Long-term effects of traffic exposures on mortality in a Chinese cohort

Thuan-Quoc THACH*, Hilda TSANG, Poh-chin LAI, Ruby Siu-yin LEE, Paulina Pui-yun WONG

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)

1 Scopus Citations

Abstract

A large proportion of the population living in close proximity to roads are continuously exposed to vehicle traffic and vulnerable to its ill effect in everyday life. However, only a limited number of epidemiological studies have examined effects of long-term road vehicle traffic exposures on mortality. We investigated long-term associations between road vehicle traffic exposures measured by vehicle-kilometres travelled (VKT) and mortality in a cohort of Chinese elderly in Hong Kong, where road vehicle traffic is generally high. The Elderly Health Service cohort consisted of 66,820 adults aged 65 years or older enrolled at 18 Elderly Health Centres of the Department of Health from 1998 to 2001. Deaths were followed-up until 2011. All cohort members had medical, socio-demographic, lifestyle, anthropometric data and place of residence recorded at baseline. The residential addresses of cohort members were geo-coded and aggregated by geographic areas, Tertiary Planning Units (TPU). The annual total VKT was used as traffic exposure at the TPU level. We used Cox proportional hazards regression to estimate hazard ratios (HR) for one million km increase in the annual total VKT for natural-cause and cardiopulmonary mortality, adjusted for individual demographic and socio-economic variables, lifestyle, and medication, as well as environmental covariates. There were 17,422 deaths in 197 TPUs, with the median age at death of 75.3 years. The mean annual total VKT was 26 million kilometres. A 1 million increase in the annual total VKT was associated with excess risk [100 × (HR - 1)] of 0.45% (95% confidence interval [CI]: 0.17, 0.74) for natural-cause mortality and 0.81% (95% CI: 0.30, 1.32) for cardiovascular mortality. No significant association was found for respiratory mortality. These findings suggest that vehicle traffic exposure is associated with raised risks of natural-cause and cardiovascular mortality in the older population.
Original languageEnglish
Article number100609
JournalJournal of Transport and Health
Volume14
Early online date8 Aug 2019
DOIs
Publication statusPublished - 1 Sep 2019

Fingerprint

mortality
traffic
Mortality
planning unit
road
death
cause
Hazards
Life Style
Health Services for the Aged
Health
confidence
Demography
Confidence Intervals
place of residence
Hong Kong
health
Population
Planning
everyday life

Bibliographical note

We thank the Health and Medical Research Fund for funding this study, the Department of Health for cohort data and mortality data, and the Environmental Protection Department for air pollutant data.

Keywords

  • Vehicle-kilometres travelled
  • Hazard ratioMortality
  • Cox proportional hazards regression
  • Hong Kong

Cite this

THACH, Thuan-Quoc ; TSANG, Hilda ; LAI, Poh-chin ; LEE, Ruby Siu-yin ; WONG, Paulina Pui-yun. / Long-term effects of traffic exposures on mortality in a Chinese cohort. In: Journal of Transport and Health. 2019 ; Vol. 14.
@article{74f408997a9b4348b2c35961034e1e34,
title = "Long-term effects of traffic exposures on mortality in a Chinese cohort",
abstract = "A large proportion of the population living in close proximity to roads are continuously exposed to vehicle traffic and vulnerable to its ill effect in everyday life. However, only a limited number of epidemiological studies have examined effects of long-term road vehicle traffic exposures on mortality. We investigated long-term associations between road vehicle traffic exposures measured by vehicle-kilometres travelled (VKT) and mortality in a cohort of Chinese elderly in Hong Kong, where road vehicle traffic is generally high. The Elderly Health Service cohort consisted of 66,820 adults aged 65 years or older enrolled at 18 Elderly Health Centres of the Department of Health from 1998 to 2001. Deaths were followed-up until 2011. All cohort members had medical, socio-demographic, lifestyle, anthropometric data and place of residence recorded at baseline. The residential addresses of cohort members were geo-coded and aggregated by geographic areas, Tertiary Planning Units (TPU). The annual total VKT was used as traffic exposure at the TPU level. We used Cox proportional hazards regression to estimate hazard ratios (HR) for one million km increase in the annual total VKT for natural-cause and cardiopulmonary mortality, adjusted for individual demographic and socio-economic variables, lifestyle, and medication, as well as environmental covariates. There were 17,422 deaths in 197 TPUs, with the median age at death of 75.3 years. The mean annual total VKT was 26 million kilometres. A 1 million increase in the annual total VKT was associated with excess risk [100 × (HR - 1)] of 0.45{\%} (95{\%} confidence interval [CI]: 0.17, 0.74) for natural-cause mortality and 0.81{\%} (95{\%} CI: 0.30, 1.32) for cardiovascular mortality. No significant association was found for respiratory mortality. These findings suggest that vehicle traffic exposure is associated with raised risks of natural-cause and cardiovascular mortality in the older population.",
keywords = "Vehicle-kilometres travelled, Hazard ratioMortality, Cox proportional hazards regression, Hong Kong",
author = "Thuan-Quoc THACH and Hilda TSANG and Poh-chin LAI and LEE, {Ruby Siu-yin} and WONG, {Paulina Pui-yun}",
note = "We thank the Health and Medical Research Fund for funding this study, the Department of Health for cohort data and mortality data, and the Environmental Protection Department for air pollutant data.",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.jth.2019.100609",
language = "English",
volume = "14",
journal = "Journal of Transport and Health",
issn = "2214-1405",
publisher = "Elsevier BV",

}

Long-term effects of traffic exposures on mortality in a Chinese cohort. / THACH, Thuan-Quoc; TSANG, Hilda; LAI, Poh-chin; LEE, Ruby Siu-yin; WONG, Paulina Pui-yun.

In: Journal of Transport and Health, Vol. 14, 100609, 01.09.2019.

Research output: Journal PublicationsJournal Article (refereed)

TY - JOUR

T1 - Long-term effects of traffic exposures on mortality in a Chinese cohort

AU - THACH, Thuan-Quoc

AU - TSANG, Hilda

AU - LAI, Poh-chin

AU - LEE, Ruby Siu-yin

AU - WONG, Paulina Pui-yun

N1 - We thank the Health and Medical Research Fund for funding this study, the Department of Health for cohort data and mortality data, and the Environmental Protection Department for air pollutant data.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - A large proportion of the population living in close proximity to roads are continuously exposed to vehicle traffic and vulnerable to its ill effect in everyday life. However, only a limited number of epidemiological studies have examined effects of long-term road vehicle traffic exposures on mortality. We investigated long-term associations between road vehicle traffic exposures measured by vehicle-kilometres travelled (VKT) and mortality in a cohort of Chinese elderly in Hong Kong, where road vehicle traffic is generally high. The Elderly Health Service cohort consisted of 66,820 adults aged 65 years or older enrolled at 18 Elderly Health Centres of the Department of Health from 1998 to 2001. Deaths were followed-up until 2011. All cohort members had medical, socio-demographic, lifestyle, anthropometric data and place of residence recorded at baseline. The residential addresses of cohort members were geo-coded and aggregated by geographic areas, Tertiary Planning Units (TPU). The annual total VKT was used as traffic exposure at the TPU level. We used Cox proportional hazards regression to estimate hazard ratios (HR) for one million km increase in the annual total VKT for natural-cause and cardiopulmonary mortality, adjusted for individual demographic and socio-economic variables, lifestyle, and medication, as well as environmental covariates. There were 17,422 deaths in 197 TPUs, with the median age at death of 75.3 years. The mean annual total VKT was 26 million kilometres. A 1 million increase in the annual total VKT was associated with excess risk [100 × (HR - 1)] of 0.45% (95% confidence interval [CI]: 0.17, 0.74) for natural-cause mortality and 0.81% (95% CI: 0.30, 1.32) for cardiovascular mortality. No significant association was found for respiratory mortality. These findings suggest that vehicle traffic exposure is associated with raised risks of natural-cause and cardiovascular mortality in the older population.

AB - A large proportion of the population living in close proximity to roads are continuously exposed to vehicle traffic and vulnerable to its ill effect in everyday life. However, only a limited number of epidemiological studies have examined effects of long-term road vehicle traffic exposures on mortality. We investigated long-term associations between road vehicle traffic exposures measured by vehicle-kilometres travelled (VKT) and mortality in a cohort of Chinese elderly in Hong Kong, where road vehicle traffic is generally high. The Elderly Health Service cohort consisted of 66,820 adults aged 65 years or older enrolled at 18 Elderly Health Centres of the Department of Health from 1998 to 2001. Deaths were followed-up until 2011. All cohort members had medical, socio-demographic, lifestyle, anthropometric data and place of residence recorded at baseline. The residential addresses of cohort members were geo-coded and aggregated by geographic areas, Tertiary Planning Units (TPU). The annual total VKT was used as traffic exposure at the TPU level. We used Cox proportional hazards regression to estimate hazard ratios (HR) for one million km increase in the annual total VKT for natural-cause and cardiopulmonary mortality, adjusted for individual demographic and socio-economic variables, lifestyle, and medication, as well as environmental covariates. There were 17,422 deaths in 197 TPUs, with the median age at death of 75.3 years. The mean annual total VKT was 26 million kilometres. A 1 million increase in the annual total VKT was associated with excess risk [100 × (HR - 1)] of 0.45% (95% confidence interval [CI]: 0.17, 0.74) for natural-cause mortality and 0.81% (95% CI: 0.30, 1.32) for cardiovascular mortality. No significant association was found for respiratory mortality. These findings suggest that vehicle traffic exposure is associated with raised risks of natural-cause and cardiovascular mortality in the older population.

KW - Vehicle-kilometres travelled

KW - Hazard ratioMortality

KW - Cox proportional hazards regression

KW - Hong Kong

UR - http://www.scopus.com/inward/record.url?scp=85070227467&partnerID=8YFLogxK

U2 - 10.1016/j.jth.2019.100609

DO - 10.1016/j.jth.2019.100609

M3 - Journal Article (refereed)

VL - 14

JO - Journal of Transport and Health

JF - Journal of Transport and Health

SN - 2214-1405

M1 - 100609

ER -