Long term exposure to air pollution and mortality in an elderly cohort in Hong Kong

Yang YANG, Robert TANG, Hong QIU, Poh Chin LAI, Paulina WONG, Thuan Quoc THACH, Ryan ALLEN, Michael BRAUER, Linwei TIAN, Benjamin BARRATT*

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)

3 Citations (Scopus)

Abstract

Background: Several studies have reported associations between long term exposure to air pollutants and cause-specific mortality. However, since the concentrations of air pollutants in Asia are much higher compared to those reported in North American and European cohort studies, cohort studies on long term effects of air pollutants in Asia are needed for disease burden assessment and to inform policy. Objectives: To assess the effects of long-term exposure to particulate matter with aerodynamic diameter < 2.5 μm (PM2.5), black carbon (BC) and nitrogen dioxide (NO2) on cause-specific mortality in an elderly cohort in Hong Kong. Methods: In a cohort of 66,820 participants who were older than or equal to 65 years old in Hong Kong from 1998 to 2011, air pollutant concentrations were estimated by land use regression and assigned to the residential addresses of all participants at baseline and for each year during a 11 year follow up period. Hazard ratios (HRs) of cause-specific mortality (including all natural cause, cardiovascular and respiratory mortality) associated with air pollutants were estimated with Cox models, including a number of personal and area-level socioeconomic, demographic, and lifestyle factors. Results: The median concentration of PM2.5 during the baseline period was 42.2 μg/m3 with an IQR of 5.5 μg/m3, 12.1 (9.6) μg/m3 for BC and 104 (25.6) μg/m3 for NO2. For PM2.5, adjusted HR per IQR increase and per 10 μg/m3 for natural cause mortality was 1.03 (95%CI: 1.01, 1.06) and 1.06 (95%CI: 1.02, 1.11) respectively. The corresponding HR were 1.06 (95%CI: 1.02, 1.10) and 1.01 (95%CI: 0.96, 1.06) for cardiovascular disease and respiratory disease mortality, respectively. For BC, the HR of an interquartile range increase for all natural cause mortality was 1.03 (95%CI: 1.00, 1.05). The corresponding HR was 1.07 (95%CI: 1.03, 1.11) and 0.99 (95%CI: 0.94, 1.04) for cardiovascular disease and respiratory disease mortality. For NO2, almost all HRs were approximately 1.0, except for IHD (ischemic heart disease) mortality. Conclusion: Long-term exposure to ambient PM2.5 and BC was associated with an elevated risk of cardiovascular mortality. Despite far higher air pollution exposure concentrations, HRs per unit increase in PM2.5 were similar to those from recent comparable studies in North America.

Original languageEnglish
Pages (from-to)99-106
Number of pages8
JournalEnvironment International
Volume117
Early online date3 May 2018
DOIs
Publication statusPublished - 1 Aug 2018

Fingerprint

atmospheric pollution
mortality
hazard
black carbon
cardiovascular disease
respiratory disease
exposure
pollution exposure
nitrogen dioxide
lifestyle
aerodynamics
particulate matter
carbon dioxide
air pollutant
land use

Keywords

  • Air pollution
  • Cohort study
  • Hong Kong
  • Mortality

Cite this

YANG, Yang ; TANG, Robert ; QIU, Hong ; LAI, Poh Chin ; WONG, Paulina ; THACH, Thuan Quoc ; ALLEN, Ryan ; BRAUER, Michael ; TIAN, Linwei ; BARRATT, Benjamin. / Long term exposure to air pollution and mortality in an elderly cohort in Hong Kong. In: Environment International. 2018 ; Vol. 117. pp. 99-106.
@article{dd92b88ac83f4bb887ca572f09f43339,
title = "Long term exposure to air pollution and mortality in an elderly cohort in Hong Kong",
abstract = "Background: Several studies have reported associations between long term exposure to air pollutants and cause-specific mortality. However, since the concentrations of air pollutants in Asia are much higher compared to those reported in North American and European cohort studies, cohort studies on long term effects of air pollutants in Asia are needed for disease burden assessment and to inform policy. Objectives: To assess the effects of long-term exposure to particulate matter with aerodynamic diameter < 2.5 μm (PM2.5), black carbon (BC) and nitrogen dioxide (NO2) on cause-specific mortality in an elderly cohort in Hong Kong. Methods: In a cohort of 66,820 participants who were older than or equal to 65 years old in Hong Kong from 1998 to 2011, air pollutant concentrations were estimated by land use regression and assigned to the residential addresses of all participants at baseline and for each year during a 11 year follow up period. Hazard ratios (HRs) of cause-specific mortality (including all natural cause, cardiovascular and respiratory mortality) associated with air pollutants were estimated with Cox models, including a number of personal and area-level socioeconomic, demographic, and lifestyle factors. Results: The median concentration of PM2.5 during the baseline period was 42.2 μg/m3 with an IQR of 5.5 μg/m3, 12.1 (9.6) μg/m3 for BC and 104 (25.6) μg/m3 for NO2. For PM2.5, adjusted HR per IQR increase and per 10 μg/m3 for natural cause mortality was 1.03 (95{\%}CI: 1.01, 1.06) and 1.06 (95{\%}CI: 1.02, 1.11) respectively. The corresponding HR were 1.06 (95{\%}CI: 1.02, 1.10) and 1.01 (95{\%}CI: 0.96, 1.06) for cardiovascular disease and respiratory disease mortality, respectively. For BC, the HR of an interquartile range increase for all natural cause mortality was 1.03 (95{\%}CI: 1.00, 1.05). The corresponding HR was 1.07 (95{\%}CI: 1.03, 1.11) and 0.99 (95{\%}CI: 0.94, 1.04) for cardiovascular disease and respiratory disease mortality. For NO2, almost all HRs were approximately 1.0, except for IHD (ischemic heart disease) mortality. Conclusion: Long-term exposure to ambient PM2.5 and BC was associated with an elevated risk of cardiovascular mortality. Despite far higher air pollution exposure concentrations, HRs per unit increase in PM2.5 were similar to those from recent comparable studies in North America.",
keywords = "Air pollution, Cohort study, Hong Kong, Mortality",
author = "Yang YANG and Robert TANG and Hong QIU and LAI, {Poh Chin} and Paulina WONG and THACH, {Thuan Quoc} and Ryan ALLEN and Michael BRAUER and Linwei TIAN and Benjamin BARRATT",
year = "2018",
month = "8",
day = "1",
doi = "10.1016/j.envint.2018.04.034",
language = "English",
volume = "117",
pages = "99--106",
journal = "Environmental International",
issn = "0160-4120",
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}

YANG, Y, TANG, R, QIU, H, LAI, PC, WONG, P, THACH, TQ, ALLEN, R, BRAUER, M, TIAN, L & BARRATT, B 2018, 'Long term exposure to air pollution and mortality in an elderly cohort in Hong Kong', Environment International, vol. 117, pp. 99-106. https://doi.org/10.1016/j.envint.2018.04.034

Long term exposure to air pollution and mortality in an elderly cohort in Hong Kong. / YANG, Yang; TANG, Robert; QIU, Hong; LAI, Poh Chin; WONG, Paulina; THACH, Thuan Quoc; ALLEN, Ryan; BRAUER, Michael; TIAN, Linwei; BARRATT, Benjamin.

In: Environment International, Vol. 117, 01.08.2018, p. 99-106.

Research output: Journal PublicationsJournal Article (refereed)

TY - JOUR

T1 - Long term exposure to air pollution and mortality in an elderly cohort in Hong Kong

AU - YANG, Yang

AU - TANG, Robert

AU - QIU, Hong

AU - LAI, Poh Chin

AU - WONG, Paulina

AU - THACH, Thuan Quoc

AU - ALLEN, Ryan

AU - BRAUER, Michael

AU - TIAN, Linwei

AU - BARRATT, Benjamin

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: Several studies have reported associations between long term exposure to air pollutants and cause-specific mortality. However, since the concentrations of air pollutants in Asia are much higher compared to those reported in North American and European cohort studies, cohort studies on long term effects of air pollutants in Asia are needed for disease burden assessment and to inform policy. Objectives: To assess the effects of long-term exposure to particulate matter with aerodynamic diameter < 2.5 μm (PM2.5), black carbon (BC) and nitrogen dioxide (NO2) on cause-specific mortality in an elderly cohort in Hong Kong. Methods: In a cohort of 66,820 participants who were older than or equal to 65 years old in Hong Kong from 1998 to 2011, air pollutant concentrations were estimated by land use regression and assigned to the residential addresses of all participants at baseline and for each year during a 11 year follow up period. Hazard ratios (HRs) of cause-specific mortality (including all natural cause, cardiovascular and respiratory mortality) associated with air pollutants were estimated with Cox models, including a number of personal and area-level socioeconomic, demographic, and lifestyle factors. Results: The median concentration of PM2.5 during the baseline period was 42.2 μg/m3 with an IQR of 5.5 μg/m3, 12.1 (9.6) μg/m3 for BC and 104 (25.6) μg/m3 for NO2. For PM2.5, adjusted HR per IQR increase and per 10 μg/m3 for natural cause mortality was 1.03 (95%CI: 1.01, 1.06) and 1.06 (95%CI: 1.02, 1.11) respectively. The corresponding HR were 1.06 (95%CI: 1.02, 1.10) and 1.01 (95%CI: 0.96, 1.06) for cardiovascular disease and respiratory disease mortality, respectively. For BC, the HR of an interquartile range increase for all natural cause mortality was 1.03 (95%CI: 1.00, 1.05). The corresponding HR was 1.07 (95%CI: 1.03, 1.11) and 0.99 (95%CI: 0.94, 1.04) for cardiovascular disease and respiratory disease mortality. For NO2, almost all HRs were approximately 1.0, except for IHD (ischemic heart disease) mortality. Conclusion: Long-term exposure to ambient PM2.5 and BC was associated with an elevated risk of cardiovascular mortality. Despite far higher air pollution exposure concentrations, HRs per unit increase in PM2.5 were similar to those from recent comparable studies in North America.

AB - Background: Several studies have reported associations between long term exposure to air pollutants and cause-specific mortality. However, since the concentrations of air pollutants in Asia are much higher compared to those reported in North American and European cohort studies, cohort studies on long term effects of air pollutants in Asia are needed for disease burden assessment and to inform policy. Objectives: To assess the effects of long-term exposure to particulate matter with aerodynamic diameter < 2.5 μm (PM2.5), black carbon (BC) and nitrogen dioxide (NO2) on cause-specific mortality in an elderly cohort in Hong Kong. Methods: In a cohort of 66,820 participants who were older than or equal to 65 years old in Hong Kong from 1998 to 2011, air pollutant concentrations were estimated by land use regression and assigned to the residential addresses of all participants at baseline and for each year during a 11 year follow up period. Hazard ratios (HRs) of cause-specific mortality (including all natural cause, cardiovascular and respiratory mortality) associated with air pollutants were estimated with Cox models, including a number of personal and area-level socioeconomic, demographic, and lifestyle factors. Results: The median concentration of PM2.5 during the baseline period was 42.2 μg/m3 with an IQR of 5.5 μg/m3, 12.1 (9.6) μg/m3 for BC and 104 (25.6) μg/m3 for NO2. For PM2.5, adjusted HR per IQR increase and per 10 μg/m3 for natural cause mortality was 1.03 (95%CI: 1.01, 1.06) and 1.06 (95%CI: 1.02, 1.11) respectively. The corresponding HR were 1.06 (95%CI: 1.02, 1.10) and 1.01 (95%CI: 0.96, 1.06) for cardiovascular disease and respiratory disease mortality, respectively. For BC, the HR of an interquartile range increase for all natural cause mortality was 1.03 (95%CI: 1.00, 1.05). The corresponding HR was 1.07 (95%CI: 1.03, 1.11) and 0.99 (95%CI: 0.94, 1.04) for cardiovascular disease and respiratory disease mortality. For NO2, almost all HRs were approximately 1.0, except for IHD (ischemic heart disease) mortality. Conclusion: Long-term exposure to ambient PM2.5 and BC was associated with an elevated risk of cardiovascular mortality. Despite far higher air pollution exposure concentrations, HRs per unit increase in PM2.5 were similar to those from recent comparable studies in North America.

KW - Air pollution

KW - Cohort study

KW - Hong Kong

KW - Mortality

UR - http://www.scopus.com/inward/record.url?scp=85046410953&partnerID=8YFLogxK

U2 - 10.1016/j.envint.2018.04.034

DO - 10.1016/j.envint.2018.04.034

M3 - Journal Article (refereed)

AN - SCOPUS:85046410953

VL - 117

SP - 99

EP - 106

JO - Environmental International

JF - Environmental International

SN - 0160-4120

ER -