Environmental research · 2025
Long-term exposure to black carbon and incident asthma and chronic obstructive pulmonary disease in adults: The Danish Nurse Cohort.
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Zhang Jiawei, So Rina, Bergmann Marie, Tuffier Stéphane, Andersson Nystedt Tanya, Lawlor Cale, Pira Kajsa, Napolitano George, Brandt Jørgen, Ketzel Matthias, Loft Steffen, Malmqvist Ebba, Oudin Anna, Lim Youn-Hee, Jovanovic Andersen Zorana
Аннотация
BACKGROUND: Air pollution is a known risk factor for chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). However, evidence regarding the role of black carbon (BC) remains mixed and sparse. This study aimed to examine the association of long-term exposure to air pollution, focusing on BC, with incident asthma and COPD in adults.
METHOD: We followed 28,731 female nurses from the Danish Nurse Cohort from baseline (1993/1999) until the end of 2018, tracking their first-ever hospital contact (inpatient, outpatient, or emergency visit) for asthma or COPD. Annual mean concentrations of BC, fine particulate matter (PM2.5), and nitrogen dioxide (NO2), were modeled since 1979 onward using the Danish DEHM/UBM/AirGIS modeling system and assigned to time-varying residential addresses. Time-varying Cox models were used to assess the association between 3-year running mean air pollution and incident asthma and COPD, adjusting for individual and area-level covariates.
RESULTS: Over an average follow-up of 23 years, 633 nurses developed asthma, and 1145 developed COPD. We found long-term exposure to BC was consistently associated with increased risks of both asthma and COPD, with hazard ratios (HR) per 0.34 μg/m3 (interquartile range) increase in BC of 1.06 (95 % confidence interval: 1.00-1.13) for asthma and 1.04 (0.98-1.11) for COPD. These associations persisted and strengthened after controlling for total PM2.5 or non-BC PM2.5. Stronger associations of air pollution were observed among individuals with underlying comorbidity.
CONCLUSION: We observed that BC is an independent risk factor for developing chronic respiratory diseases, such as asthma and COPD, and BC may play a more significant role than PM2.5. This underscored the need for targeted air quality regulations to reduce BC emissions, which may have a greater impact on mitigating the burden of chronic respiratory diseases than focusing solely on PM2.5.
METHOD: We followed 28,731 female nurses from the Danish Nurse Cohort from baseline (1993/1999) until the end of 2018, tracking their first-ever hospital contact (inpatient, outpatient, or emergency visit) for asthma or COPD. Annual mean concentrations of BC, fine particulate matter (PM2.5), and nitrogen dioxide (NO2), were modeled since 1979 onward using the Danish DEHM/UBM/AirGIS modeling system and assigned to time-varying residential addresses. Time-varying Cox models were used to assess the association between 3-year running mean air pollution and incident asthma and COPD, adjusting for individual and area-level covariates.
RESULTS: Over an average follow-up of 23 years, 633 nurses developed asthma, and 1145 developed COPD. We found long-term exposure to BC was consistently associated with increased risks of both asthma and COPD, with hazard ratios (HR) per 0.34 μg/m3 (interquartile range) increase in BC of 1.06 (95 % confidence interval: 1.00-1.13) for asthma and 1.04 (0.98-1.11) for COPD. These associations persisted and strengthened after controlling for total PM2.5 or non-BC PM2.5. Stronger associations of air pollution were observed among individuals with underlying comorbidity.
CONCLUSION: We observed that BC is an independent risk factor for developing chronic respiratory diseases, such as asthma and COPD, and BC may play a more significant role than PM2.5. This underscored the need for targeted air quality regulations to reduce BC emissions, which may have a greater impact on mitigating the burden of chronic respiratory diseases than focusing solely on PM2.5.