Association between long-term exposure to air pollution and mortality in France: A 25-year follow-up study |
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| Institution: | 1. French Institute for Public Health Surveillance (InVS), Saint-Maurice, France;2. Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France;3. Versailles St-Quentin University, UMS 011, F-94807 Villejuif, France;4. School of Public Health (EHESP/SPC) — IRSET Inserm UMR 1085, Rennes, France;1. Department of Allergy and Immunology, Gunma, Japan.;2. Department of Nephrology, Gunma, Japan.;3. Department of Hematology and Oncology, Gunma Children''s Medical Center, Gunma, Japan.;1. State Environmental Protection Key Laboratory of Urban Environment & Ecology, South China Institute of Environmental Sciences (SCIES), Ministry of Environmental Protection, Guangzhou 510655, China;2. Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou 510631, China |
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| Abstract: | IntroductionLong-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France.ObjectivesWe analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013.MethodsThe study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM10, PM10–2.5, PM2.5, NO2, O3, SO2, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations.ResultsThe cohort recorded 1967 non-accidental deaths. Long-term exposures to baseline PM2.5, PM10-25, NO2 and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m3, PM10-25; HR = 1.09;95% CI: 1.04, 1.15 per 2.2 μg/m3, NO2: HR = 1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m3 and benzene: HR = 1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m3).The strongest association was found for PM10: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m3. PM10, PM10-25 and SO2 were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality.ConclusionLong-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample. |
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