Academic journal article Environmental Health Perspectives

Particulate Matter Air Pollution Exposure, Distance to Road, and Incident Lung Cancer in the Nurses' Health Study Cohort

Academic journal article Environmental Health Perspectives

Particulate Matter Air Pollution Exposure, Distance to Road, and Incident Lung Cancer in the Nurses' Health Study Cohort

Article excerpt

Introduction

A number of general population studies around the world have demonstrated adverse associations of chronic exposures to ambient particulate matter (PM) and/or traffic-related pollutants with lung cancer (Beelen et al. 2008a, 2008b; Beeson et al. 1998; Cao and Gao 2012; Carey et al. 2013; Cesaroni et al. 2013; Hales et al. 2013; Hart et al. 2011; Heinrich et al. 2013; Hystad et al. 2013; Jerrett et al. 2013; Katanoda et al. 2011; Krewski et al. 2009; Lepeule et al. 2012; Lipsett et al. 2011; McDonnell et al. 2000; Naess et al. 2007; Nafstad et al. 2003; Nyberg et al. 2000; Pope et al. 2002; Raaschou-Nielsen et al. 2010, 2011, 2013; Turner et al. 2011). Many of these studies have observed effect modification by smoking status, providing evidence for the link between PM exposure and lung cancer in the absence of the strong influence of smoking behavior. Based primarily on the findings of these studies and evidence from occupationally exposed populations, the International Agency for Research on Cancer (IARC) has recently declared outdoor air pollution generally, and PM specifically, as Group 1 human carcinogens (Loomis et al. 2013).

To date, the pollutants/exposures examined and the time periods and spatial scale of those exposures have been somewhat inconsistent across the literature. Most studies in the literature have focused primarily on PM [less than or equal to] 10 [micro]m in aerodynamic diameter ([PM.sub.10]) or [less than or equal to] 2.5 [micro]m ([PM.sub.2.5]); however, a number have also considered black carbon/black smoke, nitrogen dioxide (N[O.sub.2]), nitrogen oxides (N[O.sub.x]), sulfure dioxide, ozone, and volatile organic compounds (Beelen et al. 2008a, 2008b; Dockery et al. 1993; Filleul et al. 2005; Heinrich et al. 2013; Jerrett et al. 2013; Krewski et al. 2009; Nafstad et al. 2003; Nyberg et al. 2000; Raaschou-Nielsen et al. 2010, 2011; Villeneuve et al. 2013; Vineis et al. 2006). A few studies have focused on traffic exposures: modeling N[O.sub.2] from traffic sources alone (Nafstad et al. 2003; Nyberg et al. 2000; Raaschou-Nielsen et al. 2010, 2011) or using distance to major roadways or traffic volume surrounding a location (Beelen et al. 2008a, 2008b; Cesaroni et al. 2013; Hystad et al. 2013; Raaschou-Nielsen et al. 2011, 2013; Vineis et al. 2006). Many studies have relied on area-level assessment of exposure; however, some have also modeled air pollution at the residential level with the intent to decrease measurement error. Studies have also used a variety of periods of exposure relative to disease diagnosis, given that the relevant time period of exposure is unknown. Furthermore, with a few exceptions (Cao and Gao 2012; Lipsett et al. 2011), potential confounders have been assessed only once, even in prospective cohort studies. Despite these inconsistencies in the current body of literature, a link between lung cancer and ambient air pollution has been demonstrated.

The current study is based in the United States within the all-female Nurses' Health Study (NHS) cohort. Our objective is to examine the association of lung cancer incidence with residential-level chronic exposure to [PM.sub.2.5], PM between 2.5 and 10 [micro]m in diameter ([PM.sub.2.5-10]), [PM.sub.10], and residential distance to road. With a wealth of time-varying information on exposures and potential confounders, this cohort provides a unique opportunity to examine these associations.

Methods

Study population. The NHS is an ongoing prospective cohort of 121,700 female nurses who were enrolled in 1976 when they were between 30 and 55 years of age. Participants initially were recruited from 11 states, but as of the mid-1990s nurses now reside in each of the 50 states. A map of all residential addresses in the 48 contiguous states is presented in the Supplemental Material, Figure S1. Participants complete mailed biennial questionnaires to provide information on potential risk factors and to self-report new diagnoses of health outcomes. …

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