Long-term exposure to air pollution and liver cancer incidence in six European cohorts

Rina So; Jie Chen; Amar J. Mehta; Shuo Liu; Maciej Strak; Kathrin Wolf; Ulla A. Hvidtfeldt; Sophia Rodopoulou; Massimo Stafoggia; Jochem O. Klompmaker; Evangelia Samoli; Ole Raaschou-Nielsen; Richard Atkinson; Mariska Bauwelinck; Tom Bellander; Marie Christine Boutron-Ruault; Jørgen Brandt; Bert Brunekreef; Giulia Cesaroni; Hans Concin; Francesco Forastiere; Carla H. van Gils; John Gulliver; Ole Hertel; Barbara Hoffmann; Kees de Hoogh; Nicole Janssen; Youn hee Lim; Rudi Westendorp; Jeanette T. Jørgensen; Klea Katsouyanni; Matthias Ketzel; Anton Lager; Alois Lang; Petter L. Ljungman; Patrik K.E. Magnusson; Gabriele Nagel; Mette K. Simonsen; Göran Pershagen; Raphael S. Peter; Annette Peters; Matteo Renzi; Debora Rizzuto; Torben Sigsgaard; Danielle Vienneau; Gudrun Weinmayr; Gianluca Severi; Daniela Fecht; Anne Tjønneland; Karin Leander; Gerard Hoek; Zorana J. Andersen

doi:10.1002/ijc.33743

Long-term exposure to air pollution and liver cancer incidence in six European cohorts

Rina So, Jie Chen, Amar J. Mehta, Shuo Liu, Maciej Strak, Kathrin Wolf, Ulla A. Hvidtfeldt, Sophia Rodopoulou, Massimo Stafoggia, Jochem O. Klompmaker, Evangelia Samoli, Ole Raaschou-Nielsen, Richard Atkinson, Mariska Bauwelinck, Tom Bellander, Marie Christine Boutron-Ruault, Jørgen Brandt, Bert Brunekreef, Giulia Cesaroni, Hans ConcinFrancesco Forastiere, Carla H. van Gils, John Gulliver, Ole Hertel, Barbara Hoffmann, Kees de Hoogh, Nicole Janssen, Youn hee Lim, Rudi Westendorp, Jeanette T. Jørgensen, Klea Katsouyanni, Matthias Ketzel, Anton Lager, Alois Lang, Petter L. Ljungman, Patrik K.E. Magnusson, Gabriele Nagel, Mette K. Simonsen, Göran Pershagen, Raphael S. Peter, Annette Peters, Matteo Renzi, Debora Rizzuto, Torben Sigsgaard, Danielle Vienneau, Gudrun Weinmayr, Gianluca Severi, Daniela Fecht, Anne Tjønneland, Karin Leander, Gerard Hoek, Zorana J. Andersen

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Abstract

Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the “Effects of low-level air pollution: A study in Europe” (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015. The annual average exposure to nitrogen dioxide (NO₂), particulate matter with diameter <2.5 μm (PM_2.5), black carbon (BC), warm-season ozone (O₃), and eight elemental components of PM_2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330 064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO₂ (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 μg/m³), PM_2.5 (1.12, 0.92-1.36 per 5 μg/m³), and BC (1.15, 1.00-1.33 per 0.5 10⁻⁵/m) and liver cancer incidence. Associations with NO₂ and BC persisted in two-pollutant models with PM_2.5. Most components of PM_2.5 were associated with the risk of liver cancer, with the strongest associations for sulfur and vanadium, which were robust to adjustment for PM_2.5 or NO₂. Our study suggests that ambient air pollution may increase the risk of liver cancer, even at concentrations below current EU standards.

Original language	English
Pages (from-to)	1887-1897
Number of pages	11
Journal	International Journal of Cancer
Volume	149
Issue number	11
DOIs	https://doi.org/10.1002/ijc.33743
Publication status	Published - 1 Dec 2021

Keywords

air pollution
cohort study
liver cancer incidence
particulate matter

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10.1002/ijc.33743

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So, R., Chen, J., Mehta, A. J., Liu, S., Strak, M., Wolf, K., Hvidtfeldt, U. A., Rodopoulou, S., Stafoggia, M., Klompmaker, J. O., Samoli, E., Raaschou-Nielsen, O., Atkinson, R., Bauwelinck, M., Bellander, T., Boutron-Ruault, M. C., Brandt, J., Brunekreef, B., Cesaroni, G., ... Andersen, Z. J. (2021). Long-term exposure to air pollution and liver cancer incidence in six European cohorts. International Journal of Cancer, 149(11), 1887-1897. https://doi.org/10.1002/ijc.33743

@article{0c01678f473b42aa8e6ca64497476246,

title = "Long-term exposure to air pollution and liver cancer incidence in six European cohorts",

abstract = "Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the “Effects of low-level air pollution: A study in Europe” (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015. The annual average exposure to nitrogen dioxide (NO2), particulate matter with diameter <2.5 μm (PM2.5), black carbon (BC), warm-season ozone (O3), and eight elemental components of PM2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330 064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO2 (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 μg/m3), PM2.5 (1.12, 0.92-1.36 per 5 μg/m3), and BC (1.15, 1.00-1.33 per 0.5 10−5/m) and liver cancer incidence. Associations with NO2 and BC persisted in two-pollutant models with PM2.5. Most components of PM2.5 were associated with the risk of liver cancer, with the strongest associations for sulfur and vanadium, which were robust to adjustment for PM2.5 or NO2. Our study suggests that ambient air pollution may increase the risk of liver cancer, even at concentrations below current EU standards.",

keywords = "air pollution, cohort study, liver cancer incidence, particulate matter",

author = "Rina So and Jie Chen and Mehta, {Amar J.} and Shuo Liu and Maciej Strak and Kathrin Wolf and Hvidtfeldt, {Ulla A.} and Sophia Rodopoulou and Massimo Stafoggia and Klompmaker, {Jochem O.} and Evangelia Samoli and Ole Raaschou-Nielsen and Richard Atkinson and Mariska Bauwelinck and Tom Bellander and Boutron-Ruault, {Marie Christine} and J{\o}rgen Brandt and Bert Brunekreef and Giulia Cesaroni and Hans Concin and Francesco Forastiere and {van Gils}, {Carla H.} and John Gulliver and Ole Hertel and Barbara Hoffmann and {de Hoogh}, Kees and Nicole Janssen and Lim, {Youn hee} and Rudi Westendorp and J{\o}rgensen, {Jeanette T.} and Klea Katsouyanni and Matthias Ketzel and Anton Lager and Alois Lang and Ljungman, {Petter L.} and Magnusson, {Patrik K.E.} and Gabriele Nagel and Simonsen, {Mette K.} and G{\"o}ran Pershagen and Peter, {Raphael S.} and Annette Peters and Matteo Renzi and Debora Rizzuto and Torben Sigsgaard and Danielle Vienneau and Gudrun Weinmayr and Gianluca Severi and Daniela Fecht and Anne Tj{\o}nneland and Karin Leander and Gerard Hoek and Andersen, {Zorana J.}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.",

year = "2021",

month = dec,

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doi = "10.1002/ijc.33743",

language = "English",

volume = "149",

pages = "1887--1897",

journal = "International Journal of Cancer",

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So, R, Chen, J, Mehta, AJ, Liu, S, Strak, M, Wolf, K, Hvidtfeldt, UA, Rodopoulou, S, Stafoggia, M, Klompmaker, JO, Samoli, E, Raaschou-Nielsen, O, Atkinson, R, Bauwelinck, M, Bellander, T, Boutron-Ruault, MC, Brandt, J, Brunekreef, B, Cesaroni, G, Concin, H, Forastiere, F, van Gils, CH, Gulliver, J, Hertel, O, Hoffmann, B, de Hoogh, K, Janssen, N, Lim, YH, Westendorp, R, Jørgensen, JT, Katsouyanni, K, Ketzel, M, Lager, A, Lang, A, Ljungman, PL, Magnusson, PKE, Nagel, G, Simonsen, MK, Pershagen, G, Peter, RS, Peters, A, Renzi, M, Rizzuto, D, Sigsgaard, T, Vienneau, D, Weinmayr, G, Severi, G, Fecht, D, Tjønneland, A, Leander, K, Hoek, G & Andersen, ZJ 2021, 'Long-term exposure to air pollution and liver cancer incidence in six European cohorts', International Journal of Cancer, vol. 149, no. 11, pp. 1887-1897. https://doi.org/10.1002/ijc.33743

TY - JOUR

T1 - Long-term exposure to air pollution and liver cancer incidence in six European cohorts

AU - So, Rina

AU - Chen, Jie

AU - Mehta, Amar J.

AU - Liu, Shuo

AU - Strak, Maciej

AU - Wolf, Kathrin

AU - Hvidtfeldt, Ulla A.

AU - Rodopoulou, Sophia

AU - Stafoggia, Massimo

AU - Klompmaker, Jochem O.

AU - Samoli, Evangelia

AU - Raaschou-Nielsen, Ole

AU - Atkinson, Richard

AU - Bauwelinck, Mariska

AU - Bellander, Tom

AU - Boutron-Ruault, Marie Christine

AU - Brandt, Jørgen

AU - Brunekreef, Bert

AU - Cesaroni, Giulia

AU - Concin, Hans

AU - Forastiere, Francesco

AU - van Gils, Carla H.

AU - Gulliver, John

AU - Hertel, Ole

AU - Hoffmann, Barbara

AU - de Hoogh, Kees

AU - Janssen, Nicole

AU - Lim, Youn hee

AU - Westendorp, Rudi

AU - Jørgensen, Jeanette T.

AU - Katsouyanni, Klea

AU - Ketzel, Matthias

AU - Lager, Anton

AU - Lang, Alois

AU - Ljungman, Petter L.

AU - Magnusson, Patrik K.E.

AU - Nagel, Gabriele

AU - Simonsen, Mette K.

AU - Pershagen, Göran

AU - Peter, Raphael S.

AU - Peters, Annette

AU - Renzi, Matteo

AU - Rizzuto, Debora

AU - Sigsgaard, Torben

AU - Vienneau, Danielle

AU - Weinmayr, Gudrun

AU - Severi, Gianluca

AU - Fecht, Daniela

AU - Tjønneland, Anne

AU - Leander, Karin

AU - Hoek, Gerard

AU - Andersen, Zorana J.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the “Effects of low-level air pollution: A study in Europe” (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015. The annual average exposure to nitrogen dioxide (NO2), particulate matter with diameter <2.5 μm (PM2.5), black carbon (BC), warm-season ozone (O3), and eight elemental components of PM2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330 064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO2 (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 μg/m3), PM2.5 (1.12, 0.92-1.36 per 5 μg/m3), and BC (1.15, 1.00-1.33 per 0.5 10−5/m) and liver cancer incidence. Associations with NO2 and BC persisted in two-pollutant models with PM2.5. Most components of PM2.5 were associated with the risk of liver cancer, with the strongest associations for sulfur and vanadium, which were robust to adjustment for PM2.5 or NO2. Our study suggests that ambient air pollution may increase the risk of liver cancer, even at concentrations below current EU standards.

AB - Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the “Effects of low-level air pollution: A study in Europe” (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015. The annual average exposure to nitrogen dioxide (NO2), particulate matter with diameter <2.5 μm (PM2.5), black carbon (BC), warm-season ozone (O3), and eight elemental components of PM2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330 064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO2 (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 μg/m3), PM2.5 (1.12, 0.92-1.36 per 5 μg/m3), and BC (1.15, 1.00-1.33 per 0.5 10−5/m) and liver cancer incidence. Associations with NO2 and BC persisted in two-pollutant models with PM2.5. Most components of PM2.5 were associated with the risk of liver cancer, with the strongest associations for sulfur and vanadium, which were robust to adjustment for PM2.5 or NO2. Our study suggests that ambient air pollution may increase the risk of liver cancer, even at concentrations below current EU standards.

KW - air pollution

KW - cohort study

KW - liver cancer incidence

KW - particulate matter

UR - http://www.scopus.com/inward/record.url?scp=85112352135&partnerID=8YFLogxK

U2 - 10.1002/ijc.33743

DO - 10.1002/ijc.33743

M3 - Article

C2 - 34278567

AN - SCOPUS:85112352135

SN - 0020-7136

VL - 149

SP - 1887

EP - 1897

JO - International Journal of Cancer

JF - International Journal of Cancer

IS - 11

ER -

Long-term exposure to air pollution and liver cancer incidence in six European cohorts

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