Exposure to air pollution and risk of respiratory tract infections in the adult Danish population - a nationwide study

TY - JOUR

T1 - Exposure to air pollution and risk of respiratory tract infections in the adult Danish population - a nationwide study

AU - Kaspersen, Kathrine A

AU - Antonsen, Sussie

AU - Horsdal, Henriette T

AU - Kjerulff, Bertram

AU - Brandt, Jørgen

AU - Geels, Camilla

AU - Christensen, Jesper H

AU - Frohn, Lise M

AU - Sabel, Clive E

AU - Dinh, Khoa M

AU - Hertel, Ole

AU - Sigsgaard, Torben

AU - Pedersen, Carsten B

AU - Erikstrup, Christian

N1 - Copyright © 2023. Published by Elsevier Ltd.

PY - 2024/1

Y1 - 2024/1

N2 - Objectives: The association between air pollution and risk of respiratory tract infection (RTI) in adults needs to be clarified in settings with low to moderate levels of air pollution. We investigated this in the Danish population between 2004 and 2016. Methods: We included 3 653 490 persons aged 18–64 years in a nested case-control study. Exposure was defined as the average daily concentration at the individual's residential address of CO, NO X, NO 2, O 3, SO 2, NH 3, PPM 2.5, black carbon, organic carbon, mineral dust, sea salt, secondary inorganic aerosols, SO 4 2-, NO 3 -, NH 4 +, secondary organic aerosols, PM 2.5, and PM 10 during a 3-month exposure window. RTIs were defined by hospitalization for RTIs. Incidence rate ratios (IRRs) and 95% CIs were estimated comparing highest with lowest decile of exposure using conditional logistic regression models. Results: In total, 188 439 incident cases of RTI were identified. Exposure to most air pollutants was positively associated with risk of RTI. For example, NO 2 showed an IRR of 1.52 (CI: 1.48–1.55), and PM 2.5 showed an IRR of 1.45 (CI: 1.40–1.50). In contrast, exposure to sea salt, PM 10, NH 3, and O 3 was negatively associated with a risk of RTIs. Discussion: In this nationwide study comprising adults, exposure to air pollution was associated with risk of RTIs and subgroups hereof. Sea salt, PM 10, NH 3, and O 3 may be proxies for rural areas, as the levels of these species in Denmark are higher near the western coastlines and/or in rural areas with fewer combustion sources.

AB - Objectives: The association between air pollution and risk of respiratory tract infection (RTI) in adults needs to be clarified in settings with low to moderate levels of air pollution. We investigated this in the Danish population between 2004 and 2016. Methods: We included 3 653 490 persons aged 18–64 years in a nested case-control study. Exposure was defined as the average daily concentration at the individual's residential address of CO, NO X, NO 2, O 3, SO 2, NH 3, PPM 2.5, black carbon, organic carbon, mineral dust, sea salt, secondary inorganic aerosols, SO 4 2-, NO 3 -, NH 4 +, secondary organic aerosols, PM 2.5, and PM 10 during a 3-month exposure window. RTIs were defined by hospitalization for RTIs. Incidence rate ratios (IRRs) and 95% CIs were estimated comparing highest with lowest decile of exposure using conditional logistic regression models. Results: In total, 188 439 incident cases of RTI were identified. Exposure to most air pollutants was positively associated with risk of RTI. For example, NO 2 showed an IRR of 1.52 (CI: 1.48–1.55), and PM 2.5 showed an IRR of 1.45 (CI: 1.40–1.50). In contrast, exposure to sea salt, PM 10, NH 3, and O 3 was negatively associated with a risk of RTIs. Discussion: In this nationwide study comprising adults, exposure to air pollution was associated with risk of RTIs and subgroups hereof. Sea salt, PM 10, NH 3, and O 3 may be proxies for rural areas, as the levels of these species in Denmark are higher near the western coastlines and/or in rural areas with fewer combustion sources.

KW - air pollution

KW - hospitalization

KW - pneumonia

KW - public health

KW - respiratory tract infections

KW - Respiratory tract infections

KW - Pneumonia

KW - Air pollution

KW - Hospitalization

KW - Public health

KW - Humans

KW - Respiratory Tract Infections/epidemiology

KW - Carbon

KW - Air Pollution/adverse effects

KW - Case-Control Studies

KW - Respiratory Aerosols and Droplets

KW - Air Pollutants/adverse effects

KW - Denmark/epidemiology

KW - Nitrogen Dioxide

KW - Particulate Matter/adverse effects

KW - Adult

KW - Environmental Exposure/adverse effects

U2 - 10.1016/j.cmi.2023.10.013

DO - 10.1016/j.cmi.2023.10.013

M3 - Journal article

C2 - 37858866

SN - 1198-743X

VL - 30

SP - 122

EP - 129

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

IS - 1

ER -