Exposure to low-level ambient air pollution and the relationship with lung and bladder cancer in older men, in Perth, Western Australia

Background Air pollution is a cause of lung cancer and is associated with bladder cancer. However, the relationship between air pollution and these cancers in regions of low pollution is unclear. We investigated associations between fine particulate matter (PM 2.5 ), nitrogen dioxide, and black carbon (BC), and both these cancers in a low-pollution city. Methods A cohort of 11,679 men ≥65 years old in Perth (Western Australia) were followed from 1996–1999 until 2018. Pollutant concentrations, as a time-varying variable, were estimated at participants’ residential addresses using land use regression models. Incident lung and bladder cancer were identified through the Western Australian Cancer Registry. Risks were estimated using Cox proportional-hazard models (age as the timescale), adjusting for smoking, socioeconomic status, and co-pollutants. Results Lung cancer was associated with PM 2.5 and BC in the adjusted single-pollutant models. A weak positive association was observed between ambient air pollution and squamous cell lung carcinoma but not lung adenocarcinoma. Positive associations were observed with bladder cancer, although these were not statistically significant. Associations were attenuated in two-pollutant models. Conclusion Low-level ambient air pollution is associated with lung, and possibly bladder, cancer among older men, suggesting there is no known safe level for air pollution as a carcinogen.