Prospective cohort study finds elevated cardiovascular and cancer mortality linked to sulfur dioxide and particulate matter in adults, highlighting the need for stricter emission controls.
Key Points
To examine the impact of long-term exposure to multiple ambient air pollutants on cardiovascular disease- and cancer-related mortality.
Prospective cohort study enrolling 83,257 adults in Taiwan with stable residential addresses between 2005 and 2017, followed for a mean of 10.6 years (879,834 person-years).
Individual residential pollutant levels were estimated using an Ordinary Kriging model, and associations with mortality were evaluated using time-dependent Cox proportional hazards and Fine–Gray competing-risk models.
A total of 2,554 participants died during follow-up, comprising 485 cardiovascular deaths (19.0%) and 1,230 cancer deaths (48.2%).
Per 2-ppb increase, SO₂ exposure showed the strongest risk for both cardiovascular mortality (aHR 1.23; 95% CI 1.07–1.41) and cancer mortality (aHR 1.23; 95% CI 1.07–1.41), followed by PM₂.₅ (aHR 1.05; 95% CI 1.03–1.08) and PM₁₀ (aHR 1.02; 95% CI 1.01–1.04).
Long-term exposure to NO₂ and O₃ demonstrated no statistically significant association with cardiovascular or cancer mortality.