Long-term exposure to ambient air pollution and bladder cancer incidence in a pooled European cohort: the ELAPSE project

Jie Chen, Sophia Rodopoulou, Maciej Strak, Kees de Hoogh, Tahir Taj, Aslak Harbo Poulsen, Zorana J Andersen, Tom Bellander, Jørgen Brandt, Emanuel Zitt, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, W M Monique Verschuren, Jeanette T Jørgensen, Klea Katsouyanni, Matthias KetzelAnton Lager, Karin Leander, Shuo Liu, Petter Ljungman, Gianluca Severi, Marie-Christine Boutron-Ruault, Patrik K E Magnusson, Gabriele Nagel, Göran Pershagen, Annette Peters, Debora Rizzuto, Yvonne T van der Schouw, Evangelia Samoli, Mette Sørensen, Massimo Stafoggia, Anne Tjønneland, Gudrun Weinmayr, Kathrin Wolf, Bert Brunekreef, Ole Raaschou-Nielsen, Gerard Hoek

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: The evidence linking ambient air pollution to bladder cancer is limited and mixed.

METHODS: We assessed the associations of bladder cancer incidence with residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC), warm season ozone (O3) and eight PM2.5 elemental components (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) in a pooled cohort (N = 302,493). Exposures were primarily assessed based on 2010 measurements and back-extrapolated to the baseline years. We applied Cox proportional hazard models adjusting for individual- and area-level potential confounders.

RESULTS: During an average of 18.2 years follow-up, 967 bladder cancer cases occurred. We observed a positive though statistically non-significant association between PM2.5 and bladder cancer incidence. Hazard Ratios (HR) were 1.09 (95% confidence interval (CI): 0.93-1.27) per 5 µg/m3 for 2010 exposure and 1.06 (95% CI: 0.99-1.14) for baseline exposure. Effect estimates for NO2, BC and O3 were close to unity. A positive association was observed with PM2.5 zinc (HR 1.08; 95% CI: 1.00-1.16 per 10 ng/m3).

CONCLUSIONS: We found suggestive evidence of an association between long-term PM2.5 mass exposure and bladder cancer, strengthening the evidence from the few previous studies. The association with zinc in PM2.5 suggests the importance of industrial emissions.

Original languageEnglish
Pages (from-to)1499-1507
Number of pages9
JournalBritish Journal of Cancer
Issue number10
Early online date16 Feb 2022
Publication statusPublished - 1 Jun 2022


Dive into the research topics of 'Long-term exposure to ambient air pollution and bladder cancer incidence in a pooled European cohort: the ELAPSE project'. Together they form a unique fingerprint.

Cite this