Air Quality Guidelines Global Update 2005 - World Health ...

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AIR QUALITY GUIDELINES
Table 4. Long-term effects of nitrogen dioxide: cancer risks in selected studies
Reference Area, population,
period
Feychting, Svensson &
Ahlbom (184)
Nyberg et al. (185)
Raashou-Nielsen et al.
(186)
Filleul et al. (187)
Hoek et al. (188)
Pope et al. (189)
142 patients with childhood cancer
and 550 controls
1042 patients with lung cancer
and 2364 controls aged 40–75
years, Stockholm County, Sweden,
1950–1990
1989 children with leukaemia,
tumour of the central nervous
system or malignant lymphoma and
5506 control children, Denmark,
1968–1991
14 284 adults recruited in 24 areas
of 7 French cities (1974–1976), 25year
mortality follow-up based on
death certificates
5000 adults in the Netherlands
aged 55–69 years, 8-year follow-up,
1986–1994
Approximately 409 000 to 493 000
adults in the United States from
78 metropolitan areas (nitrogen
dioxide data as of 1980) or from
101 metropolitan areas (nitrogen
dioxide data as of 1982–1998)
Outcome
Cancer (risk ratio)
Lung cancer (risk ratio)
Leukaemia, tumour of the
central nervous system or
malignant lymphoma (risk ratio)
Lung cancer mortality (hazard
ratio)
Lung cancer mortality (hazard
ratio)
Lung cancer mortality (relative
risk)
these studies, owing to the fact that (a) by design, area-specific estimates neglect
the (often high) spatial variability of nitrogen dioxide within the area (city or residential
area) and (b) these estimates only capture part of the individual exposure,
disregarding contributions from transport, work/school, domestic appliances,
hobbies, etc. In addition, studies of spatial variability are faced with the potential
for uncontrolled confounding by other variables, which include risk factors of the
considered diseases and in particular other traffic-related pollutants. Tables 3–5
list the results of selected studies on the long-term effects of nitrogen dioxide.