608
DOI: 10.1016/j.envint.2023.107960

Abstract

Background: Health implications of long-term exposure to ubiquitously present ultrafine particles (UFP) are uncertain. The aim of this study was to investigate the associations between long-term UFP exposure and natural and cause-specific mortality (including cardiovascular disease (CVD), respiratory disease, and lung cancer) in the Netherlands.

Methods: A Dutch national cohort of 10.8 million adults aged ≥ 30 years was followed from 2013 until 2019. Annual average UFP concentrations were estimated at the home address at baseline, using land-use regression models based on a nationwide mobile monitoring campaign performed at the midpoint of the follow-up period. Cox proportional hazard models were applied, adjusting for individual and area-level socio-economic status covariates. Two-pollutant models with the major regulated pollutants nitrogen dioxide (NO₂) and fine particles (PM₂_.₅ and PM₁₀), and the health relevant combustion aerosol pollutant (elemental carbon (EC)) were assessed based on dispersion modelling.

Results: A total of 945,615 natural deaths occurred during 71,008,209 person-years of follow-up. The correlation of UFP concentration with other pollutants ranged from moderate (0.59 (PM₂_.₅)) to high (0.81 (NO₂)). We found a significant association between annual average UFP exposure and natural mortality [HR 1.012 (95 % CI 1.010-1.015), per interquartile range (IQR) (2723 particles/cm³) increment]. Associations were stronger for respiratory disease mortality [HR 1.022 (1.013-1.032)] and lung cancer mortality [HR 1.038 (1.028-1.048)] and weaker for CVD mortality [HR 1.005 (1.000-1.011)]. The associations of UFP with natural and lung cancer mortality attenuated but remained significant in all two-pollutant models, whereas the associations with CVD and respiratory mortality attenuated to the null.

Conclusion: Long-term UFP exposure was associated with natural and lung cancer mortality among adults independently from other regulated air pollutants.

Keywords: Air pollution; Mortality; National cohort; Two-pollutant models; Ultrafine particles.

MeSH terms

Adult
Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
Cardiovascular Diseases*
Cause of Death
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Humans
Lung Neoplasms*
Nitrogen Dioxide / adverse effects
Nitrogen Dioxide / analysis
Particulate Matter / adverse effects
Particulate Matter / analysis
Respiratory Tract Diseases*

Substances

Particulate Matter
Nitrogen Dioxide
Air Pollutants