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. 2009 Jan 22;360(4):376-86.
doi: 10.1056/NEJMsa0805646.

Fine-particulate air pollution and life expectancy in the United States

C Arden Pope 3rd  1 , Majid Ezzati, Douglas W Dockery
Affiliations

Fine-particulate air pollution and life expectancy in the United States

C Arden Pope 3rd et al. N Engl J Med. .

Abstract

Background: Exposure to fine-particulate air pollution has been associated with increased morbidity and mortality, suggesting that sustained reductions in pollution exposure should result in improved life expectancy. This study directly evaluated the changes in life expectancy associated with differential changes in fine particulate air pollution that occurred in the United States during the 1980s and 1990s.

Methods: We compiled data on life expectancy, socioeconomic status, and demographic characteristics for 211 county units in the 51 U.S. metropolitan areas with matching data on fine-particulate air pollution for the late 1970s and early 1980s and the late 1990s and early 2000s. Regression models were used to estimate the association between reductions in pollution and changes in life expectancy, with adjustment for changes in socioeconomic and demographic variables and in proxy indicators for the prevalence of cigarette smoking.

Results: A decrease of 10 microg per cubic meter in the concentration of fine particulate matter was associated with an estimated increase in mean (+/-SE) life expectancy of 0.61+/-0.20 year (P=0.004). The estimated effect of reduced exposure to pollution on life expectancy was not highly sensitive to adjustment for changes in socioeconomic, demographic, or proxy variables for the prevalence of smoking or to the restriction of observations to relatively large counties. Reductions in air pollution accounted for as much as 15% of the overall increase in life expectancy in the study areas.

Conclusions: A reduction in exposure to ambient fine-particulate air pollution contributed to significant and measurable improvements in life expectancy in the United States.

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Figures

Figure 1
Figure 1
Location of study areas. Study counties are shaded gray and dots represent approximate location of the following 51 number-coded metropolitan areas: 1. Akron, OH; 2. Albuquerque, NM; 3. Allentown, NY; 4. Atlanta, GA; 5. Boise, ID; 6. Boston, MA; 7. Buffalo, NY; 8. Charlotte, NC; 9. Charlotte, SC; 10. Chicago, IL; 11. Cincinnati, OH; 12. Cleveland, OH; 13. Dallas, TX; 14. Dayton, OH; 15. Denver, CO; 16. El Paso, TX; 17. Gary, IN; 18. Houston, TX; 19. Indianapolis, IN; 20. Jersey City, NJ; 21. Kansas City, MO; 22. Little Rock, AR; 23. Los Angeles, CA; 24. Minneapolis, MN; 25. New York, NY; 26. Norfolk, VA; 27. Oklahoma City, OK; 28. Philadelphia, PA; 29. Phoenix, AZ; 30. Pittsburg, PA; 31. Portland, OR; 32. Providence, RI; 33. Pueblo, CO; 34. Raleigh, NC; 35. Reno, NV; 36. St. Louis, MO; 37. San Diego, CA; 38. San Francisco, CA; 39. Salt Lake City, UT; 40. San Jose, CA; 41. Seattle, WA; 42. Spokane, WA; 43. Springfield, MA; 44. Steubenville, OH; 45. Tampa, FL; 46. Topeka, KS; 47. Washington, DC; 48. Wichita, KS; 49. Wilmington, DE; 50. Worcester, MA; 51. Youngstown, OH.
Figure 2
Figure 2
Cross-sectional life expectancies for 1978–1982 plotted over 1979–1983 PM2.5 concentrations. Dots and number-labeled circles represent county level and metro-level population-weighted mean life expectancies, respectively. Metropolitan area locations and number codes are presented in Figure 1. Solid and broken lines represent regression lines using county- and metro-level observations, respectively.
Figure 3
Figure 3
Cross-sectional life expectancies for 1997–2001 plotted over 1999–2000 PM2.5 concentrations. Dots and number-labeled circles represent county level and metro-level and population-weighted mean life expectancies, respectively. Metropolitan area locations and number codes are presented in Figure 1. Solid and broken lines represent regression lines using county- and metro-level observations, respectively.
Figure 4
Figure 4
Changes in life expectancies plotted over reductions in PM2.5 concentrations. Dots and number-labeled circles represent county level and metro-level and population-weighted mean life expectancies, respectively. Metropolitan area locations and number codes are presented in Figure 1. Solid and broken lines represent regression lines using county- and metro-level observations, respectively.
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References

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