TY - JOUR
T1 - Long-term Air Pollution Exposure and Pneumonia Related Mortality in a Large Pooled European Cohort
AU - Liu, Shuo
AU - Lim, Youn-Hee
AU - Chen, Jie
AU - Strak, Maciek
AU - Wolf, Kathrin
AU - Weinmayr, Gudrun
AU - Rodopolou, Sophia
AU - de Hoogh, Kees
AU - Bellander, Tom
AU - Brandt, Jørgen
AU - Concin, Hans
AU - Zitt, Emanuel
AU - Fecht, Daniela
AU - Forastiere, Francesco
AU - Gulliver, John
AU - Hertel, Ole
AU - Hoffmann, Barbara
AU - Hvidtfeldt, Ulla A
AU - Verschuren, W M Monique
AU - Jöckel, Karl-Heinz
AU - Jørgensen, Jeanette T
AU - So, Rina
AU - Amini, Heresh
AU - Cole-Hunter, Thomas
AU - Mehta, Amar J
AU - Mortensen, Laust H
AU - Ketzel, Matthias
AU - Lager, Anton
AU - Leander, Karin
AU - Ljungman, Petter
AU - Severi, Gianluca
AU - Boutron-Ruault, Marie-Christine
AU - Magnusson, Patrik K E
AU - Nagel, Gabriele
AU - Pershagen, Göran
AU - Peters, Annette
AU - Raaschou-Nielsen, Ole
AU - Rizzuto, Debora
AU - van der Schouw, Yvonne T
AU - Schramm, Sara
AU - Sørensen, Mette
AU - Stafoggia, Massimo
AU - Tjønneland, Anne
AU - Katsouyanni, Klea
AU - Huang, Wei
AU - Samoli, Evangelia
AU - Brunekreef, Bert
AU - Hoek, Gerard
AU - Andersen, Zorana J
PY - 2022
Y1 - 2022
N2 - RATIONALE: Ambient air pollution exposure has been linked to mortality from chronic cardiorespiratory diseases, while evidence on respiratory infections remains more limited.OBJECTIVES: We examined the association between long-term exposure to air pollution and pneumonia related mortality in adults in a pool of eight European cohorts.METHODS: Within the multicenter project 'Effects of Low-Level Air Pollution: A Study in Europe' (ELAPSE), we pooled data from eight cohorts among six European countries. Annual mean residential concentrations in 2010 for fine particulate matter (PM
2.5), nitrogen dioxide (NO
2), black carbon (BC), and ozone (O
3) were estimated using Europe-wide hybrid land use regression models. We applied stratified Cox proportional hazard models to investigate the associations between air pollution and pneumonia, influenza, and acute lower respiratory infections (ALRI) mortality.
MEASUREMENTS AND MAIN RESULTS: Of 325,367 participants, 712 died from pneumonia and influenza combined, 682 from pneumonia, and 695 from ALRI during a mean follow-up of 19.5 years. NO
2 and BC were associated with 10-12% increases in pneumonia and influenza combined mortality, but 95% confidence intervals included unity [hazard ratios: 1.12 (0.99-1.26) per 10 µg/m
3 for NO
2; 1.10 (0.97-1.24) per 0.5 10
-5m
-1 for BC]. Associations with pneumonia and ALRI mortality were almost identical. We detected effect modification suggesting stronger associations with NO
2 or BC in overweight, employed, or currently smoking participants compared to normal weight, unemployed, or non-smoking participants.
CONCLUSIONS: Long-term exposure to combustion-related air pollutants NO
2 and BC may be associated with mortality from lower respiratory infections, but larger studies are needed to estimate these associations more precisely.
AB - RATIONALE: Ambient air pollution exposure has been linked to mortality from chronic cardiorespiratory diseases, while evidence on respiratory infections remains more limited.OBJECTIVES: We examined the association between long-term exposure to air pollution and pneumonia related mortality in adults in a pool of eight European cohorts.METHODS: Within the multicenter project 'Effects of Low-Level Air Pollution: A Study in Europe' (ELAPSE), we pooled data from eight cohorts among six European countries. Annual mean residential concentrations in 2010 for fine particulate matter (PM
2.5), nitrogen dioxide (NO
2), black carbon (BC), and ozone (O
3) were estimated using Europe-wide hybrid land use regression models. We applied stratified Cox proportional hazard models to investigate the associations between air pollution and pneumonia, influenza, and acute lower respiratory infections (ALRI) mortality.
MEASUREMENTS AND MAIN RESULTS: Of 325,367 participants, 712 died from pneumonia and influenza combined, 682 from pneumonia, and 695 from ALRI during a mean follow-up of 19.5 years. NO
2 and BC were associated with 10-12% increases in pneumonia and influenza combined mortality, but 95% confidence intervals included unity [hazard ratios: 1.12 (0.99-1.26) per 10 µg/m
3 for NO
2; 1.10 (0.97-1.24) per 0.5 10
-5m
-1 for BC]. Associations with pneumonia and ALRI mortality were almost identical. We detected effect modification suggesting stronger associations with NO
2 or BC in overweight, employed, or currently smoking participants compared to normal weight, unemployed, or non-smoking participants.
CONCLUSIONS: Long-term exposure to combustion-related air pollutants NO
2 and BC may be associated with mortality from lower respiratory infections, but larger studies are needed to estimate these associations more precisely.
U2 - 10.1164/rccm.202106-1484OC
DO - 10.1164/rccm.202106-1484OC
M3 - Journal article
C2 - 35258439
VL - 205
SP - 1429
EP - 1439
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 12
ER -