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      Fine particulate matter associated mortality burden of lung cancer in Hebei Province, China

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          Abstract

          Background

          The association between fine particulate matter (PM 2.5) and lung cancer (LC) mortality in China is limited. The Beijing‐Tianjin‐Hebei region is infamous for serious air pollution. Seven of the top 10 cities with the worst air quality are located in Hebei Province. Thus, we explored the effect of 10 years of PM 2.5 on the LC mortality rate in Hebei Province.

          Methods

          We quantified associations between LC mortality and PM 2.5 and estimated the LC mortality burden attributed to PM 2.5 with predicted county level LC deaths in 2014.

          Results

          The 10‐year PM 2.5 LC mortality associations were non‐linear, with thresholds of 63 μg/m 3 overall, 69 μg/m 3 for men, 68 μg/m 3 for women, 66 μg/m 3 for those aged 30–64 years, and 62 μg/m 3 for those aged ≥ 65 years. The relative risks for these groups were 1.09 (95% confidence interval [CI] 1.08–1.10), 1.06 (95% CI 1.03–1.10), 1.20 (95% CI 1.10–1.26), 1.07 (95% CI 1.05–1.11), and 1.10 (95% CI: 1.07–1.13), respectively. There were 2525 (95% CI 2265–2780) LC deaths attributed to 10‐year PM 2.5 in 2014, at fractions of 8.3% (95% CI 7.4–9.1%) overall, 5.7% (95% CI 2.8–9.4%) for men, 16.7% (95% CI: 8.3–21.6%) for women, 6.5% (95% CI 4.7–10.3%) for those aged 30–64 years, and 9.1% (95% CI 6.4–11.5%) for those aged ≥ 65 years.

          Conclusion

          Our results suggest that a reduction in the PM 2.5 exposure levels below thresholds would prevent a substantial number of LC deaths in Hebei Province.

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          Most cited references21

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          Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE).

          Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between long-term exposure to ambient air pollution and lung cancer incidence in European populations. This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Effects used data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 μm (PM10), less than 2·5 μm (PM2·5), and between 2·5 and 10 μm (PMcoarse), soot (PM2·5absorbance), nitrogen oxides, and two traffic indicators. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses. The 312 944 cohort members contributed 4 013 131 person-years at risk. During follow-up (mean 12·8 years), 2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically significant association between risk for lung cancer and PM10 (hazard ratio [HR] 1·22 [95% CI 1·03-1·45] per 10 μg/m(3)). For PM2·5 the HR was 1·18 (0·96-1·46) per 5 μg/m(3). The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the lung of 1·51 (1·10-2·08) and 1·55 (1·05-2·29), respectively. An increase in road traffic of 4000 vehicle-km per day within 100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99-1·21). The results showed no association between lung cancer and nitrogen oxides concentration (HR 1·01 [0·95-1·07] per 20 μg/m(3)) or traffic intensity on the nearest street (HR 1·00 [0·97-1·04] per 5000 vehicles per day). Particulate matter air pollution contributes to lung cancer incidence in Europe. European Community's Seventh Framework Programme. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project

            Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants. We used data from 22 European cohort studies, which created a total study population of 367,251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and between 10 μm and 2.5 μm (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOx), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buffer. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta-analysis. The total study population consisted of 367,251 participants who contributed 5,118,039 person-years at risk (average follow-up 13.9 years), of whom 29,076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2.5 of 1.07 (95% CI 1.02-1.13) per 5 μg/m(3) was recorded. No heterogeneity was noted between individual cohort effect estimates (I(2) p value=0.95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 μg/m(3) (HR 1.06, 95% CI 1.00-1.12) or below 20 μg/m(3) (1.07, 1.01-1.13). Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value. European Community's Seventh Framework Program (FP7/2007-2011). Copyright © 2014 Elsevier Ltd. All rights reserved.
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              Long-Term Ozone Exposure and Mortality in a Large Prospective Study.

              Tropospheric ozone (O3) is potentially associated with cardiovascular disease risk and premature death. Results from long-term epidemiological studies on O3 are scarce and inconclusive.
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                Author and article information

                Contributors
                baoenshan@hbydsy.com
                Journal
                Thorac Cancer
                Thorac Cancer
                10.1111/(ISSN)1759-7714
                TCA
                Thoracic Cancer
                John Wiley & Sons Australia, Ltd (Melbourne )
                1759-7706
                1759-7714
                14 May 2018
                July 2018
                : 9
                : 7 ( doiID: 10.1111/tca.2018.9.issue-7 )
                : 820-826
                Affiliations
                [ 1 ] Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province Shijiazhuang China
                Author notes
                [*] [* ] Correspondence

                Baoen Shan, Cancer Institute, The Fourth Hospital of Hebei Medical University/The Tumor Hospital of Hebei Province, Jiankang Road 12th, Shijiazhuang, Hebei 050011, China.

                Tel: +86 311 8609 5631

                Fax: +86 311 8607 7634

                Email: baoenshan@ 123456hbydsy.com

                Article
                TCA12653
                10.1111/1759-7714.12653
                6026611
                29756316
                904b1309-5bcf-4d55-ae4a-d8933bcc09b9
                © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 06 March 2018
                : 29 March 2018
                : 01 April 2018
                Page count
                Figures: 4, Tables: 2, Pages: 7, Words: 4458
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                tca12653
                July 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.1.1 mode:remove_FC converted:01.07.2018

                air pollution,attributed fraction,fine particulate matter,generalized additive model,lung cancer mortality

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