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Cited by 141Air Quality and Health ImpactsUrban Green Space and HealthEnvironmental Justice and Health Disparities

Outdoor air pollution, green space, and cancer incidence in Saxony: a semi-individual cohort study

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Datzmann, Thomas, Markevych, Iana, Trautmann, Freya, Heinrich, Joachim, Schmitt, Jochen, Tesch, Falko·2018·BMC Public Health
DOI 10.1186/s12889-018-5615-2PMC PMC5994126
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Abstract

There are a few epidemiological studies that (1) link increased ambient air pollution (AP) with an increase in lung cancer incidence rates and (2) investigate whether residing in green spaces could be protective against cancer. However, it is completely unclear whether other forms of cancer are also affected by AP and if residential green spaces could lower cancer incidence rates in general. Therefore, the objective was to estimate whether AP and green space are associated with several cancer types. The analysis was based on routine health care data from around 1.9 million people from Saxony who were free of cancer in 2008 and 2009. Incident cancer cases (2010–2014) of mouth and throat, skin (non-melanoma skin cancer - NMSC), prostate, breast, and colorectum were defined as: (1) one inpatient diagnosis, or (2) two outpatient diagnoses in two different quarters within one year and a specific treatment or death within two quarters after the diagnosis. Exposures, derived from freely available 3rd party data, included particulate matter with aerodynamic diameter of less than 10 μm (PM 10 ) and nitrogen dioxide (N0 2 ) as well as green space (Normalized Difference Vegetation Index - NDVI). Associations between air pollutants, green space, and cancer incidence were assessed by multilevel Poisson models. Age, sex, physician contacts, short- and long-term unemployment, population density, and having an alcohol-related disorder were considered as potential confounders. Three thousand one hundred seven people developed mouth and throat cancer, 33,178 NMSC, 9611 prostate cancer, 9577 breast cancer, and 11,975 colorectal cancer during the follow-up period (2010–2014). An increase in PM 10 of 10 μg/m 3 was associated with a 53% increase in relative risk (RR) of mouth and throat cancer and a 52% increase in RR of NMSC. Prostate and breast cancer were modestly associated with PM 10 with an increase in RR of 23 and 19%, respectively. The associations with N0 2 were in the same direction as PM 10 but the effect estimates were much lower (7–24%). A 10% increase in NDVI was most protective of mouth and throat cancer (− 11% RR) and of NMSC (− 16% RR). Colorectal cancer was not affected by any of the exposures. In addition to the studies carried out so far, this study was able to provide evidence that higher ambient AP levels increase the risk of mouth and throat cancer as well as of NMSC and that a higher residential green space level might have a protective effect for NMSC in areas with low to moderate UV intensity. Nevertheless, we cannot rule out residual confounding by socioeconomic or smoking status.

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  • Non-melanoma skin cancer was excluded from the final synthesis because only one potential article on non-melanoma skin cancer and air pollution was identified.

    “As there was only one potential article on NMSC and AP [28], we decided to exclude NMSC from the final synthesis.”

    From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [28]

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Authors
Datzmann, T., Markevych, I., Trautmann, F., Heinrich, J., Schmitt, J., & Tesch, F.
Affiliations
  • Nationales Centrum für Tumorerkrankungen Dresden (DE)
  • Helmholtz Munich (DE)
  • Zentrum für Evidenzbasierte Gesundheitsversorgung (DE)
Corresponding author
Datzmann, Thomas
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2018-06-08
Volume
18
Issue
1
Pages
715-715
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-018-5615-2
PMC
PMC5994126
OpenAlex
W2806004084
Cited by
141
References
3
Citations by year
2026: 5 · 2025: 21 · 2024: 29 · 2023: 22 · 2022: 23 · 2021: 17 · 2020: 15 · 2019: 8 · 2018: 1
FWCI
5.06
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion, cc-by)
  • Site cant be reached (submittedVersion, cc-by)
  • PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
  • Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by)
Funders
  • Deutsche Forschungsgemeinschaft
  • Technische Universität Dresden
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
  • Social Sciences › Sociology and Political Science › Environmental Justice and Health Disparities
Keywords
ambient air pollution, green spaces, cancer incidence, PM10, nitrogen dioxide, NDVI, non-melanoma skin cancer, prostate cancer, breast cancer, colorectal cancer, Saxony, residential exposure, cancer risk factors, unemployment, population density, physician contact
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Air Pollution, Child, Child, Preschool, Female, Germany, Poaceae, Humans, Infant, Infant, Newborn, Male, Middle Aged, Neoplasms, Residence Characteristics, Trees, Cohort Studies, Incidence, Young Adult

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