TY - JOUR
T1 - Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease
T2 - The ELAPSE project
AU - Liu, Shuo
AU - Jørgensen, Jeanette T.
AU - Ljungman, Petter
AU - Pershagen, Göran
AU - Bellander, Tom
AU - Leander, Karin
AU - Magnusson, Patrik K.E.
AU - Rizzuto, Debora
AU - Hvidtfeldt, Ulla A.
AU - Raaschou-Nielsen, Ole
AU - Wolf, Kathrin
AU - Hoffmann, Barbara
AU - Brunekreef, Bert
AU - Strak, Maciej
AU - Chen, Jie
AU - Mehta, Amar
AU - Atkinson, Richard W.
AU - Bauwelinck, Mariska
AU - Varraso, Raphaëlle
AU - Boutron-Ruault, Marie Christine
AU - Brandt, Jørgen
AU - Cesaroni, Giulia
AU - Forastiere, Francesco
AU - Fecht, Daniela
AU - Gulliver, John
AU - Hertel, Ole
AU - de Hoogh, Kees
AU - Janssen, Nicole A.H.
AU - Katsouyanni, Klea
AU - Ketzel, Matthias
AU - Klompmaker, Jochem O.
AU - Nagel, Gabriele
AU - Oftedal, Bente
AU - Peters, Annette
AU - Tjønneland, Anne
AU - Rodopoulou, Sophia P.
AU - Samoli, Evangelia
AU - Bekkevold, Terese
AU - Sigsgaard, Torben
AU - Stafoggia, Massimo
AU - Vienneau, Danielle
AU - Weinmayr, Gudrun
AU - Hoek, Gerard
AU - Andersen, Zorana J.
PY - 2021
Y1 - 2021
N2 - Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods: Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants’ baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models. Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 µg/m3 for PM2.5, 1.11 (1.06, 1.16) per 10 µg/m3 for NO2, and 1.11 (1.06, 1.15) per 0.5 10−5m−1 for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC. Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant.
AB - Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods: Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants’ baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models. Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 µg/m3 for PM2.5, 1.11 (1.06, 1.16) per 10 µg/m3 for NO2, and 1.11 (1.06, 1.15) per 0.5 10−5m−1 for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC. Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant.
KW - Air pollution
KW - COPD incidence
KW - Low-level exposure
U2 - 10.1016/j.envint.2020.106267
DO - 10.1016/j.envint.2020.106267
M3 - Journal article
C2 - 33276316
AN - SCOPUS:85097128896
VL - 146
JO - Environment international
JF - Environment international
SN - 0160-4120
M1 - 106267
ER -