Associations between metal constituents of ambient particulate matter and mortality in England: An ecological study

Aurore Lavigne, Anna Freni Sterrantino, Silvia Liverani, Marta Blangiardo, Kees De Hoogh, John Molitor, Anna Hansell*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Objectives To investigate long-term associations between metal components of particulate matter (PM) and mortality and lung cancer incidence. Design Small area (ecological) study. Setting Population living in all wards (∼9000 individuals per ward) in the London and Oxford area of England, comprising 13.6 million individuals. Exposure and outcome measures We used land use regression models originally used in the Transport related Air Pollution and Health Impacts - Integrated Methodologies for Assessing Particulate Matter study to estimate exposure to copper, iron and zinc in ambient air PM. We examined associations of metal exposure with Office for National Statistics mortality data from cardiovascular disease (CVD) and respiratory causes and with lung cancer incidence during 2008-2011. Results There were 108 478 CVD deaths, 48 483 respiratory deaths and 24 849 incident cases of lung cancer in the study period and area. Using Poisson regression models adjusted for area-level deprivation, tobacco sales and ethnicity, we found associations between cardiovascular mortality and PM 2.5 copper with interdecile range (IDR 2.6-5.7 ng/m 3) and IDR relative risk (RR) 1.005 (95%CI 1.001 to 1.009) and between respiratory mortality and PM 10 zinc (IDR 1135-153 ng/m 3) and IDR RR 1.136 (95%CI 1.010 to 1.277). We did not find relevant associations for lung cancer incidence. Metal elements were highly correlated. Conclusion Our analysis showed small but not fully consistent adverse associations between mortality and particulate metal exposures likely derived from non-tailpipe road traffic emissions (brake and tyre wear), which have previously been associated with increases in inflammatory markers in the blood.

Original languageEnglish
Article numbere030140
JournalBMJ Open
Issue number12
Publication statusPublished - 3 Dec 2019
Externally publishedYes

Bibliographical note

Funding Information:
(MRC) (grant G09018401) and the Small Area Health Statistics Unit (SAHSU). The work of the UK SAHSU is funded by Public Health England as part of the MRC-Public Health England (PHE) Centre for Environment and Health, funded also by the UK Medical Research Council. The air pollution exposure assessments used in the research leading to these results were funded by the European Community’s Seventh Framework Program (FP7/2007-2011), European Study of Cohorts and Air Pollution Effects projects (grant agreement 211250) and Transport related Air Pollution and Health Impacts—Integrated Methodologies for Assessing Particulate Matter. The research was funded/part funded by the National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards at King’s College London in partnership with PHE and Imperial College London.

Funding Information:
Funding The research project was funded through Medical Research Council

Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.


  • Correlation
  • Environmental Epidemiology
  • Metals
  • Multipollutant effect
  • Particulate matter elements


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