Impacts of Transportation Emissions on the Risk of Mortality: Findings from the Literature and Policy Implications

Main Article Content

Razieh Nadafianshahamabadi Mohammad Tayarani H. Oliver Gao


Introduction: Externalities from transportation, and in particular exposure to vehicle emissions have been considered a possible cause of several negative health outcomes including mortality. However, the existing findings are too inconsistent to drive a well-founded exposure-response function to be fully exploited to curb the negative impacts of transportation systems on public health. In this study, we investigate the association between exposure to air pollution and mortality. We then evaluate how using different air quality methods may result in detecting different health outcomes.

Methods: We conduct an analysis of reviewing a representative sample of main published studies that specifically focused on the association between vehicle air pollution and mortality.

Results: Our study finds that vehicle air pollution may increase the risk of mortality through a slightly high association. Most importantly, the risk of overall mortality increases by 5% per 10 µg/m3 increase in NO2 concentration, 2% per unit of traffic intensity on the road, and 7% per unit of distance closer to the road.

Conclusion: The findings imply the role of exposure to vehicle emissions in increasing the risk of mortality. The method used to detect the health outcomes can alter the health finding from positive to null or vice versa and even extensively affect the analysis outcomes. The results suggest the need for establishing indicators to benchmark the performance of air quality methods and emphasize the necessity to integrate public health measures into the urban and transportation planning process.

Keywords: Transportation Emissions, Cardiovascular, Meta-Analysis, Mortality, Air Pollution, Land-use Regression Model

Article Details

How to Cite
NADAFIANSHAHAMABADI, Razieh; TAYARANI, Mohammad; GAO, H. Oliver. Impacts of Transportation Emissions on the Risk of Mortality: Findings from the Literature and Policy Implications. Medical Research Archives, [S.l.], v. 9, n. 8, aug. 2021. ISSN 2375-1924. Available at: <>. Date accessed: 31 jan. 2023. doi:
Research Articles


1. Allen RW, Criqui MH, Diez Roux AV, et al. Fine Particulate Matter Air Pollution, Proximity to Traffic, and Aortic Atherosclerosis. Epidemiology. 2009;20(2):254-264. doi:10.1097/EDE.0b013e31819644cc
2. Brugge D, Durant JL, Rioux C. Near-highway pollutants in motor vehicle exhaust: A review of epidemiologic evidence of cardiac and pulmonary health risks. Environmental Health. 2007;6(1):23. doi:10.1186/1476-069X-6-23
3. Gan WQ, Tamburic L, Davies HW, Demers PA, Koehoorn M, Brauer M. Changes in Residential Proximity to Road Traffic and the Risk of Death From Coronary Heart Disease: Epidemiology. 2010;21(5):642-649. doi:10.1097/EDE.0b013e3181e89f19
4. Garshick E, Laden F, Hart JE, Caron A. Residence Near a Major Road and Respiratory Symptoms in U.S. Veterans. Epidemiology. 2003;14(6):728-736. doi:10.1097/01.ede.0000082045.50073.66
5. Gauderman WJ, Vora H, McConnell R, et al. Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohort study. Lancet. 2007;369(9561):571-577. doi:10.1016/S0140-6736(07)60037-3
6. HEI. Traffic-Related Air Pollution: A Critical Review of the Literature on Emissions, Exposure, and Health Effects. Health Effects Institute; 2010.
7. McConnell R, Berhane K, Yao L, et al. Traffic, Susceptibility, and Childhood Asthma. Environ Health Perspect. 2006;114(5):766-772. doi:10.1289/ehp.8594
8. Peters A, von Klot S, Heier M, et al. Exposure to Traffic and the Onset of Myocardial Infarction. New England Journal of Medicine. 2004;351(17):1721-1730. doi:10.1056/NEJMoa040203
9. Franco Suglia S, Gryparis A, Schwartz J, Wright RJ. Association between traffic-related black carbon exposure and lung function among urban women. Environ Health Perspect. 2008;116(10):1333-1337. doi:10.1289/ehp.11223
10. Wilhelm M, Ritz B. Residential proximity to traffic and adverse birth outcomes in Los Angeles county, California, 1994-1996. Environ Health Perspect. 2003;111(2):207-216.
11. Özkaynak H, Baxter LK, Dionisio KL, Burke J. Air pollution exposure prediction approaches used in air pollution epidemiology studies. J Expos Sci Environ Epidemiol. 2013;23(6):566-572. doi:10.1038/jes.2013.15
12. Jerrett M, Burnett RT, Ma R, et al. Spatial analysis of air pollution and mortality in Los Angeles. Epidemiology. 2005;16(6):727-736.
13. Briggs DJ, de Hoogh C, Gulliver J, et al. A regression-based method for mapping traffic-related air pollution: application and testing in four contrasting urban environments. Science of The Total Environment. 2000;253(1):151-167. doi:10.1016/S0048-9697(00)00429-0
14. Pan S, Choi Y, Roy A, Jeon W. Allocating emissions to 4 km and 1 km horizontal spatial resolutions and its impact on simulated NOx and O3 in Houston, TX. Atmospheric Environment. 2017;164:398-415. doi:
15. Molitor J, Jerrett M, Chang C-C, et al. Assessing Uncertainty in Spatial Exposure Models for Air Pollution Health Effects Assessment. Environ Health Perspect. 2007;115(8):1147-1153. doi:10.1289/ehp.9849
16. Preston J, Rajé F. Accessibility, mobility and transport-related social exclusion. Journal of Transport Geography. 2007;15(3):151-160. doi:10.1016/j.jtrangeo.2006.05.002
17. Zou B, Wilson JG, Zhan FB, Zeng Y. Air pollution exposure assessment methods utilized in epidemiological studies. J Environ Monit. 2009;11(3):475-490. doi:10.1039/B813889C
18. Krzyżanowski M, Kuna-Dibbert B, Schneider J. Health Effects of Transport-Related Air Pollution. WHO Regional Office Europe; 2005.
19. Beelen R, Hoek G, van den Brandt PA, et al. Long-Term Effects of Traffic-Related Air Pollution on Mortality in a Dutch Cohort (NLCS-AIR Study). Environ Health Perspect. 2008;116(2):196-202. doi:10.1289/ehp.10767
20. Cesaroni G, Badaloni C, Gariazzo C, et al. Long-Term Exposure to Urban Air Pollution and Mortality in a Cohort of More than a Million Adults in Rome. Environmental Health Perspectives. 2013;121(3):324-331. doi:10.1289/ehp.1205862
21. Chen H, Goldberg MS, Burnett RT, Jerrett M, Wheeler AJ, Villeneuve PJ. Long-Term Exposure to Traffic-Related Air Pollution and Cardiovascular Mortality. Epidemiology. 2013;24(1):35–43. doi:10.1097/EDE.0b013e318276c005
22. Finkelstein MM, Jerrett M, Sears MR. Traffic Air Pollution and Mortality Rate Advancement Periods. Am J Epidemiol. 2004;160(2):173-177. doi:10.1093/aje/kwh181
23. Finkelstein MM, Jerrett M, Sears MR. Environmental inequality and circulatory disease mortality gradients. Journal of Epidemiology & Community Health. 2005;59(6):481-487. doi:10.1136/jech.2004.026203
24. Gehring U, Heinrich J, Krämer U, et al. Long-Term Exposure to Ambient Air Pollution and Cardiopulmonary Mortality in Women. Epidemiology. 2006;17(5):545–551. doi:10.1097/01.ede.0000224541.38258.87
25. Hoek G, Brunekreef B, Goldbohm S, Fischer P, van den Brandt PA. Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. The Lancet. 2002;360(9341):1203-1209. doi:10.1016/S0140-6736(02)11280-3
26. Jerrett M, Finkelstein MM, Brook JR, et al. A Cohort Study of Traffic-Related Air Pollution and Mortality in Toronto, Ontario, Canada. Environ Health Perspect. 2009;117(5):772-777. doi:10.1289/ehp.11533
27. Maheswaran R, Elliott P. Stroke Mortality Associated With Living Near Main Roads in England and Wales: A Geographical Study. Stroke. 2003;34(12):2776-2780. doi:10.1161/01.STR.0000101750.77547.11
28. Rosenlund M, Bellander T, Nordquist T, Alfredsson L. Traffic-Generated Air Pollution and Myocardial Infarction. Epidemiology. 2009;20(2):265–271. doi:10.1097/EDE.0b013e318190ea68
29. Yorifuji T, Kashima S, Tsuda T, et al. Long-term exposure to traffic-related air pollution and the risk of death from hemorrhagic stroke and lung cancer in Shizuoka, Japan. Science of The Total Environment. 2013;443(Supplement C):397-402. doi:10.1016/j.scitotenv.2012.10.088
30. Turner MC, Krewski D, Diver WR, et al. Ambient Air Pollution and Cancer Mortality in the Cancer Prevention Study II. Environ Health Perspect. 2017;125(8):087013. doi:10.1289/EHP1249
31. Crouse DL, Peters PA, Hystad P, et al. Ambient PM2.5, O₃, and NO₂ Exposures and Associations with Mortality over 16 Years of Follow-Up in the Canadian Census Health and Environment Cohort (CanCHEC). Environ Health Perspect. 2015;123(11):1180-1186. doi:10.1289/ehp.1409276
32. Thurston GD, Burnett RT, Turner MC, et al. Ischemic Heart Disease Mortality and Long-Term Exposure to Source-Related Components of US Fine Particle Air Pollution. Environ Health Perspect. 2016;124(6):785-794. doi:10.1289/ehp.1509777
33. Raaschou-Nielsen O, Andersen ZJ, Jensen SS, et al. Traffic air pollution and mortality from cardiovascular disease and all causes: a Danish cohort study. Environmental Health. 2012;11:60. doi:10.1186/1476-069X-11-60
34. Pedde M, Szpiro AA, Adar SD. Traffic Congestion as a Risk Factor for Mortality in Near-Road Communities: A Case-Crossover Study. Am J Epidemiol. 2017;186(5):564-572. doi:10.1093/aje/kwx130
35. Bidoli E, Pappagallo M, Birri S, Frova L, Zanier L, Serraino D. Residential Proximity to Major Roadways and Lung Cancer Mortality. Italy, 1990–2010: An Observational Study. Int J Environ Res Public Health. 2016;13(2). doi:10.3390/ijerph13020191
36. Halonen JI, Blangiardo M, Toledano MB, et al. Is long-term exposure to traffic pollution associated with mortality? A small-area study in London. Environmental Pollution. 2016;208(Part A):25-32. doi:10.1016/j.envpol.2015.06.036
37. Phan K, Tian DH, Cao C, Black D, Yan TD. Systematic review and meta-analysis: techniques and a guide for the academic surgeon. Ann Cardiothorac Surg. 2015;4(2):112-122. doi:10.3978/j.issn.2225-319X.2015.02.04
38. Tayarani M, Nadafianshahamabadi R, Poorfakhraei A, Rowangould G. Evaluating the cumulative impacts of a long range regional transportation plan: Particulate matter exposure, greenhouse gas emissions, and transportation system performance. Transportation Research Part D: Transport and Environment. 2018;63:261-275. doi:10.1016/j.trd.2018.05.014
39. Poorfakhraei A, Tayarani M, Rowangould G. Evaluating health outcomes from vehicle emissions exposure in the long range regional transportation planning process. Journal of Transport & Health. 2017;6:501-515. doi:10.1016/j.jth.2017.05.177
40. Hankey S, Marshall JD, Brauer M. Health Impacts of the Built Environment: Within-Urban Variability in Physical Inactivity, Air Pollution, and Ischemic Heart Disease Mortality. Environmental Health Perspectives. 2012;120:247-253. doi:
41. Marshall JD, Nethery E, Brauer M. Within-urban variability in ambient air pollution: Comparison of estimation methods. Atmospheric Environment. 2008;42(6):1359-1369. doi:10.1016/j.atmosenv.2007.08.012
42. Karner AA, Eisinger DS, Niemeier DA. Near-Roadway Air Quality: Synthesizing the Findings from Real-World Data. Environ Sci Technol. 2010;44(14):5334-5344. doi:10.1021/es100008x