Multiple myeloma risk in relation to long-term air pollution exposure - A pooled analysis of four European cohorts

Environ Res. 2023 Dec 15;239(Pt 1):117230. doi: 10.1016/j.envres.2023.117230. Epub 2023 Oct 6.


Background: Air pollution is a growing concern worldwide, with significant impacts on human health. Multiple myeloma is a type of blood cancer with increasing incidence. Studies have linked air pollution exposure to various types of cancer, including leukemia and lymphoma, however, the relationship with multiple myeloma incidence has not been extensively investigated.

Methods: We pooled four European cohorts (N = 234,803) and assessed the association between residential exposure to nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), and ozone (O3) and multiple myeloma. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level.

Results: During 4,415,817 person-years of follow-up (average 18.8 years), we observed 404 cases of multiple myeloma. The results of the fully adjusted linear analyses showed hazard ratios (95% confidence interval) of 0.99 (0.84, 1.16) per 10 μg/m³ NO2, 1.04 (0.82, 1.33) per 5 μg/m³ PM2.5, 0.99 (0.84, 1.18) per 0.5 10-5 m-1 BCE, and 1.11 (0.87, 1.41) per 10 μg/m³ O3.

Conclusions: We did not observe an association between long-term ambient air pollution exposure and incidence of multiple myeloma.

Keywords: Air pollution; Multiple myeloma; Nitrogen dioxide; Ozone; Particulate matter.

MeSH terms

  • Air Pollutants* / analysis
  • Air Pollutants* / toxicity
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Cohort Studies
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Humans
  • Multiple Myeloma* / chemically induced
  • Multiple Myeloma* / epidemiology
  • Nitrogen Dioxide / analysis
  • Nitrogen Dioxide / toxicity
  • Particulate Matter / analysis


  • Air Pollutants
  • Nitrogen Dioxide
  • Particulate Matter