Yutong Cai1, Tamara Schikowski2, Martin Adam3, Anna Buschka4, Anne-Elie Carsin5, Benedicte Jacquemin6, Alessandro Marcon7, Margaux Sanchez8, Andrea Vierkötter4, Zaina Al-Kanaani1, Rob Beelen9, Matthias Birk10, Bert Brunekreef9, Marta Cirach5, Françoise Clavel-Chapelon11, Christophe Declercq12, Kees de Hoogh13, Audrey de Nazelle14, Regina E Ducret-Stich3, Virginia Valeria Ferretti15, Bertil Forsberg16, Margaret W Gerbase17, Rebecca Hardy18, Joachim Heinrich10, Gerard Hoek9, Debbie Jarvis19, Dirk Keidel3, Diana Kuh18, Mark J Nieuwenhuijsen5, Martina S Ragettli3, Andrea Ranzi20, Thierry Rochat17, Christian Schindler3, Dorothea Sugiri4, Sofia Temam8, Ming-Yi Tsai3, Raphaëlle Varraso8, Francine Kauffmann8, Ursula Krämer4, Jordi Sunyer5, Nino Künzli3, Nicole Probst-Hensch3, Anna L Hansell21. 1. Department of Epidemiology & Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. 2. Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf, Germany. 3. Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland. 4. Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf, Germany. 5. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. 6. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain INSERM, CESP Centre for research in Epidemiology and Population Health, U1018, Respiratory and Environmental epidemiology team, Villejuif, France. Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France. 7. Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy. 8. INSERM, CESP Centre for research in Epidemiology and Population Health, U1018, Respiratory and Environmental epidemiology team, Villejuif, France. Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France. 9. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. 10. German Research Centre for Environmental Health, Institutes of Epidemiology I and II, Neuherberg, Germany. 11. Université Paris Sud 11, UMRS 1018, F-94807, Villejuif, France INSERM, CESP Centre for research in Epidemiology and Population Health, U1018, Nutrition, Hormones, and Women's Health team, Villejuif, France. 12. French Institute for Public Health Surveillance, Saint-Maurice, France. 13. Department of Epidemiology & Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland. 14. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Centre for Environmental Policy, Imperial College London, London, UK. 15. Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Neuroscience, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. 16. Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umea University, Umea, Sweden. 17. Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland. 18. MRC Unit for Lifelong Health and Ageing at UCL, Institute of Epidemiology and Health Care, University College London, London, UK. 19. Department of Epidemiology & Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK Respiratory Epidemiology and Public Health Group, National Heart and Lung Institute, Imperial College London, London, UK. 20. Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy. 21. Department of Epidemiology & Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London, UK.
Abstract
BACKGROUND: This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project. METHODS: Annual average particulate matter (PM(10), PM(2.5), PM(absorbance), PM(coarse)), NO(2), nitrogen oxides (NO(x)) and road traffic measures modelled from ESCAPE measurement campaigns 2008-2011 were assigned to home address at most recent assessments (1998-2011). Symptoms examined were chronic bronchitis (cough and phlegm for ≥3 months of the year for ≥2 years), chronic cough (with/without phlegm) and chronic phlegm (with/without cough). Cohort-specific cross-sectional multivariable logistic regression analyses were conducted using common confounder sets (age, sex, smoking, interview season, education), followed by meta-analysis. RESULTS: 15 279 and 10 537 participants respectively were included in the main NO(2) and PM analyses at assessments in 1998-2011. Overall, there were no statistically significant associations with any air pollutant or traffic exposure. Sensitivity analyses including in asthmatics only, females only or using back-extrapolated NO(2) and PM10 for assessments in 1985-2002 (ECRHS, NSHD, SALIA, SAPALDIA) did not alter conclusions. In never-smokers, all associations were positive, but reached statistical significance only for chronic phlegm with PM(coarse) OR 1.31 (1.05 to 1.64) per 5 µg/m(3) increase and PM(10) with similar effect size. Sensitivity analyses of older cohorts showed increased risk of chronic cough with PM(2.5abs) (black carbon) exposures. CONCLUSIONS: Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project. METHODS: Annual average particulate matter (PM(10), PM(2.5), PM(absorbance), PM(coarse)), NO(2), nitrogen oxides (NO(x)) and road traffic measures modelled from ESCAPE measurement campaigns 2008-2011 were assigned to home address at most recent assessments (1998-2011). Symptoms examined were chronic bronchitis (cough and phlegm for ≥3 months of the year for ≥2 years), chronic cough (with/without phlegm) and chronic phlegm (with/without cough). Cohort-specific cross-sectional multivariable logistic regression analyses were conducted using common confounder sets (age, sex, smoking, interview season, education), followed by meta-analysis. RESULTS: 15 279 and 10 537 participants respectively were included in the main NO(2) and PM analyses at assessments in 1998-2011. Overall, there were no statistically significant associations with any air pollutant or traffic exposure. Sensitivity analyses including in asthmatics only, females only or using back-extrapolated NO(2) and PM10 for assessments in 1985-2002 (ECRHS, NSHD, SALIA, SAPALDIA) did not alter conclusions. In never-smokers, all associations were positive, but reached statistical significance only for chronic phlegm with PM(coarse) OR 1.31 (1.05 to 1.64) per 5 µg/m(3) increase and PM(10) with similar effect size. Sensitivity analyses of older cohorts showed increased risk of chronic cough with PM(2.5abs) (black carbon) exposures. CONCLUSIONS: Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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