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Pope III CA, Burnett RT, Thun MJ, et al. Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine
Particulate Air Pollution. JAMA. 2002;287(9):1132–1141. doi:10.1001/jama.287.9.1132
Author Affiliations: Brigham Young University, Provo, Utah (Dr Pope); Health Canada, Ottawa, Ontario (Dr Burnett); University of Ottawa, Ottawa, Ontario (Drs Burnett and Krewski); American Cancer Society, Atlanta, Ga (Drs Thun and Calle); and New York University School of Medicine, Tuxedo, NY (Drs Ito and Thurston).
Context Associations have been found between day-to-day particulate air pollution
and increased risk of various adverse health outcomes, including cardiopulmonary
mortality. However, studies of health effects of long-term particulate air
pollution have been less conclusive.
Objective To assess the relationship between long-term exposure to fine particulate
air pollution and all-cause, lung cancer, and cardiopulmonary mortality.
Design, Setting, and Participants Vital status and cause of death data were collected by the American
Cancer Society as part of the Cancer Prevention II study, an ongoing prospective
mortality study, which enrolled approximately 1.2 million adults in 1982.
Participants completed a questionnaire detailing individual risk factor data
(age, sex, race, weight, height, smoking history, education, marital status,
diet, alcohol consumption, and occupational exposures). The risk factor data
for approximately 500 000 adults were linked with air pollution data
for metropolitan areas throughout the United States and combined with vital
status and cause of death data through December 31, 1998.
Main Outcome Measure All-cause, lung cancer, and cardiopulmonary mortality.
Results Fine particulate and sulfur oxide–related pollution were associated
with all-cause, lung cancer, and cardiopulmonary mortality. Each 10-µg/m3 elevation in fine particulate air pollution was associated with approximately
a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer
mortality, respectively. Measures of coarse particle fraction and total suspended
particles were not consistently associated with mortality.
Conclusion Long-term exposure to combustion-related fine particulate air pollution
is an important environmental risk factor for cardiopulmonary and lung cancer
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