Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank
Bibliographic record
Abstract
Background and Aim: Air pollution is associated with lung function, and both are associated with premature mortality and cardiovascular disease (CVD). We performed mediation analysis to estimate the proportion of the relationship between air pollution and mortality or incident CVD explained by the association between air pollution and forced expiratory volume in 1 second (FEV1). Methods: We used data from the UK Biobank cohort (aged 40-69 years at baseline 2006-2010) with 8-year follow-up to mortality (N=208,998) and incident CVD (N=199,577). Exposures to PM10, PM2.5, and NO2 were assessed by land-use regression modelling to estimate exposures at baseline. Lung function (Forced Vital Capacity (FVC), FEV1) was measured by spirometry and transformed to Global Lung Function Initiative z-scores. Adjusted Cox proportional hazards and causal proportional hazards mediation analysis models were fitted, stratified by smoking status. Results: Long-term exposures to PM2.5 and NO2 (but not PM10) were associated with incident CVD, with similar effect sizes between ever-smokers and never-smokers (Hazard Ratio (HR) per IQR in ever-smokers, PM2.5: 1.05 [95%CI: 1.01, 1.09]; NO2: 1.04 [95%CI 1.00, 1.09]). PM2.5 was associated with CVD mortality in ever-smokers only (HR per IQR: 1.15 [95%CI: 1.02, 1.30]. Positive but non-significant associations were found with all-cause mortality. FEV1 and FVC were associated with all-cause, CVD mortality and incident CVD. Point estimates for the mortality outcomes were larger in ever-smokers than never-smokers. Mediated proportions of the air pollution—all-cause mortality estimates driven by FEV1 were 18% [95%CI: 2%-33%] for PM2.5, and 27% [95%CI: 3%-51%] for NO2. The estimated mediated proportions for air pollution—incident CVD were 9% [95%CI: 4%-13%] for PM2.5 and 16% [95%CI: 6%-25%] for NO2. Conclusions: Lower FEV1 may mediate the effect of PM2.5 and NO2 on mortality and incident CVD outcomes, with more pronounced effects for NO2 than for PM2.5. Keywords: air pollution; lung function; mortality; mediation analysis; cardiovascular;
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.070 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".