Long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in 15 European cohorts within the ESCAPE project

Research output: Contribution to journalArticle


BACKGROUND: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) ≤2:5 μm, ≤10 μm, and 2:5–10 μm in diameter (PM2:5, PM10, and PMcoarse, respectively); PM2:5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2:5 {hazard ratio (HR) =1:08 [95% confidence interval (CI): 0.77, 1.51] per 5 μg/m3 }, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 μg/m3 ], PMcoarse [1.20 (95% CI: 0.96, 1.49 per 5 μg/m3 ], and NO2 [1.02 (95% CI: 0.98, 1.07 per 10 μg/m3 ], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 μg/m3, p =0:04]. CONCLUSIONS: We found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women.


  • Zorana J. Andersen
  • Massimo Stafoggia
  • Gudrun Weinmayr
  • Marie Pedersen
  • Claudia Galassi
  • Jeanette T. Jørgensen
  • Bertil Forsberg
  • David Olsson
  • Bente Oftedal
  • Gunn Marit Aasvang
  • Geir Aamodt
  • Andrei Pyko
  • Göran Pershagen
  • Michal Korek
  • Ulf de Faire
  • Nancy L. Pedersen
  • Claes Göran Östenson
  • Laura Fratiglioni
  • Kirsten T. Eriksen
  • Anne Tjønneland
  • Petra H. Peeters
  • Bas Bueno-De-Mesquita
  • Michelle Plusquin
  • Timothy J. Key
  • Andrea Jaensch
  • Gabriele Nagel
  • Alois Lang
  • Meng Wang
  • Ming Yi Tsai
  • Agnes Fournier
  • Marie Christine Boutron-Ruault
  • Laura Baglietto
  • Sara Grioni
  • Alessandro Marcon
  • Vittorio Krogh
  • Fulvio Ricceri
  • Carlotta Sacerdote
  • Enrica Migliore
  • Ibon Tamayo-Uria
  • Pilar Amiano
  • Miren Dorronsoro
  • Roel Vermeulen
  • Ranjeet Sokhi
  • Menno Keuken
  • Kees de Hoogh
  • Rob Beelen
  • Paolo Vineis
  • Giulia Cesaroni
  • Bert Brunekreef
  • Gerard Hoek
  • Ole Raaschou-Nielsen
External organisations
  • University of Copenhagen
  • Karolinska Institutet
  • University of Ulm
  • Danish Cancer Society Research Center
  • Citta' della Salute e della Scienza Hospital-University of Turin
  • Umeå University
  • Norwegian Institute of Public Health
  • University Medical Center Utrecht
  • Imperial College London
  • University of Malaya
  • University of Oxford
  • University of Washington
  • Swiss Tropical and Public Health Institute (Swiss TPH)
  • University of Basel
  • University of Paris-Saclay
  • Institut Gustave Roussy
  • Istituto Nazionale dei Tumori
  • University of Verona
  • Regional Health Service ASL TO3
  • ISGlobal Instituto de Salud Global de Barcelona
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Pompeu Fabra University
  • Utrecht University
  • University of Hertfordshire
  • Netherlands Organisation for Applied Scientific Research (Utrecht)
  • National Institute for Public Health and the Environment (RIVM)
  • Human Genetics Foundation
  • Aarhus University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Environmental Health and Occupational Health
Original languageEnglish
Article number107005
JournalEnvironmental Health Perspectives
Issue number10
StatePublished - 2017 Oct 1
Publication categoryResearch