Long‐term exposure to air pollution and incidence of gastric and the upper aerodigestive tract cancers in a pooled European cohort: The ELAPSE project

Author:

Nagel Gabriele1ORCID,Chen Jie2,Jaensch Andrea1,Skodda Lea1,Rodopoulou Sophia3,Strak Maciej24,de Hoogh Kees56,Andersen Zorana J.7,Bellander Tom8,Brandt Jørgen910,Fecht Daniela11,Forastiere Francesco1213,Gulliver John1114,Hertel Ole15,Hoffmann Barbara16,Hvidtfeldt Ulla Arthur17ORCID,Katsouyanni Klea311,Ketzel Matthias918,Leander Karin8,Magnusson Patrik K. E.19,Pershagen Göran8,Rizzuto Debora2021,Samoli Evangelia3,Severi Gianluca22ORCID,Stafoggia Massimo812,Tjønneland Anne717,Vermeulen Roel C. H.2,Wolf Kathrin23,Zitt Emanuel2425,Brunekreef Bert2,Hoek Gerard2,Raaschou‐Nielsen Ole917ORCID,Weinmayr Gudrun1

Affiliation:

1. Institute of Epidemiology and Medical Biometry Ulm University Ulm Germany

2. Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands

3. Department of Hygiene, Epidemiology and Medical Statistics, Medical School National and Kapodistrian University of Athens Athens Greece

4. National Institute for Public Health and the Environment Bilthoven The Netherlands

5. Swiss Tropical and Public Health Institute Basel Switzerland

6. University of Basel Basel Switzerland

7. Department of Public Health University of Copenhagen Copenhagen Denmark

8. Institute of Environmental Medicine, Karolinska Institutet Stockholm Sweden

9. Department of Environmental Science Aarhus University Roskilde Denmark

10. iClimate – Interdisciplinary Centre for Climate Change Aarhus University Roskilde Denmark

11. MRC Centre for Environment and Health, School of Public Health Imperial College London London UK

12. Department of Epidemiology Lazio Region Health Service/ASL Roma 1 Rome Italy

13. Environmental Research Group, School of Public Health, Faculty of Medicine Imperial College London UK

14. Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment University of Leicester Leicester UK

15. Faculty of Technical Sciences Aarhus University Roskilde Denmark

16. Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty Heinrich Heine University Düsseldorf Düsseldorf Germany

17. The Danish Cancer Institute Copenhagen Denmark

18. Global Centre for Clean Air Research (GCARE) University of Surrey Guildford UK

19. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet Stockholm Sweden

20. Department of Neurobiology, Care Sciences, and Society Karolinska Institutet and Stockholm University Stockholm Sweden

21. Stockholm Gerontology Research Center Stockholm Sweden

22. University Paris‐Saclay Villejuif France

23. Institute of Epidemiology, Helmholtz Zentrum München Neuherberg Germany

24. Agency for Preventive and Social Medicine (aks) Bregenz Austria

25. Department of Internal Medicine 3 LKH Feldkirch Feldkirch Austria

Abstract

AbstractAir pollution has been shown to significantly impact human health including cancer. Gastric and upper aerodigestive tract (UADT) cancers are common and increased risk has been associated with smoking and occupational exposures. However, the association with air pollution remains unclear. We pooled European subcohorts (N = 287,576 participants for gastric and N = 297,406 for UADT analyses) and investigated the association between residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone in the warm season (O3w) with gastric and UADT cancer. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area‐level. During 5,305,133 and 5,434,843 person‐years, 872 gastric and 1139 UADT incident cancer cases were observed, respectively. For gastric cancer, we found no association with PM2.5, NO2 and BC while for UADT the hazard ratios (95% confidence interval) were 1.15 (95% CI: 1.00–1.33) per 5 μg/m3 increase in PM2.5, 1.19 (1.08–1.30) per 10 μg/m3 increase in NO2, 1.14 (1.04–1.26) per 0.5 × 10−5 m−1 increase in BC and 0.81 (0.72–0.92) per 10 μg/m3 increase in O3w. We found no association between long‐term ambient air pollution exposure and incidence of gastric cancer, while for long‐term exposure to PM2.5, NO2 and BC increased incidence of UADT cancer was observed.

Funder

Deutsche Krebshilfe

Health Effects Institute

Publisher

Wiley

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