PARTICULATE AIR-POLLUTION

Time-series, cross-sectional, and prospective cohort studies ha ve obs erved associations between mortality and particulate air pollution but have been limited by ecologic design or small numbers of subjects or study areas. The present study evaluates effects of particulate air po llution on mortality using data from a large cohort drawn from many st udy areas. We linked ambient air pollution data from 151 U.S. metropol itan areas in 1980 with individual risk factors on 552 138 adults who resided in these areas when enrolled in a prospective study in 1982. D eaths were ascertained through December, 1989. Exposure to sulfate and fine particulate air pollution, which is primarily from fossil fuel c ombustion, was estimated from national data bases. The relationships o f air pollution to all-cause, lung cancer, and cardiopulmonary mortali ty were examined using multivariate analysis which controlled for smok ing, education, and other risk factors. Although small compared with c igarette smoking, an association between mortality and particulate air pollution was observed Adjusted relative risk ratios (and 95% confide nce intervals) of all-cause mortality for the most polluted areas comp ared with the least polluted equaled 1.15 (1.09 to 1.22) and 1.17 (1.0 9 to 1.26) when using sulfate and fine particulate measures respective ly Particulate air pollution was associated with cardiopulmonary and l ung cancer mortality but not with mortality due to other causes. Incre ased mortality is associated with sulfate and fine particulate air pol lution at levels commonly found in U.S. cities. The increase in risk i s not attributable to tobacco smoking, although other unmeasured corre lates of pollution cannot be excluded with certainty.