Degree Name





Family, Home, and Social Sciences

Defense Date


Publication Date


First Faculty Advisor

C. Arden Pope III

First Faculty Reader

Ray Merrill

Honors Coordinator

John Stovall


PM2.5, cancer, mortality, air pollution, smoking



Purpose: Multiple studies have indicated that air pollution and smoking are associated with various types of mortality, including cancer. The current study utilizes a publicly accessible, nationally representative cohort to explore relationships between fine particulate matter (PM2.5) exposure, smoking, and cancer mortality.

Methods: National Health Interview Survey and mortality follow-up data were combined to create a study population of 635,539 individuals surveyed from 1987 to 2014. A sub-cohort of 341,665 never-smokers from the full cohort was also evaluated. Individuals were assigned modeled PM2.5 exposure. Cox proportional hazard models were utilized to estimate hazard ratios for cancer-specific mortality controlling for age, sex, race, smoking status, body mass, income, education, marital status, rural versus urban, region, and survey year.

Results: The risk of all cancer mortality was positively associated with PM2.5 (per 10 µg/m3 increase) in the full cohort (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08–1.22) and the never-smokers’ cohort (HR 1.19, 95% CI 1.06–1.33). PM2.5-morality associations were also observed for stomach, colorectal, liver, breast, cervix, and bladder, as well as Hodgkin lymphoma, non-Hodgkin lymphoma, and leukemia. After adjusting for multiple comparisons, however, only the PM2.5-morality association with lung cancer in the non-smoking cohort was statistically significant. Cigarette smoking was statistically associated with mortality from lung, oral and oropharyngeal, esophageal, colorectal, liver, bladder, laryngeal, leukemia and unspecified cancers, even with adjustment for multiple testing.

Conclusions: Exposure to PM2.5 air pollution likely contributes to lung cancer mortality and may be a risk factor for other cancer sites. Cigarette smoking has a much larger and statistically robust impact on cancer mortality than PM2.5 but is associated with similar cancer sites.


Included in

Economics Commons