Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project

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  • Shuo Liu, University of Copenhagen, Department of Public Health, Danmark
  • Jeanette Therming Jørgensen, University of Copenhagen, Department of Public Health, Danmark
  • Petter Ljungman, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital, Department of Cardiology, Danderyd University Hospital, Stockholm, Sverige
  • Göran Pershagen, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital, Center for Occupational and Environmental Medicine, Region Stockholm, Sverige
  • Tom Bellander, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital, Center for Occupational and Environmental Medicine, Region Stockholm, Sverige
  • Karin Leander, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital, Sverige
  • Patrik K E Magnusson, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital, Sverige
  • Debora Rizzuto, Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, The Stockholm Gerontology Research Center, Sverige
  • Ulla A Hvidtfeldt, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Danmark
  • Ole Raaschou-Nielsen
  • Kathrin Wolf, Institute of Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, D-85764 Neuherberg, Germany., Tyskland
  • Barbara Hoffmann, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University, Dusseldorf, Tyskland
  • Bert Brunekreef, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Holland
  • Maciej Strak, Institute for Risk Assessment Sciences (IRAS), Utrecht University, National Institute for Public Health and the Environment (RIVM), Bilthoven, Holland
  • Jie Chen, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Holland
  • Amar Mehta, University of Copenhagen, Department of Public Health, Danmark
  • Richard W Atkinson, Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George’s, University of London, London, UK, Storbritannien
  • Mariska Bauwelinck, Interface Demography – Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium, Belgien
  • Raphaëlle Varraso, CESP INSERM UMRS 1018, Villejuif Cedex, France., Frankrig
  • Marie-Christine Boutron-Ruault, CESP INSERM UMRS 1018, Villejuif Cedex, France., Institut Gustave Roussy, Villejuif, France., Frankrig
  • Jørgen Brandt
  • Giulia Cesaroni, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Italien
  • Francesco Forastiere, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Italien
  • Daniela Fecht, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Storbritannien
  • John Gulliver, Imperial Coll London, Imperial College London, Imperial Clin Trials Unit, Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Storbritannien
  • Ole Hertel
  • Kees de Hoogh, Swiss Tropical and Public Health Institute (Swiss TPH), Schweiz
  • Nicole A H Janssen, National Institute for Public Health and the Environment (RIVM), Holland
  • Klea Katsouyanni, National and Kapodistrian University of Athens, Grækenland
  • Matthias Ketzel
  • Jochem O Klompmaker, Univ Utrecht, Utrecht University, Utrecht University Medical Center, UMC Utrecht, Dept Hematol, National Institute for Public Health and the Environment (RIVM), Bilthoven, Holland
  • Gabriele Nagel, Ulm Univ, Ulm University, Tyskland
  • Bente Oftedal, Norwegian Institute of Public Health, Norge
  • Annette Peters, Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre of Environmental Health, Neuherberg, Germany., Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Tyskland
  • Anne Tjønneland, University of Copenhagen, Department of Public Health, The Danish Cancer Society Research Center, Danmark
  • Sophia P Rodopoulou, National and Kapodistrian University of Athens, Grækenland
  • Evangelia Samoli, National and Kapodistrian University of Athens, Grækenland
  • Doris Tove Kristoffersen, Norwegian Institute of Public Health, Norge
  • Torben Sigsgaard
  • Massimo Stafoggia, Karolinska Univ Hosp, Karolinska Institutet, Karolinska University Hospital, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Sverige
  • Danielle Vienneau, Swiss Tropical and Public Health Institute (Swiss TPH), Schweiz
  • Gudrun Weinmayr, Ulm Univ, Ulm University, Tyskland
  • Gerard Hoek, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Holland
  • Zorana Jovanovic Andersen, University of Copenhagen, Department of Public Health, Nykøbing Falster Hospital, Center for Epidemiological Research, Ejegodvej 63, DK-4800 Nykøbing, Denmark, Danmark

BACKGROUND: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, while evidence is still insufficient. Within the multicentre project "Effects of Low-Level Air Pollution: A Study in Europe" (ELAPSE), we examined the associations of long-term exposures to particulate matter with diameter<2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) with asthma incidence in adults.

METHODS: We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land use regression models at participants' baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders.

RESULTS: Of 98 326 participants, 1965 developed asthma during a 16.6 years mean follow-up. We observed associations in fully adjusted models with hazard ratios and 95% confidence intervals of 1.22 (1.04-1.43) per 5 μg·m-3 for PM2.5, 1.17 (1.10-1.25) per 10 µg·m-3 for NO2, and 1.15 (1.08-1.23) per 0.5 10-5 m-1 for BC. Hazard ratios were larger in cohort subsets with exposure levels below the EU and US limit values and possibly WHO guidelines for PM2.5 and NO2. NO2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration response curves showed no evidence of a threshold.

CONCLUSIONS: Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.

OriginalsprogEngelsk
Artikelnummer2003099
BogserieEuropean Respiratory Journal. Supplement
Antal sider67
ISSN0904-1850
DOI
StatusE-pub ahead of print - 10 dec. 2020

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