Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project.
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Liu Shuo, Jørgensen Jeanette Therming, Ljungman Petter, Pershagen Göran, Bellander Tom, Leander Karin, Magnusson Patrik K E, Rizzuto Debora, Hvidtfeldt Ulla A, Raaschou-Nielsen Ole, Wolf Kathrin, Hoffmann Barbara, Brunekreef Bert, Strak Maciej, Chen Jie, Mehta Amar, Atkinson Richard W, Bauwelinck Mariska, Varraso Raphaëlle, Boutron-Ruault Marie-Christine, Brandt Jørgen, Cesaroni Giulia, Forastiere Francesco, Fecht Daniela, Gulliver John, Hertel Ole, de Hoogh Kees, Janssen Nicole A H, Katsouyanni Klea, Ketzel Matthias, Klompmaker Jochem O, Nagel Gabriele, Oftedal Bente, Peters Annette, Tjønneland Anne, Rodopoulou Sophia P, Samoli Evangelia, Kristoffersen Doris Tove, Sigsgaard Torben, Stafoggia Massimo, Vienneau Danielle, Weinmayr Gudrun, Hoek Gerard, Andersen Zorana Jovanovic
Аннотация
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.