{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:06:57Z","timestamp":1793171217926,"version":"4.5.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Center for Air, Climate, and Energy Solutions","award":["No. R835873"],"award-info":[{"award-number":["No. R835873"]}]},{"DOI":"10.13039\/100000139","name":"US Environmental Protection Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000139","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Exposure to fine particulate matter (PM2.5) air pollution has been linked to increased risk of mortality, especially cardiopulmonary and lung cancer mortality. It is unknown if cancer patients and survivors are especially vulnerable to PM2.5 air pollution exposure. This study evaluates PM2.5 exposure and risk for cancer and cardiopulmonary mortality in cohorts of US cancer patients and survivors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A primary cohort of 5\u00a0591\u00a0168 of cancer patients and a 5-year survivor cohort of 2\u00a0318\u00a0068 was constructed using Surveillance, Epidemiology, and End Results Program data from 2000 to 2016, linked with county-level estimates of long-term average concentrations of PM2.5. Cox proportional hazards models were used to estimate PM2.5-mortality hazard ratios controlling for age-sex-race combinations and individual and county-level covariables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of those who died, 26% died of noncancer causes, mostly from cardiopulmonary disease. Minimal PM2.5-mortality associations were observed for all-cause mortality (hazard ratio [HR] = 1.01, 95% confidence interval [CI] = 1.00 to 1.03) per 10\u2009\u00b5g\/m3 increase in PM2.5. Substantial adverse PM2.5-mortality associations were observed for cardiovascular (HR\u2009=\u20091.32, 95% CI = 1.26 to 1.39), chronic obstructive pulmonary disease (HR\u2009=\u20091.10, 95% CI = 1.01 to 1.20), influenza and pneumonia (HR\u2009=\u20091.55, 95% CI = 1.33 to 1.80), and cardiopulmonary mortality combined (HR\u2009=\u20091.25, 95% CI = 1.21 to 1.30). PM2.5-cardiopulmonary mortality hazard ratio was higher for cancer patients who received chemotherapy or radiation treatments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Air pollution is adversely associated with cardiopulmonary mortality for cancer patients and survivors, especially those who received chemotherapy or radiation treatment. Given ubiquitous and involuntary air pollution exposures and large numbers of cancer patients and survivors, these results are of substantial clinical and public health importance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jncics\/pkab001","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T17:48:24Z","timestamp":1609955304000},"source":"Crossref","is-referenced-by-count":53,"title":["Fine Particulate Matter Air Pollution and Mortality Risk Among US Cancer Patients and Survivors"],"prefix":"10.1093","volume":"5","author":[{"given":"Nathan C","family":"Coleman","sequence":"first","affiliation":[{"name":"Department of Economics, Brigham Young University, Provo, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Ezzati","sequence":"additional","affiliation":[{"name":"MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4087-1209","authenticated-orcid":false,"given":"Julian D","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen L","family":"Robinson","sequence":"additional","affiliation":[{"name":"Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard T","family":"Burnett","sequence":"additional","affiliation":[{"name":"Health Canada, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4239-6686","authenticated-orcid":false,"suffix":"III","given":"C Arden","family":"Pope","sequence":"additional","affiliation":[{"name":"Department of Economics, Brigham Young University, Provo, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,21]]},"reference":[{"issue":"21","key":"2021022209193307800_pkab001-B1","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1161\/CIR.0b013e3181dbece1","article-title":"Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association","volume":"121","author":"Brook","year":"2010","journal-title":"Circulation"},{"issue":"10119","key":"2021022209193307800_pkab001-B2","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/S0140-6736(17)32345-0","article-title":"The Lancet Commission on pollution and health","volume":"391","author":"Landrigan","year":"2018","journal-title":"Lancet"},{"issue":"10082","key":"2021022209193307800_pkab001-B3","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1016\/S0140-6736(17)30505-6","article-title":"Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015","volume":"389","author":"Cohen","year":"2017","journal-title":"Lancet"},{"issue":"10053","key":"2021022209193307800_pkab001-B4","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1016\/S0140-6736(16)31679-8","article-title":"Global, regional, and national comparative risk assessment of 79 behavioral, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"GBD 2015 Risk Factors Collaborators","year":"2016","journal-title":"Lancet"},{"issue":"38","key":"2021022209193307800_pkab001-B5","doi-asserted-by":"crossref","first-page":"9592","DOI":"10.1073\/pnas.1803222115","article-title":"Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter","volume":"115","author":"Burnett","year":"2018","journal-title":"Proc Natl Acad Sci USA"},{"issue":"39","key":"2021022209193307800_pkab001-B6","doi-asserted-by":"crossref","first-page":"10384","DOI":"10.1073\/pnas.1616784114","article-title":"New evidence on the impact of sustained exposure to air pollution on life expectancy from China\u2019s Huai River Policy","volume":"114","author":"Ebenstein","year":"2017","journal-title":"Proc Natl Acad Sci USA"},{"issue":"24","key":"2021022209193307800_pkab001-B7","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1056\/NEJM199312093292401","article-title":"An association between air pollution and mortality in six US cities","volume":"329","author":"Dockery","year":"1993","journal-title":"N Engl J Med"},{"issue":"1","key":"2021022209193307800_pkab001-B8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1161\/01.CIR.0000108927.80044.7F","article-title":"Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease","volume":"109","author":"Pope","year":"2004","journal-title":"Circulation"},{"issue":"9919","key":"2021022209193307800_pkab001-B9","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/S0140-6736(13)62158-3","article-title":"Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project","volume":"383","author":"Beelen","year":"2014","journal-title":"Lancet"},{"issue":"11","key":"2021022209193307800_pkab001-B10","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1289\/ehp.1409276","article-title":"Ambient PM2.5, O3, and NO2 exposures and associations with mortality over 16 years of follow-up in the Canadian Census Health and Environment Cohort (CanCHEC)","volume":"123","author":"Crouse","year":"2015","journal-title":"Environ Health Perspect"},{"issue":"26","key":"2021022209193307800_pkab001-B11","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1056\/NEJMoa1702747","article-title":"Air pollution and mortality in the Medicare population","volume":"376","author":"Di","year":"2017","journal-title":"N Engl J Med"},{"issue":"10","key":"2021022209193307800_pkab001-B12","doi-asserted-by":"crossref","first-page":"e470","DOI":"10.1016\/S2468-2667(18)30144-0","article-title":"All-cause mortality risk associated with long-term exposure to ambient PM2.5 in China: a cohort study","volume":"3","author":"Li","year":"2018","journal-title":"Lancet Public Health"},{"issue":"7","key":"2021022209193307800_pkab001-B13","doi-asserted-by":"crossref","first-page":"077007","DOI":"10.1289\/EHP4438","article-title":"Mortality risk and fine particulate air pollution in a large, representative cohort of US adults","volume":"127","author":"Pope","year":"2019","journal-title":"Environ Health Perspect"},{"key":"2021022209193307800_pkab001-B14","doi-asserted-by":"crossref","first-page":"108924","DOI":"10.1016\/j.envres.2019.108924","article-title":"Fine particulate air pollution and human mortality: 25+ years of cohort studies","volume":"183","author":"Pope","year":"2020","journal-title":"Environ Res"},{"issue":"8","key":"2021022209193307800_pkab001-B15","doi-asserted-by":"crossref","first-page":"087013","DOI":"10.1289\/EHP1249","article-title":"Ambient air pollution and cancer mortality in the cancer prevention study II","volume":"125","author":"Turner","year":"2017","journal-title":"Environ Health Perspect"},{"issue":"1","key":"2021022209193307800_pkab001-B16","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/1476-069X-10-67","article-title":"Air pollution from traffic and cancer incidence: a Danish cohort study","volume":"10","author":"Raaschou-Nielsen","year":"2011","journal-title":"Environ Health"},{"issue":"5","key":"2021022209193307800_pkab001-B17","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1158\/1055-9965.EPI-15-0626","article-title":"Cancer mortality risks from long-term exposure to ambient fine particle","volume":"25","author":"Wong","year":"2016","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"3","key":"2021022209193307800_pkab001-B18","doi-asserted-by":"crossref","DOI":"10.1093\/jnci\/djv341","article-title":"Fine particle pollution, alanine transaminase, and liver cancer: A Taiwanese prospective cohort study (REVEAL-HBV)","volume":"108","author":"Pan","year":"2016","journal-title":"J Natl Cancer Inst"},{"issue":"1","key":"2021022209193307800_pkab001-B19","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1136\/jim-2016-000263","article-title":"Association between fine particulate matter and oral cancer among Taiwanese men","volume":"67","author":"Chu","year":"2019","journal-title":"J Investig Med"},{"issue":"4","key":"2021022209193307800_pkab001-B20","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1158\/1055-9965.EPI-18-0803","article-title":"Particulate Matter and Traffic-Related Exposures in Relation to Breast Cancer Survival","volume":"28","author":"DuPr\u00e9","year":"2019","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"8","key":"2021022209193307800_pkab001-B21","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s10552-020-01317-w","article-title":"Cancer mortality risk, fine particulate air pollution, and smoking in a large representative cohort of US adults","volume":"31","author":"Coleman","year":"2020","journal-title":"Cancer Causes Control"},{"issue":"24","key":"2021022209193307800_pkab001-B22","doi-asserted-by":"crossref","first-page":"3026","DOI":"10.1016\/j.jacc.2019.09.066","article-title":"Ambient air pollution and mortality after cardiac transplantation","volume":"74","author":"Al-Kindi","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"2021022209193307800_pkab001-B23","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1164\/rccm.200306-779OC","article-title":"Effect of ambient air pollution on pulmonary exacerbations and lung function in cystic fibrosis","volume":"169","author":"Goss","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"issue":"9","key":"2021022209193307800_pkab001-B24","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1289\/EHP185","article-title":"Ambient fine particulate matter and mortality among survivors of myocardial infarction: population-based cohort study","volume":"124","author":"Chen","year":"2016","journal-title":"Environ Health Perspect"},{"key":"2021022209193307800_pkab001-B25","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/j.scitotenv.2016.12.128","article-title":"Long-term exposure to ambient air pollution and mortality in a Chinese tuberculosis cohort","volume":"580","author":"Peng","year":"2017","journal-title":"Sci Total Environ"},{"issue":"10203","key":"2021022209193307800_pkab001-B26","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/S0140-6736(19)31674-5","article-title":"Medium and long-term risks of specific cardiovascular diseases in survivors of 20 adult cancers: a population-based cohort study using multiple linked UK electronic health records databases","volume":"394","author":"Strongman","year":"2019","journal-title":"Lancet"},{"issue":"1","key":"2021022209193307800_pkab001-B27","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/jnci\/djp440","article-title":"Cardiotoxicity of anticancer drugs: the need for cardio-oncology and cardio-oncological prevention","volume":"102","author":"Albini","year":"2010","journal-title":"J Natl Cancer Inst"},{"issue":"10","key":"2021022209193307800_pkab001-B28","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1136\/thoraxjnl-2015-207927","article-title":"Air pollution affects lung cancer survival","volume":"71","author":"Eckel","year":"2016","journal-title":"Thorax"},{"key":"2021022209193307800_pkab001-B29","author":"National Cancer Institute"},{"key":"2021022209193307800_pkab001-B30","author":"Surveillance, Epidemiology, and End Results (SEER) Program","year":"2018"},{"key":"2021022209193307800_pkab001-B31","author":"Surveillance, Epidemiology, and End Results (SEER) Program","year":"2019"},{"issue":"2","key":"2021022209193307800_pkab001-B32","doi-asserted-by":"crossref","first-page":"e0228535","DOI":"10.1371\/journal.pone.0228535","article-title":"Concentrations of criteria pollutants in the contiguous U.S., 1979 - 2015: role of model parsimony in integrated empirical geographic regression","volume":"15","author":"Kim","year":"2020","journal-title":"PLoS One"},{"key":"2021022209193307800_pkab001-B33","author":"National Cancer Institute","year":"2019"},{"key":"2021022209193307800_pkab001-B34","author":"National Cancer Institute","year":"2017"},{"issue":"6","key":"2021022209193307800_pkab001-B35","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.2105\/AJPH.2014.302313","article-title":"Drinking patterns in US counties from 2002 to 2012","volume":"105","author":"Dwyer-Lindgren","year":"2015","journal-title":"Am J Public Health"},{"issue":"1","key":"2021022209193307800_pkab001-B36","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1478-7954-11-7","article-title":"Prevalence of physical activity and obesity in US counties, 2001-2011: a road map for action","volume":"11","author":"Dwyer-Lindgren","year":"2013","journal-title":"Popul Health Metrics"},{"issue":"2","key":"2021022209193307800_pkab001-B37","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s11869-011-0140-9","article-title":"Confounding and exposure measurement error in air pollution epidemiology","volume":"5","author":"Sheppard","year":"2012","journal-title":"Air Qual Atmos Health"},{"issue":"1","key":"2021022209193307800_pkab001-B38","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/s12940-019-0544-9","article-title":"Air pollution and mortality in a large, representative US cohort: multiple-pollutant analyses, and spatial and temporal decompositions","volume":"18","author":"Lefler","year":"2019","journal-title":"Environ Health"},{"issue":"9","key":"2021022209193307800_pkab001-B39","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.1097\/MLR.0000000000000073","article-title":"Comparison of SEER treatment data with Medicare claims","volume":"54","author":"Noone","year":"2016","journal-title":"Med Care"},{"issue":"6","key":"2021022209193307800_pkab001-B40","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.3390\/ijerph16061081","article-title":"Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers","volume":"16","author":"Ou","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"6","key":"2021022209193307800_pkab001-B41","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1164\/rccm.201709-1883OC","article-title":"Short-term elevation of fine particulate matter air pollution and acute lower respiratory infection","volume":"198","author":"Horne","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2021022209193307800_pkab001-B42","doi-asserted-by":"crossref","DOI":"10.1093\/biostatistics\/kxaa002","article-title":"Bias due to Berksen error: Issues when using predicted values in place of observed covariates","author":"Haber","year":"2020","journal-title":"Biostatistics"}],"container-title":["JNCI Cancer Spectrum"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jncics\/advance-article-pdf\/doi\/10.1093\/jncics\/pkab001\/36163662\/pkab001.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jncics\/article-pdf\/5\/1\/pkab001\/36332398\/pkab001.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jncics\/article-pdf\/5\/1\/pkab001\/36332398\/pkab001.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T09:36:36Z","timestamp":1613986596000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jncics\/article\/doi\/10.1093\/jncics\/pkab001\/6125366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,5]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1,5]]}},"URL":"https:\/\/doi.org\/10.1093\/jncics\/pkab001","relation":{},"ISSN":["2515-5091"],"issn-type":[{"value":"2515-5091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2]]},"published":{"date-parts":[[2021,1,5]]},"article-number":"pkab001"}}