Long term exposure to air pollution, mortality and morbidity in New Zealand: Cohort study. 2021

Simon Hales, and June Atkinson, and Jayne Metcalfe, and Gerda Kuschel, and Alistair Woodward
Department of Public Health, University of Otago, Wellington, New Zealand. Electronic address: simon.hales@otago.ac.nz.

OBJECTIVE To investigate associations between long-term exposure to PM2.5, NO2, mortality and morbidity in New Zealand, a country with low levels of exposure. METHODS Retrospective cohort study. METHODS The New Zealand resident population. METHODS The main analyses included all adults aged 30 years and over with complete data on covariates: N = 2,223,507. People who died, or were admitted to hospital, (2013-2016) were linked anonymously to the 2013 census, and to estimates of ambient PM2.5, and NO2 concentration. We fitted Poisson regression models of mortality and morbidity in adults (≥30) for all natural causes of death, and by sub- group of major cause. Person-time of exposure, censored at the time of death, was included as an offset. We adjusted for confounding by age, sex, ethnicity, income, education, smoking status and ambient temperature. Further analyses stratified by ethnic group, and investigated respiratory hospital admissions in children. RESULTS There were statistically significant positive associations between pollutants and natural causes of death: RR (per 10 μg/m3) for PM2.5 1.11 (1.07 to 1.15) and for NO2 1.10 (1.07 to 1.12). For morbidity, the strongest associations were for PM2.5 and ischaemic heart disease in adults, RR: 1.29 (1.23 to 1.35) and for NO2 and asthma in children, RR: 1.18 (1.09 to 1.28). In models restricted to specific ethnic groups, we found no consistent differences in any of the associations. CONCLUSIONS The results for NO2 are higher than those published previously. Other studies have reported that the dose-response for PM2.5 may be higher at low concentrations, but less is known about NO2. It is possible NO2 is acting as a proxy for other traffic-related pollutants that are causally related to health impacts. This study underlines the importance of controlling pollution caused by motor vehicles.

UI MeSH Term Description Entries
D009017 Morbidity The proportion of patients with a particular disease during a given year per given unit of population. Morbidities
D009520 New Zealand A group of islands in the southwest Pacific. Its capital is Wellington. It was discovered by the Dutch explorer Abel Tasman in 1642 and circumnavigated by Cook in 1769. Colonized in 1840 by the New Zealand Company, it became a British crown colony in 1840 until 1907 when colonial status was terminated. New Zealand is a partly anglicized form of the original Dutch name Nieuw Zeeland, new sea land, possibly with reference to the Dutch province of Zeeland. (From Webster's New Geographical Dictionary, 1988, p842 & Room, Brewer's Dictionary of Names, 1992, p378)
D009585 Nitrogen Dioxide Nitrogen oxide (NO2). A highly poisonous gas. Exposure produces inflammation of lungs that may only cause slight pain or pass unnoticed, but resulting edema several days later may cause death. (From Merck, 11th ed) It is a major atmospheric pollutant that is able to absorb UV light that does not reach the earth's surface. Nitrogen Peroxide,Dioxide, Nitrogen,Peroxide, Nitrogen
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004781 Environmental Exposure The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. Exposure, Environmental,Environmental Exposures,Exposures, Environmental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000393 Air Pollutants Any substance in the air which could, if present in high enough concentration, harm humans, animals, vegetation or materials. Substances include GASES; PARTICULATE MATTER; and volatile ORGANIC CHEMICALS. Air Pollutant,Air Pollutants, Environmental,Environmental Air Pollutants,Environmental Pollutants, Air,Air Environmental Pollutants,Pollutant, Air,Pollutants, Air,Pollutants, Air Environmental,Pollutants, Environmental Air
D000397 Air Pollution The presence of contaminants or pollutant substances in the air (AIR POLLUTANTS) that interfere with human health or welfare, or produce other harmful environmental effects. The substances may include GASES; PARTICULATE MATTER; or volatile ORGANIC CHEMICALS. Air Quality,Air Pollutions,Pollution, Air
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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