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Associations of long-term exposure to nitrogen oxides with all-cause and cause-specific mortality

Author

Listed:
  • Siru Yang

    (The First Affiliated Hospital of Guangzhou Medical University
    Guangzhou Medical University)

  • Mengmeng Li

    (Sun Yat-sen University Cancer Center)

  • Cui Guo

    (the University of Hong Kong)

  • Weeberb J. Requia

    (Fundação Getúlio Vargas)

  • Mohammad Javad Zare Sakhvidi

    (Yazd Medical University)

  • Kaili Lin

    (Guangzhou Medical University)

  • Qiongyu Zhu

    (Guangzhou Medical University)

  • Zhaoyue Chen

    (ISGLOBAL)

  • Peihua Cao

    (Southern Medical University
    Southern Medical University)

  • Lei Yang

    (Guangzhou Medical University)

  • Dan Luo

    (Guangzhou Medical University)

  • Jun Yang

    (The First Affiliated Hospital of Guangzhou Medical University
    Guangzhou Medical University)

Abstract

Associations between long-term exposure to nitrogen oxides (NOx) and cause-specific mortality remain insufficiently explored. This study utilizes data from 502,040 participants registered in the UK Biobank. Time-varying Cox regression is used to estimate mortality risks associated with NOx. Cause-specific mortality risks, including non-accidental, accidental and 15 major disease categories across 103 subcategories, are assessed for each 10 μg/m3 increase in NOx. Positive associations are observed between NOx and mortality from all-cause (HR: 1.036; 95% CI: 1.024, 1.049) and non-accidental diseases (HR: 1.032; 95% CI: 1.019, 1.045). We further identify 20 specific diseases related to NOx, notably respiratory diseases, mental and behavioral disorders, and circulatory diseases, with generally linear exposure-response relationships. Sex and residential areas are potential modifiers of the observed associations. Our findings suggest long-term exposure to NOx may increase mortality risks from a range of diseases, emphasizing the urgent need for clean air policies to alleviate the health burden.

Suggested Citation

  • Siru Yang & Mengmeng Li & Cui Guo & Weeberb J. Requia & Mohammad Javad Zare Sakhvidi & Kaili Lin & Qiongyu Zhu & Zhaoyue Chen & Peihua Cao & Lei Yang & Dan Luo & Jun Yang, 2025. "Associations of long-term exposure to nitrogen oxides with all-cause and cause-specific mortality," Nature Communications, Nature, vol. 16(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-56963-y
    DOI: 10.1038/s41467-025-56963-y
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    References listed on IDEAS

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    1. Cathie Sudlow & John Gallacher & Naomi Allen & Valerie Beral & Paul Burton & John Danesh & Paul Downey & Paul Elliott & Jane Green & Martin Landray & Bette Liu & Paul Matthews & Giok Ong & Jill Pell &, 2015. "UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age," PLOS Medicine, Public Library of Science, vol. 12(3), pages 1-10, March.
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