Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project

Shanshan Xu; Alessandro Marcon; Randi Jacobsen Bertelsen; Bryndis Benediktsdottir; Jørgen Brandt; Kristine Engemann; Lise Marie Frohn; Camilla Geels; Thorarinn Gislason; Joachim Heinrich; Mathias Holm; Christer Janson; Iana Markevych; Lars Modig; Hans Orru; Vivi Schlünssen; Torben Sigsgaard; Ane Johannessen

doi:10.1016/j.envint.2023.108257

Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project

Shanshan Xu^*, Alessandro Marcon, Randi Jacobsen Bertelsen, Bryndis Benediktsdottir, Jørgen Brandt, Kristine Engemann, Lise Marie Frohn, Camilla Geels, Thorarinn Gislason, Joachim Heinrich, Mathias Holm, Christer Janson, Iana Markevych, Lars Modig, Hans Orru, Vivi Schlünssen, Torben Sigsgaard, Ane Johannessen

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

13 Citationer (Scopus)

Abstract

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory. Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM_2.5 and PM₁₀), black carbon (BC), nitrogen dioxide (NO₂), ozone (O₃) and greenness (normalized difference vegetation index - NDVI) across different exposure time windows. Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40–65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders. Results: Altogether, 327 (3.6 %) persons died in the period 2010–2021. Increased exposures in 1990 of PM_2.5, PM₁₀, BC and NO₂ were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04–1.87 per 5 μg/m³), 1.33 (95 % CI: 1.02–1.74 per 10 μg/m³), 1.16 (95 % CI: 0.98–1.38 per 0.4 μg/m³) and 1.17 (95 % CI: 0.92–1.50 per 10 μg/m³), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O₃ showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM_2.5, PM₁₀, BC and NO₂ exposures in 1990. We did not find significant interactions between greenness and air pollution metrics. Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

Originalsprog	Engelsk
Artikelnummer	108257
Tidsskrift	Environment International
Vol/bind	181
ISSN	0160-4120
DOI	https://doi.org/10.1016/j.envint.2023.108257
Status	Udgivet - nov. 2023

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10.1016/j.envint.2023.108257Licens: CC BY

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Xu, S., Marcon, A., Bertelsen, R. J., Benediktsdottir, B., Brandt, J., Engemann, K., Frohn, L. M., Geels, C., Gislason, T., Heinrich, J., Holm, M., Janson, C., Markevych, I., Modig, L., Orru, H., Schlünssen, V., Sigsgaard, T., & Johannessen, A. (2023). Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project. Environment International, 181, Artikel 108257. https://doi.org/10.1016/j.envint.2023.108257

@article{f0d119dfde414479952d0211ed3598db,

title = "Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project",

abstract = "Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory. Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index - NDVI) across different exposure time windows. Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40–65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders. Results: Altogether, 327 (3.6 %) persons died in the period 2010–2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04–1.87 per 5 μg/m3), 1.33 (95 % CI: 1.02–1.74 per 10 μg/m3), 1.16 (95 % CI: 0.98–1.38 per 0.4 μg/m3) and 1.17 (95 % CI: 0.92–1.50 per 10 μg/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics. Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.",

keywords = "Green space, Long-term effect, Nitrogen dioxide, Ozone, Particulate matter, Premature mortality",

author = "Shanshan Xu and Alessandro Marcon and Bertelsen, {Randi Jacobsen} and Bryndis Benediktsdottir and J{\o}rgen Brandt and Kristine Engemann and Frohn, {Lise Marie} and Camilla Geels and Thorarinn Gislason and Joachim Heinrich and Mathias Holm and Christer Janson and Iana Markevych and Lars Modig and Hans Orru and Vivi Schl{\"u}nssen and Torben Sigsgaard and Ane Johannessen",

year = "2023",

month = nov,

doi = "10.1016/j.envint.2023.108257",

language = "English",

volume = "181",

journal = "Environment International",

issn = "0160-4120",

publisher = "Elsevier Ltd",

}

Xu, S, Marcon, A, Bertelsen, RJ, Benediktsdottir, B, Brandt, J, Engemann, K, Frohn, LM , Geels, C, Gislason, T, Heinrich, J, Holm, M, Janson, C, Markevych, I, Modig, L, Orru, H, Schlünssen, V , Sigsgaard, T & Johannessen, A 2023, 'Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project', Environment International, bind 181, 108257. https://doi.org/10.1016/j.envint.2023.108257

Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project. / Xu, Shanshan; Marcon, Alessandro; Bertelsen, Randi Jacobsen et al.
I: Environment International, Bind 181, 108257, 11.2023.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe

T2 - The Life-GAP project

AU - Xu, Shanshan

AU - Marcon, Alessandro

AU - Bertelsen, Randi Jacobsen

AU - Benediktsdottir, Bryndis

AU - Brandt, Jørgen

AU - Engemann, Kristine

AU - Frohn, Lise Marie

AU - Geels, Camilla

AU - Gislason, Thorarinn

AU - Heinrich, Joachim

AU - Holm, Mathias

AU - Janson, Christer

AU - Markevych, Iana

AU - Modig, Lars

AU - Orru, Hans

AU - Schlünssen, Vivi

AU - Sigsgaard, Torben

AU - Johannessen, Ane

PY - 2023/11

Y1 - 2023/11

N2 - Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory. Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index - NDVI) across different exposure time windows. Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40–65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders. Results: Altogether, 327 (3.6 %) persons died in the period 2010–2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04–1.87 per 5 μg/m3), 1.33 (95 % CI: 1.02–1.74 per 10 μg/m3), 1.16 (95 % CI: 0.98–1.38 per 0.4 μg/m3) and 1.17 (95 % CI: 0.92–1.50 per 10 μg/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics. Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

AB - Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory. Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index - NDVI) across different exposure time windows. Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40–65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders. Results: Altogether, 327 (3.6 %) persons died in the period 2010–2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04–1.87 per 5 μg/m3), 1.33 (95 % CI: 1.02–1.74 per 10 μg/m3), 1.16 (95 % CI: 0.98–1.38 per 0.4 μg/m3) and 1.17 (95 % CI: 0.92–1.50 per 10 μg/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics. Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

KW - Green space

KW - Long-term effect

KW - Nitrogen dioxide

KW - Ozone

KW - Particulate matter

KW - Premature mortality

UR - http://www.scopus.com/inward/record.url?scp=85175181088&partnerID=8YFLogxK

U2 - 10.1016/j.envint.2023.108257

DO - 10.1016/j.envint.2023.108257

M3 - Journal article

C2 - 37857189

AN - SCOPUS:85175181088

SN - 0160-4120

VL - 181

JO - Environment International

JF - Environment International

M1 - 108257

ER -

Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe: The Life-GAP project

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