Long-Term Exposure to Low-Level NO2 and Mortality among the Elderly Population in the Southeastern United States.

Autor: Yaoyao Qian1, Haomin Li2, Rosenberg, Andrew1, Qiulun Li1, Sarnat, Jeremy1, Papatheodorou, Stefania3, Schwartz, Joel3,4, Donghai Liang1, Yang Liu1, Pengfei Liu5, Liuhua Shi1 Liuhua.shi@emory.edu
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Zdroj: Environmental Health Perspectives. Dec2021, Vol. 129 Issue 12, p127009-1-127009-9. 9p. 1 Color Photograph, 3 Charts, 2 Graphs.
Abstrakt: BACKGROUND: Mounting evidence has shown that long-term exposure to fine particulate matter [PM ≤ 2.5 μm in aerodynamic diameter (PM2.5)] and ozone (O3) can increase mortality. However, the health effects associated with long-term exposure to nitrogen dioxide (NO2) are less clear, in particular the evidence is scarce for NO2 at low levels that are below the current international guidelines. METHODS: We constructed a population-based full cohort comprising all Medicare beneficiaries (aged ≥65, 푁 =13,590,387) in the southeastern United States from 2000 to 2016, and we then further defined the below-guideline cohort that included only those who were always exposed to low-level NO2, that is, with annual means below the current World Health Organization guidelines (i.e., ≤21 ppb). We applied previously estimated spatially and temporally resolved NO2 concentrations and assigned annual means to study participants based on their ZIP code of residence. Cox proportional hazards models were used to examine the association between long-term exposure to low-level NO2 and all-cause mortality, adjusting for potential confounders. RESULTS: About 71.1% of the Medicare beneficiaries in the southeastern United States were always exposed to low-level NO2 over the study period. We observed an association between long-term exposure to low-level NO2 and all-cause mortality, with a hazard ratio (HR)= 1.042 (95% CI: 1.040, 1.045) in single-pollutant models and a HR= 1.047 (95% CI: 1.045, 1.049) in multipollutant models (adjusting for PM2.5 and O3), per 10-ppb increase in annual NO2 concentrations. The penalized spline indicates a linear exposure–response relationship across the entire NO2 exposure range. Medicare enrollees who were White, female, and residing in urban areas were more vulnerable to long-term NO2 exposure. CONCLUSION: Using a large and representative cohort, we provide epidemiological evidence that long-term exposure to NO2, even below the national and global ambient air quality guidelines, was approximately linearly associated with a higher risk of mortality among older adults, independent of PM2.5 and O3 exposure. Improving air quality by reducing NO2 emissions, therefore, may yield significant health benefits. [ABSTRACT FROM AUTHOR]
Databáze: GreenFILE
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