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

Ulla Arthur Hvidtfeldt; Jie Chen; Sophia Rodopoulou; Maciej Strak; Kees de Hoogh; Zorana J Andersen; Tom Bellander; Jørgen Brandt; Francesco Forastiere; Boel Brynedal; Ole Hertel; Barbara Hoffmann; Klea Katsouyanni; Matthias Ketzel; Karin Leander; Patrik K E Magnusson; Gabriele Nagel; Göran Pershagen; Debora Rizzuto; Evangelia Samoli; Rina So; Massimo Stafoggia; Anne Tjønneland; Gudrun Weinmayr; Kathrin Wolf; Emanuel Zitt; Bert Brunekreef; Gerard Hoek; Ole Raaschou-Nielsen

doi:10.1016/j.envres.2023.117230

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.

Authors

Ulla Arthur Hvidtfeldt¹, Jie Chen², Sophia Rodopoulou³, Maciej Strak⁴, Kees de Hoogh⁵, Zorana J Andersen⁶, Tom Bellander⁷, Jørgen Brandt⁸, Francesco Forastiere⁹, Boel Brynedal¹⁰, Ole Hertel¹¹, Barbara Hoffmann¹², Klea Katsouyanni¹³, Matthias Ketzel¹⁴, Karin Leander⁷, Patrik K E Magnusson¹⁵, Gabriele Nagel¹⁶, Göran Pershagen⁷, Debora Rizzuto¹⁷, Evangelia Samoli³, Rina So¹⁸, Massimo Stafoggia¹⁹, Anne Tjønneland²⁰, Gudrun Weinmayr¹⁶, Kathrin Wolf²¹, Emanuel Zitt²², Bert Brunekreef², Gerard Hoek², Ole Raaschou-Nielsen²³

Affiliations

¹ The Danish Cancer Institute, Copenhagen, Denmark. Electronic address: ullah@cancer.dk.
² Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
³ Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁴ Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
⁵ Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
⁶ Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
⁷ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁸ Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark.
⁹ Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London, UK.
¹⁰ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
¹¹ Departments of Ecoscience, Aarhus University, Roskilde, Denmark.
¹² Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
¹³ Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
¹⁴ Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, GU2 7XH, United Kingdom.
¹⁵ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
¹⁶ Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
¹⁷ Department of Neurobiology, Care Sciences, And Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
¹⁸ Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
¹⁹ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy.
²⁰ The Danish Cancer Institute, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
²¹ Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
²² Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria.
²³ The Danish Cancer Institute, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark.

PMID: 37806476
DOI: 10.1016/j.envres.2023.117230

Abstract

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 (PM_2.5), 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 PM_2.5, 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

Substances

Air Pollutants
Nitrogen Dioxide
Particulate Matter