Outdoor air pollution and risk of incident adult haematologic cancer subtypes in a large US prospective cohort

Q: Which air pollutants were analyzed in this study?

The study examined residential estimates of PM2.5, PM10, PM10-2.5, ozone, nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO).

Q: How were cancer risks quantified?

Hazard ratios (HRs) with 95% confidence intervals were estimated for associations between time-varying pollutant levels and haematologic cancer subtypes.

Q: What do the results suggest about different cancer subtypes?

Associations were subtype-specific: higher PM10-2.5 related to mantle cell lymphoma, NO2 related to Hodgkin lymphoma and marginal zone lymphoma, and CO related to marginal zone and T-cell lymphomas, indicating heterogeneity.

Sep 21, 2026

Uploaded by Maeve

Outdoor air pollution and particulate matter (PM) are classified as Group 1 human carcinogens for lung cancer, yet evidence linking specific adult haematologic cancer subtypes to ambient pollutants remains limited and inconsistent. This study uses the American Cancer Society Cancer Prevention Study-II Nutrition Cohort to evaluate associations between residential air pollutant estimates and incident haematologic cancer subtypes. Higher PM10-2.5, NO2, and CO show subtype-specific hazard ratio elevations, highlighting heterogeneity and potentially underestimated effects.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Background

Study population

Methods

Exposure assessment and outcome estimation

Results

Subtype-specific associations

Conclusions

British Journal of Cancer [www.nature.com/bjc](www.nature.com/bjc) ARTICLE OPEN Epidemiology Outdoor air pollution and risk of incident adult haematologic cancer subtypes in a large US prospective cohort W. Ryan Diver 1,2,3 ✉, Lauren R. Teras 3, Emily L. Deubler3 and Michelle C. Turner 1,2,4 © The Author(s) 2024 | | BACKGROUND: Outdoor air pollution and particulate matter (PM) are classiﬁed as Group 1 human carcinogens for lung cancer. Pollutant associations with haematologic cancers are suggestive, but these cancers are aetiologically heterogeneous and sub-type examinations are lacking.
METHODS: The American Cancer Society Cancer Prevention Study-II Nutrition Cohort was used to examine associations of outdoor air pollutants with adult haematologic cancers. Census block group level annual predictions of particulate matter (PM2.5, PM10, PM10-2.5), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), and carbon monoxide (CO) were assigned with residential addresses. Hazard ratios (HR) and 95% conﬁdence intervals (CI) between time-varying pollutants and haematologic subtypes were estimated.
RESULTS: Among 108,002 participants, 2659 incident haematologic cancers were identiﬁed from 1992–2017 . Higher PM10-2.5 concentrations were associated with mantle cell lymphoma (HR per 4 .1 μg/m3 = 1.43, 95% CI 1 .08–1.90) . NO2 was associated with Hodgkin lymphoma (HR per 7.2 ppb = 1.39; 95% CI 1.01–1.92) and marginal zone lymphoma (HR per 7.2 ppb = 1.30; 95% CI 1.01–1.67) . CO was associated with marginal zone (HR per 0.21 ppm = 1.30; 95% CI 1.04–1.62) and T-cell (HR per 0.21 ppm = 1.27; 95% CI 1.00–1.61) lymphomas.
CONCLUSIONS: The role of air pollutants on haematologic cancers may have been underestimated previously because of sub-type | | | --- | --- | --- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | heterogeneity. | | | | | British Journal of Cancer (2024) 131:149–158; [https://doi.org/10.1038/s41416-024-02718-3](https://doi.org/10.1038/s41416-024-02718-3) | | | | | | BACKGROUND Ambient air pollution is an established risk factor for multiple diseases and has been recognised as a Group 1 human carcinogen by the International Agency for Research on Cancer (IARC) since 2013 [1] . The primary evidence for carcinogenicity was from studies of lung cancer. Evidence for an association with haematological malignancies was insufﬁcient with mixed results in studies of leukaemias and lymphomas combined and there were a limited number of informative studies for the evaluation. Studies of ambient air pollution in adults have not consistently identiﬁed positive relationships with haematologic cancers. A recent prospective study based on US National Health Interview Survey data reported signiﬁcant positive associations of average residential census tract PM2.5 (ﬁne particulate matter; <2.5 μm in diameter) and Hodgkin lymphoma, non-Hodgkin lymphoma (NHL), and leukaemia mortality [2] . However, ﬁndings from other large-scale prospective cohort studies of mortality in the US [3] and Denmark [4] have not reported evidence for associations with PM2.5 or other ambient air pollutants. However, a recent pooled study of low-level air pollution in Europe showed associations of NO2 with leukaemia and PM2.5 with lymphoma [5] . Findings from case-control studies [6–8] have been equally inconsistent though some positive associations were reported among sub-populations. A major limitation of prior studies is the lack of research on detailed subtypes of haematologic cancers. It is well established that they are a heterogeneous group of diseases which often have distinct risk factors [9]. For example, research on cigarette smoking [9–12] and secondhand smoke [13, 14] has identiﬁed associations with Hodgkin lymphoma, peripheral T-cell lymphoma, follicular lymphoma, marginal zone lymphoma, and acute myeloid leukaemia, while obs

FAQs

Which air pollutants were analyzed in this study?

The study examined residential estimates of PM2.5, PM10, PM10-2.5, ozone, nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO).

How were cancer risks quantified?

Hazard ratios (HRs) with 95% confidence intervals were estimated for associations between time-varying pollutant levels and haematologic cancer subtypes.

What do the results suggest about different cancer subtypes?

Associations were subtype-specific: higher PM10-2.5 related to mantle cell lymphoma, NO2 related to Hodgkin lymphoma and marginal zone lymphoma, and CO related to marginal zone and T-cell lymphomas, indicating heterogeneity.

Sep 21, 2026

Uploaded by Maeve