Sofia Temam1, Emilie Burte2, Martin Adam3, Josep M Antó4, Xavier Basagaña5, Jean Bousquet6, Anne-Elie Carsin5, Bruna Galobardes7, Dirk Keidel3, Nino Künzli3, Nicole Le Moual2, Margaux Sanchez2, Jordi Sunyer5, Roberto Bono8, Bert Brunekreef9, Joachim Heinrich10, Kees de Hoogh11, Debbie Jarvis12, Alessandro Marcon13, Lars Modig14, Rachel Nadif2, Mark Nieuwenhuijsen5, Isabelle Pin15, Valérie Siroux16, Morgane Stempfelet17, Ming-Yi Tsai3, Nicole Probst-Hensch3, Bénédicte Jacquemin18. 1. INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; Univ Paris-Sud, Kremlin-Bicêtre, France. Electronic address: sofia.temam@inserm.fr. 2. INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France. 3. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 4. ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain. 5. ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain. 6. INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; Centre Hospitalo-Universitaire, Montpellier, France. 7. School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom. 8. Department of Public Health and Pediatrics, University of Turin, Turin, Italy. 9. Institute for Risk Assessment Sciences, University Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 10. Institute of Epidemiology, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine Ludwig Maximilians University, Munich, Germany. 11. Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Population Health and Occupational disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom. 12. Population Health and Occupational disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom. 13. Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy. 14. Public Health and Clinical Medicine, Umea University, University Hospital, Umea, Sweden. 15. IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, Univ Grenoble-Alpes, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, CHU Grenoble, Grenoble, France; Pédiatrie, CHU Grenoble, Grenoble, France. 16. IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, INSERM, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, Univ Grenoble-Alpes, Grenoble, France; IAB, Environmental Epidemiology Applied to Reproduction and Respiratory Health, CHU Grenoble, Grenoble, France. 17. InVS, French Institute for Public Health Surveillance, Saint-Maurice, France. 18. INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; ISGlobal-Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain.
Abstract
BACKGROUND: Inconsistent associations between socioeconomic position (SEP) and outdoor air pollution have been reported in Europe, but methodological differences prevent any direct between-study comparison. OBJECTIVES: Assess and compare the association between SEP and outdoor nitrogen dioxide (NO2) exposure as a marker of traffic exhaust, in 16 cities from eight Western European countries. METHODS: Three SEP indicators, two defined at individual-level (education and occupation) and one at neighborhood-level (unemployment rate) were assessed in three European multicenter cohorts. NO2 annual concentration exposure was estimated at participants' addresses with land use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE; http://www.escapeproject.eu/). Pooled and city-specific linear regressions were used to analyze associations between each SEP indicator and NO2. Heterogeneity across cities was assessed using the Higgins' I-squared test (I2). RESULTS: The study population included 5692 participants. Pooled analysis showed that participants with lower individual-SEP were less exposed to NO2. Conversely, participants living in neighborhoods with higher unemployment rate were more exposed. City-specific results exhibited strong heterogeneity (I2>76% for the three SEP indicators) resulting in variation of the individual- and neighborhood-SEP patterns of NO2 exposure across cities. The coefficients from a model that included both individual- and neighborhood-SEP indicators were similar to the unadjusted coefficients, suggesting independent associations. CONCLUSIONS: Our study showed for the first time using homogenized measures of outcome and exposure across 16 cities the important heterogeneity regarding the association between SEP and NO2 in Western Europe. Importantly, our results showed that individual- and neighborhood-SEP indicators capture different aspects of the association between SEP and exposure to air pollution, stressing the importance of considering both in air pollution health effects studies.
BACKGROUND: Inconsistent associations between socioeconomic position (SEP) and outdoor air pollution have been reported in Europe, but methodological differences prevent any direct between-study comparison. OBJECTIVES: Assess and compare the association between SEP and outdoor nitrogen dioxide (NO2) exposure as a marker of traffic exhaust, in 16 cities from eight Western European countries. METHODS: Three SEP indicators, two defined at individual-level (education and occupation) and one at neighborhood-level (unemployment rate) were assessed in three European multicenter cohorts. NO2 annual concentration exposure was estimated at participants' addresses with land use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE; http://www.escapeproject.eu/). Pooled and city-specific linear regressions were used to analyze associations between each SEP indicator and NO2. Heterogeneity across cities was assessed using the Higgins' I-squared test (I2). RESULTS: The study population included 5692 participants. Pooled analysis showed that participants with lower individual-SEP were less exposed to NO2. Conversely, participants living in neighborhoods with higher unemployment rate were more exposed. City-specific results exhibited strong heterogeneity (I2>76% for the three SEP indicators) resulting in variation of the individual- and neighborhood-SEP patterns of NO2 exposure across cities. The coefficients from a model that included both individual- and neighborhood-SEP indicators were similar to the unadjusted coefficients, suggesting independent associations. CONCLUSIONS: Our study showed for the first time using homogenized measures of outcome and exposure across 16 cities the important heterogeneity regarding the association between SEP and NO2 in Western Europe. Importantly, our results showed that individual- and neighborhood-SEP indicators capture different aspects of the association between SEP and exposure to air pollution, stressing the importance of considering both in air pollution health effects studies.
Authors: Christine T Loftus; Yu Ni; Adam A Szpiro; Marnie F Hazlehurst; Frances A Tylavsky; Nicole R Bush; Sheela Sathyanarayana; Kecia N Carroll; Michael Young; Catherine J Karr; Kaja Z LeWinn Journal: Environ Res Date: 2019-12-23 Impact factor: 6.498
Authors: Mark J Nieuwenhuijsen; Mireia Gascon; David Martinez; Anna Ponjoan; Jordi Blanch; Maria Del Mar Garcia-Gil; Rafel Ramos; Maria Foraster; Natalie Mueller; Ana Espinosa; Marta Cirach; Haneen Khreis; Payam Dadvand; Xavier Basagaña Journal: Int J Environ Res Public Health Date: 2018-10-30 Impact factor: 3.390