Shuo Liu1, Jeanette Therming Jørgensen1, Petter Ljungman2,3, Göran Pershagen2,4, Tom Bellander2,4, Karin Leander2, Patrik K E Magnusson5, Debora Rizzuto6,7, Ulla A Hvidtfeldt8, Ole Raaschou-Nielsen8,9, Kathrin Wolf10, Barbara Hoffmann11, Bert Brunekreef12, Maciej Strak12,13, Jie Chen12, Amar Mehta1, Richard W Atkinson14, Mariska Bauwelinck15, Raphaëlle Varraso16, Marie-Christine Boutron-Ruault16,17, Jørgen Brandt9,18, Giulia Cesaroni19, Francesco Forastiere19, Daniela Fecht20, John Gulliver21,22, Ole Hertel9, Kees de Hoogh23, Nicole A H Janssen13, Klea Katsouyanni24, Matthias Ketzel9,25, Jochem O Klompmaker12,13, Gabriele Nagel26, Bente Oftedal27, Annette Peters10,28, Anne Tjønneland1,8, Sophia P Rodopoulou24, Evangelia Samoli24, Doris Tove Kristoffersen29, Torben Sigsgaard30, Massimo Stafoggia2,19, Danielle Vienneau23, Gudrun Weinmayr26, Gerard Hoek12, Zorana Jovanovic Andersen31,32. 1. Dept of Public Health, University of Copenhagen, Copenhagen, Denmark. 2. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 3. Dept of Cardiology, Danderyd University Hospital, Stockholm, Sweden. 4. Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden. 5. Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 6. Aging Research Center, Dept of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 7. The Stockholm Gerontology Research Center, Stockholm, Sweden. 8. Danish Cancer Society Research Center, Copenhagen, Denmark. 9. Dept of Environmental Science, Aarhus University, Roskilde, Denmark. 10. Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany. 11. Institute of Occupational, Social and Environmental Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. 12. Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands. 13. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 14. Population Health Research Institute, St George's, University of London, London, UK. 15. Interface Demography, Dept of Sociology, Vrije Universiteit Brussel, Brussels, Belgium. 16. CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France. 17. Gustave Roussy, Villejuif, France. 18. iClimate, Aarhus University Interdisciplinary Center for Climate Change, Roskilde, Denmark. 19. Dept of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy. 20. MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. 21. UK Small Area Health Statistics Unit, Dept of Epidemiology and Biostatistics, Imperial College London, London, UK. 22. Centre for Environmental Health and Sustainability and School of Geography, Geology and the Environment, University of Leicester, Leicester, UK. 23. Swiss Tropical and Public Health Institute, Basel, Switzerland. 24. Dept of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece. 25. Global Centre for Clean Air Research, University of Surrey, Guildford, UK. 26. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany. 27. Dept of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway. 28. Epidemiology, Faculty of Medicine, Ludwig Maximilians Universität München, Munich, Germany. 29. Cluster for Health Services Research, Norwegian Institute of Public Health, Oslo, Norway. 30. Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark. 31. Dept of Public Health, University of Copenhagen, Copenhagen, Denmark zorana.andersen@sund.ku.dk. 32. Center for Epidemiological Research, Nykøbing F Hospital, Nykøbing F, Denmark.
Abstract
BACKGROUND: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although 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 a 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 mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 μg·m-3 for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 µg·m-3 for NO2 and 1.15 (95% CI 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 European Union and US limit values and possibly World Health Organization 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.
BACKGROUND: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although 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 a 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 mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 μg·m-3 for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 µg·m-3 for NO2 and 1.15 (95% CI 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 European Union and US limit values and possibly World Health Organization 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.
Authors: Jie Chen; Gerard Hoek; Kees de Hoogh; Sophia Rodopoulou; Zorana J Andersen; Tom Bellander; Jørgen Brandt; Daniela Fecht; Francesco Forastiere; John Gulliver; Ole Hertel; Barbara Hoffmann; Ulla Arthur Hvidtfeldt; W M Monique Verschuren; Karl-Heinz Jöckel; Jeanette T Jørgensen; Klea Katsouyanni; Matthias Ketzel; Diego Yacamán Méndez; Karin Leander; Shuo Liu; Petter Ljungman; Elodie Faure; Patrik K E Magnusson; Gabriele Nagel; Göran Pershagen; Annette Peters; Ole Raaschou-Nielsen; Debora Rizzuto; Evangelia Samoli; Yvonne T van der Schouw; Sara Schramm; Gianluca Severi; Massimo Stafoggia; Maciej Strak; Mette Sørensen; Anne Tjønneland; Gudrun Weinmayr; Kathrin Wolf; Emanuel Zitt; Bert Brunekreef; George D Thurston Journal: Environ Sci Technol Date: 2022-06-23 Impact factor: 11.357
Authors: Amelia K Wesselink; Tanran R Wang; Matthias Ketzel; Ellen M Mikkelsen; Jørgen Brandt; Jibran Khan; Ole Hertel; Anne Sofie D Laursen; Benjamin R Johannesen; Mary D Willis; Jonathan I Levy; Kenneth J Rothman; Henrik T Sørensen; Lauren A Wise; Elizabeth E Hatch Journal: Paediatr Perinat Epidemiol Date: 2021-12-10 Impact factor: 3.103
Authors: Jie Chen; Sophia Rodopoulou; Kees de Hoogh; Maciej Strak; Zorana J Andersen; Richard Atkinson; Mariska Bauwelinck; Tom Bellander; Jørgen Brandt; Giulia Cesaroni; Hans Concin; Daniela Fecht; Francesco Forastiere; John Gulliver; Ole Hertel; Barbara Hoffmann; Ulla Arthur Hvidtfeldt; Nicole A H Janssen; Karl-Heinz Jöckel; Jeanette Jørgensen; Klea Katsouyanni; Matthias Ketzel; Jochem O Klompmaker; Anton Lager; Karin Leander; Shuo Liu; Petter Ljungman; Conor J MacDonald; Patrik K E Magnusson; Amar Mehta; Gabriele Nagel; Bente Oftedal; Göran Pershagen; Annette Peters; Ole Raaschou-Nielsen; Matteo Renzi; Debora Rizzuto; Evangelia Samoli; Yvonne T van der Schouw; Sara Schramm; Per Schwarze; Torben Sigsgaard; Mette Sørensen; Massimo Stafoggia; Anne Tjønneland; Danielle Vienneau; Gudrun Weinmayr; Kathrin Wolf; Bert Brunekreef; Gerard Hoek Journal: Environ Health Perspect Date: 2021-04-12 Impact factor: 9.031