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However, there remains uncertainty regarding the contribution of co-pollutants and the stability of pollution-mortality associations in models that include multiple air pollutants. Furthermore, it is unclear whether the PM<jats:sub>2.5<\/jats:sub>-mortality relationship varies spatially, when exposures are decomposed according to scale of spatial variability, or temporally, when effect estimates are allowed to change between years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cohort of 635,539 individuals was compiled using public National Health Interview Survey (NHIS) data from 1987 to 2014 and linked with mortality follow-up through 2015. Modelled air pollution exposure estimates for PM<jats:sub>2.5<\/jats:sub>, other criteria air pollutants, and spatial decompositions (&lt;\u20091\u2009km, 1\u201310\u2009km, 10\u2013100\u2009km, &gt;\u2009100\u2009km) of PM<jats:sub>2.5<\/jats:sub> were assigned at the census-tract level. The NHIS samples were also divided into yearly cohorts for temporally-decomposed analyses. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) in regression models that included up to six criteria pollutants; four spatial decompositions of PM<jats:sub>2.5<\/jats:sub>; and two- and five-year lagged mean PM<jats:sub>2.5<\/jats:sub> exposures in the temporally-decomposed cohorts. Meta-analytic fixed-effect estimates were calculated using results from temporally-decomposed analyses and compared with time-independent results using 17- and 28-year exposure windows.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In multiple-pollutant analyses, PM<jats:sub>2.5<\/jats:sub> demonstrated the most robust pollutant-mortality association. Coarse fraction particulate matter (PM<jats:sub>2.5\u201310<\/jats:sub>) and sulfur dioxide (SO<jats:sub>2<\/jats:sub>) were also associated with excess mortality risk. The PM<jats:sub>2.5<\/jats:sub>-mortality association was observed across all four spatial scales of PM<jats:sub>2.5<\/jats:sub>, with higher but less precisely estimated HRs observed for local (&lt;\u20091\u2009km) and neighborhood (1\u201310\u2009km) variations. In temporally-decomposed analyses, the PM<jats:sub>2.5<\/jats:sub>-mortality HRs were stable across yearly cohorts. The meta-analytic HR using two-year lagged PM<jats:sub>2.5<\/jats:sub> equaled 1.10 (95% CI 1.07, 1.13) per 10\u2009\u03bcg\/m<jats:sup>3<\/jats:sup>. Comparable results were observed in time-independent analyses using a 17-year (HR 1.13, CI 1.09, 1.16) or 28-year (HR 1.09, CI 1.07, 1.12) exposure window.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Long-term exposures to PM<jats:sub>2.5<\/jats:sub>, PM<jats:sub>2.5\u201310<\/jats:sub>, and SO<jats:sub>2<\/jats:sub> were associated with increased risk of all-cause and cardiopulmonary mortality. Each spatial decomposition of PM<jats:sub>2.5<\/jats:sub> was associated with mortality risk, and PM<jats:sub>2.5<\/jats:sub>-mortality associations were consistent over time.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12940-019-0544-9","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T16:03:17Z","timestamp":1574352197000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Air pollution and mortality in a large, representative U.S. cohort: multiple-pollutant analyses, and spatial and temporal decompositions"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5637-5379","authenticated-orcid":false,"given":"Jacob S.","family":"Lefler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Higbee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard T.","family":"Burnett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Ezzati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan C.","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalton D.","family":"Mann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian D.","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Bechle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhou","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen L.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"C.","family":"Arden Pope","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,21]]},"reference":[{"issue":"24","key":"544_CR1","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1056\/NEJM199312093292401","volume":"329","author":"DW Dockery","year":"1993","unstructured":"Dockery DW, Pope CA, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG Jr, Speizer FE. 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The research reported in this manuscript uses public data that are de-identified and not subject to federal regulations on protection of human research subjects.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare they have no actual or potential competing financial interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"101"}}