Relationship of leukaemias with long-term ambient air pollution exposures in the adult Danish population



Few population-based epidemiological studies of adults have examined the relationship between air pollution and leukaemias.


Using Danish National Cancer Registry data and Danish DEHM-UBM-AirGIS system-modelled air pollution exposures, we examined whether particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2) and ozone (O3) averaged over 1, 5 or 10 years were associated with adult leukaemia in general or by subtype. In all, 14,986 adult cases diagnosed 1989–2014 and 51,624 age, sex and time-matched controls were included. Separate conditional logistic regression models, adjusted for socio-demographic factors, assessed exposure to each pollutant with leukaemias.


Fully adjusted models showed a higher risk of leukaemia with higher 1-, 5- and 10-year-average exposures to PM2.5 prior to diagnosis (e.g. OR per 10 µg/m3 for 10-year average: 1.17, 95% CI: 1.03, 1.32), and a positive relationship with 1-year average BC. Results were driven by participants 70 years and older (OR per 10 µg/m3 for 10-year average: 1.35, 95% CI: 1.15–1.58). Null findings for younger participants. Higher 1-year average PM2.5 exposures were associated with higher risks for acute myeloid and chronic lymphoblastic leukaemia.


Among older adults, higher risk for leukaemia was associated with higher residential PM2.5 concentrations averaged over 1, 5 and 10 years prior to diagnosis.

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Author information




R.C.P. contributed to study conceptualisation, analysis, methodology and writing. A.H.P. contributed to study conceptualisation, analysis, methodology and writing. T.T. contributed to validation, review and editing. M.K., C.G., J.B. and J.C. contributed to methodology, data curation, validation, review and editing. M.S. contributed to study conceptualisation, methodology and review and editing. N.R. and U.H. contributed to methodology, data curation, review and editing. O.R.N. contributed to study conceptualisation, methodology, funding and writing.

Corresponding author

Correspondence to Robin C. Puett.

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This study is entirely register-based, involved no contact with members of the study population and published results does not allow identification of individuals. The analyses were undertaken in the secure IT environment of Statistics Denmark from where no individual level data can be retrieved. According to Danish legislation, no ethical approval of such a study is required. The study complied with the regulations of the Danish Data Protection Agency and EU (GDPR).

Data availability

Data are located at the secure IT environment at Statistics Denmark. Access to the data of Statistics Denmark can be obtained if approved by Statics Denmark. Requirements include compliance with the EU General Data Protection Regulation and the Danish Data Protection Act.

Competing interests

The authors declare no competing interest.

Funding information

The research was funded by Nordforsk under the Nordic Programme on Health and Welfare (Project #75007: NordicWelfAir - Understanding the link between Air pollution and Distribution of related Health Impacts and Welfare in the Nordic countries). The funding source had no involvement in the study design, collection, analysis, interpretation, writing and decision to submit for publication. NORDFORSK is a research funding organisation under the Nordic governments.

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Puett, R.C., Poulsen, A.H., Taj, T. et al. Relationship of leukaemias with long-term ambient air pollution exposures in the adult Danish population. Br J Cancer (2020). https://doi.org/10.1038/s41416-020-01058-2

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