Copyright 2002 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2002
To the Editor: Dr Pope and colleagues1 found that long-term exposure to air pollution
is a risk factor for death from cardiopulmonary disease and lung cancer. It
is puzzling that increased mortality risk was observed only in the 41.1% of
the population with 12 or fewer years of education. Although this might be
a chance finding related to subgroup analysis, a similar result was observed
in the reanalysis of the Harvard Six-Cities Air Pollution Study.2
That study also found no pollution-related risk in the 34% of the population
with more than 12 years of education. Why are individuals with more education
apparently immune to the adverse effects of air pollutants? It is possible
that education is a surrogate for some more proximal factors that modify risk,
such as lifestyle factors, subsequent occupational exposures, and income.
Finkelstein MM. Pollution-Related Mortality and Educational Level. JAMA. 2002;288(7):830. doi:10.1001/jama.288.7.828
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