Air Pollution and Mortality in the Netherlands; Stratified by Gender, Age and Social Status. The DUELS Study

Abstract

Air Pollution and Mortality in the Netherlands; Stratified by Gender, Age and Social Status. The DUELS StudyAbstract Number:2363 Paul Fischer*, Marten Marra, Nicole Janssen, Caroline Ameling, Gerard Hoek, Rob Beelen, Kees de Hoogh, Hanneke Kruize, and Danny Houthuijs Paul Fischer* National Institute of Public Health and the Environment, Netherlands, E-mail Address: [email protected]nl Search for more papers by this author , Marten Marra National Institute of Public Health and the Environment, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Nicole Janssen National Institute of Public Health and the Environment, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Caroline Ameling National Institute of Public Health and the Environment, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Gerard Hoek Institute for Risk Assessment Sciences, University Utrecht, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Rob Beelen Institute for Risk Assessment Sciences, University Utrecht, Netherlands, E-mail Address: [email protected] Search for more papers by this author , Kees de Hoogh Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, United Kingdom, E-mail Address: [email protected] Search for more papers by this author , Hanneke Kruize National Institute of Public Health and the Environment, Netherlands, E-mail Address: [email protected] Search for more papers by this author , and Danny Houthuijs National Institute of Public Health and the Environment, Netherlands, E-mail Address: danny.houthui[email protected] Search for more papers by this author AbstractAbstractBackground Airborne particulate matter (PM) has been associated with mortality in urban cohort studies. We studied this association in a large scale Dutch population registry. The aim of the study was to evaluate the age, gender and social-economic specific associations between long-term exposure to air pollution and all-cause and cause-specific mortalityMethods We established a cohort of 7,1 million individuals 30 years or older using existing Dutch national databases on mortality, individual characteristics, neighbourhood characteristics and national air pollution maps for particulates of PM10 and NO2. We stratified the statistical analyses on gender, age-classes and social economic status. We applied Cox proportional hazard models adjusting for potential individual and area-specific confounders.Results Hazard Rate (per 10 ug/m3) did not differ between the genders, except for lung cancer mortality where higher HR’s were found for women (1.435 vs 1.175 for PM10 and 1.239 vs. 1.037 for NO2). Overall, significant effects were found in all age categories i.e. not exclusively in the elderly, both for total and cause specific mortality. After adjustment for individual characteristics, we found increased HR for PM10 and NO2 in neighbourhoods with lower social class compared to neighbourhoods with the highest social class (HR for total mortality 1.094 vs 1.048 for PM10 and 1.031 vs. 1.013 for NO2) for total mortality. For cause specific mortality the same pattern was found.Conclusions Except for lung cancer mortality, no differences in risk estimates for PM10 and NO2 between gender was found. Higher risks for lung cancer mortality and PM10 or NO2 exposure were found for women. We found no consistent differences in HR’s between the different age groups. In neighbourhoods with the highest social status lowest risk estimates were found for mortality effects from PM10 and NO2.