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The first cohort study in Europe has been published recently (Hoek et al, 2002). This has consisted in a Dutch cohort of 5000 adults followed during 7 years. Findings indicate an association between cardiopulmonary mortality and living near a major road (relative risk 1·95, 95% CI 1·09-3·52) and, less consistently, with the estimated ambient background concentration of black smoke (1·34, 0·68-2·64). Non-cardiopulmonary, non-lung cancer deaths were unrelated to air pollution (1·03, 0·54-1·96 for living near a major road). No clear association was found with other estimates of long term exposures.

Too few people died from respiratory disorders and lung cancer to obtain stable estimates for the indicator variable for living near a major road.