Association between long-term exposure to air pollution and specific causes of mortality in Scotland

Christina Yap, Iain J Beverland, Mathew R Heal, Geoffrey R Cohen, Chris Robertson, Deborah E J Henderson, Neil S Ferguson, Carole L Hart, George Morris, Raymond M Agius

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18 Citations (Scopus)


OBJECTIVE: This study investigated the association between long-term exposure to black smoke (BS) air pollution and mortality in two related Scottish cohorts with 25 years of follow-up.

METHODS: Risk factors were collected during 1970-1976 for 15331 and 6680 participants in the Renfrew/Paisley and Collaborative cohorts respectively. Exposure to BS during 1970-1979 was estimated by inverse-distance weighted averages of observed concentrations at monitoring sites and by two alternative spatial modelling approaches which included local air quality predictors (LAQP).

RESULTS: Consistent BS-mortality associations (per 10 μg m(-3) increment in 10-year average BS) were observed in the Renfrew/Paisley cohort using LAQP-based exposure models (all-cause mortality HR 1.10 (95% CI 1.04 to 1.17); cardiovascular HR 1.11 (1.01 to 1.22); ischaemic heart disease HR 1.13 (1.02 to 1.25); respiratory HR 1.26 (1.02 to 1.28)). The associations were largely unaffected by additional adjustment for area-level deprivation category. A less consistent and generally implausible pattern of cause-specific BS-mortality associations was found for inverse-distance averaging of BS concentrations at nearby monitoring sites. BS-mortality associations in the Collaborative cohort were weaker and not statistically significant.

CONCLUSIONS: The association between mortality and long-term exposure to BS observed in the Renfrew/Paisley cohort is consistent with hypotheses of how air pollution may affect human health. The dissimilarity in pollution-mortality associations for different exposure models highlights the critical importance of reliable estimation of exposures on intraurban spatial scales to avoid potential misclassification bias.

Original languageEnglish
Pages (from-to)916-24
Number of pages9
JournalOccupational and Environmental Medicine
Issue number12
Publication statusPublished - Dec 2012


  • Adult
  • Air Pollution
  • Cardiovascular Diseases
  • Cause of Death
  • Cohort Studies
  • Environmental Exposure
  • Female
  • Humans
  • Male
  • Middle Aged
  • Respiratory Tract Diseases
  • Scotland
  • Smoke
  • Time Factors


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