Cross-sectional associations between air pollution and chronic bronchitis: an ESCAPE meta-analysis across five cohorts.
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Cai Yutong, Schikowski Tamara, Adam Martin, Buschka Anna, Carsin Anne-Elie, Jacquemin Benedicte, Marcon Alessandro, Sanchez Margaux, Vierkötter Andrea, Al-Kanaani Zaina, Beelen Rob, Birk Matthias, Brunekreef Bert, Cirach Marta, Clavel-Chapelon Françoise, Declercq Christophe, de Hoogh Kees, de Nazelle Audrey, Ducret-Stich Regina E, Valeria Ferretti Virginia, Forsberg Bertil, Gerbase Margaret W, Hardy Rebecca, Heinrich Joachim, Hoek Gerard, Jarvis Debbie, Keidel Dirk, Kuh Diana, Nieuwenhuijsen Mark J, Ragettli Martina S, Ranzi Andrea, Rochat Thierry, Schindler Christian, Sugiri Dorothea, Temam Sofia, Tsai Ming-Yi, Varraso Raphaëlle, Kauffmann Francine, Krämer Ursula, Sunyer Jordi, Künzli Nino, Probst-Hensch Nicole, Hansell Anna L
Аннотация
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.