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Domínguez A, Koch S, Marquez S, de Castro M, Urquiza J, Evandt J, Oftedal B, Aasvang GM, Kampouri M, Vafeiadi M, Mon-Williams M, Lewer D, Lepeule J, Andrusaityte S, Vrijheid M, Guxens M, Nieuwenhuijsen M. Childhood exposure to outdoor air pollution in different microenvironments and cognitive and fine motor function in children from six European cohorts. Environ Res 2024; 247:118174. [PMID: 38244968 DOI: 10.1016/j.envres.2024.118174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Exposure to air pollution during childhood has been linked with adverse effects on cognitive development and motor function. However, limited research has been done on the associations of air pollution exposure in different microenvironments such as home, school, or while commuting with these outcomes. OBJECTIVE To analyze the association between childhood air pollution exposure in different microenvironments and cognitive and fine motor function from six European birth cohorts. METHODS We included 1301 children from six European birth cohorts aged 6-11 years from the HELIX project. Average outdoor air pollutants concentrations (NO2, PM2.5) were estimated using land use regression models for different microenvironments (home, school, and commute), for 1-year before the outcome assessment. Attentional function, cognitive flexibility, non-verbal intelligence, and fine motor function were assessed using the Attention Network Test, Trail Making Test A and B, Raven Colored Progressive Matrices test, and the Finger Tapping test, respectively. Adjusted linear regressions models were run to determine the association between each air pollutant from each microenvironment on each outcome. RESULTS In pooled analysis we observed high correlation (rs = 0.9) between air pollution exposures levels at home and school. However, the cohort-by-cohort analysis revealed correlations ranging from low to moderate. Air pollution exposure levels while commuting were higher than at home or school. Exposure to air pollution in the different microenvironments was not associated with working memory, attentional function, non-verbal intelligence, and fine motor function. Results remained consistently null in random-effects meta-analysis. CONCLUSIONS No association was observed between outdoor air pollution exposure in different microenvironments (home, school, commute) and cognitive and fine motor function in children from six European birth cohorts. Future research should include a more detailed exposure assessment, considering personal measurements and time spent in different microenvironments.
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Affiliation(s)
- Alan Domínguez
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sarah Koch
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Marquez
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Montserrat de Castro
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jose Urquiza
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jorun Evandt
- Norwegian Institute of Public Health, Department of Air Quality and Noise, Oslo, Norway
| | - Bente Oftedal
- Norwegian Institute of Public Health, Department of Air Quality and Noise, Oslo, Norway
| | - Gunn Marit Aasvang
- Norwegian Institute of Public Health, Department of Air Quality and Noise, Oslo, Norway
| | - Mariza Kampouri
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Mark Mon-Williams
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Dan Lewer
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Johanna Lepeule
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Development and Respiratory Health, IAB, 38000, Grenoble, France
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Martine Vrijheid
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mònica Guxens
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Mark Nieuwenhuijsen
- ISGlobal, Dr. Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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2
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Guillien A, Slama R, Andrusaityte S, Casas M, Chatzi L, de Castro M, de Lauzon-Guillain B, Granum B, Grazuleviciene R, Julvez J, Krog NH, Lepeule J, Maitre L, McEachan R, Nieuwenhuijsen M, Oftedal B, Urquiza J, Vafeiadi M, Wright J, Vrijheid M, Basagaña X, Siroux V. Associations between combined urban and lifestyle factors and respiratory health in European children. Environ Res 2024; 242:117774. [PMID: 38036203 DOI: 10.1016/j.envres.2023.117774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/22/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Previous studies identified some environmental and lifestyle factors independently associated with children respiratory health, but few focused on exposure mixture effects. This study aimed at identifying, in pregnancy and in childhood, combined urban and lifestyle environment profiles associated with respiratory health in children. METHODS This study is based on the European Human Early-Life Exposome (HELIX) project, combining six birth cohorts. Associations between profiles of pregnancy (38 exposures) and childhood (84 exposures) urban and lifestyle factors, identified by clustering analysis, and respiratory health were estimated by regression models adjusted for confounders. RESULTS Among the 1033 included children (mean ± standard-deviation (SD) age: 8.2 ± 1.6 years old, 47% girls) the mean ± SD forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) were 99 ± 13% and 101 ± 14%, respectively, and 12%, 12% and 24% reported ever-asthma, wheezing and rhinitis, respectively. Four profiles of pregnancy exposures and four profiles of childhood exposures were identified. Compared to the reference childhood exposure profile (low exposures), two exposure profiles were associated with lower levels of FEV1. One profile was characterized by few natural spaces in the surroundings and high exposure to the built environment and road traffic. The second profile was characterized by high exposure to meteorological factors and low levels of all other exposures and was also associated with an increased risk of ever-asthma and wheezing. A pregnancy exposure profile characterized by high exposure levels to all risk factors, but a healthy maternal lifestyle, was associated with a lower risk of wheezing and rhinitis in children, compared to the reference pregnancy profile (low exposures). CONCLUSION This comprehensive approach revealed pregnancy and childhood profiles of urban and lifestyle exposures associated with lung function and/or respiratory conditions in children. Our findings highlight the need to pursue the study of combined exposures to improve prevention strategies for multifactorial diseases such as asthma.
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Affiliation(s)
- Alicia Guillien
- University of Grenoble Alpes, French National Institute of Health and Medical Research, French National Center for Scientific Research, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France.
| | - Rémy Slama
- University of Grenoble Alpes, French National Institute of Health and Medical Research, French National Center for Scientific Research, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, 53361, Academia, Lithuania
| | - Maribel Casas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Leda Chatzi
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Montserrat de Castro
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Berit Granum
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, 53361, Academia, Lithuania
| | - Jordi Julvez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Institut d'Investigatió Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Norun Hjertager Krog
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Johanna Lepeule
- University of Grenoble Alpes, French National Institute of Health and Medical Research, French National Center for Scientific Research, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Léa Maitre
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Bente Oftedal
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jose Urquiza
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Valérie Siroux
- University of Grenoble Alpes, French National Institute of Health and Medical Research, French National Center for Scientific Research, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
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Chen J, Braun D, Christidis T, Cork M, Rodopoulou S, Samoli E, Stafoggia M, Wolf K, Wu X, Yuchi W, Andersen ZJ, Atkinson R, Bauwelinck M, de Hoogh K, Janssen NA, Katsouyanni K, Klompmaker JO, Kristoffersen DT, Lim YH, Oftedal B, Strak M, Vienneau D, Zhang J, Burnett RT, Hoek G, Dominici F, Brauer M, Brunekreef B. Long-Term Exposure to Low-Level PM2.5 and Mortality: Investigation of Heterogeneity by Harmonizing Analyses in Large Cohort Studies in Canada, United States, and Europe. Environ Health Perspect 2023; 131:127003. [PMID: 38039140 PMCID: PMC10691665 DOI: 10.1289/ehp12141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 08/10/2023] [Accepted: 11/09/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Studies across the globe generally reported increased mortality risks associated with particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) exposure with large heterogeneity in the magnitude of reported associations and the shape of concentration-response functions (CRFs). We aimed to evaluate the impact of key study design factors (including confounders, applied exposure model, population age, and outcome definition) on PM 2.5 effect estimates by harmonizing analyses on three previously published large studies in Canada [Mortality-Air Pollution Associations in Low Exposure Environments (MAPLE), 1991-2016], the United States (Medicare, 2000-2016), and Europe [Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), 2000-2016] as much as possible. METHODS We harmonized the study populations to individuals 65 + years of age, applied the same satellite-derived PM 2.5 exposure estimates, and selected the same sets of potential confounders and the same outcome. We evaluated whether differences in previously published effect estimates across cohorts were reduced after harmonization among these factors. Additional analyses were conducted to assess the influence of key design features on estimated risks, including adjusted covariates and exposure assessment method. A combined CRF was assessed with meta-analysis based on the extended shape-constrained health impact function (eSCHIF). RESULTS More than 81 million participants were included, contributing 692 million person-years of follow-up. Hazard ratios and 95% confidence intervals (CIs) for all-cause mortality associated with a 5 - μ g / m 3 increase in PM 2.5 were 1.039 (1.032, 1.046) in MAPLE, 1.025 (1.021, 1.029) in Medicare, and 1.041 (1.014, 1.069) in ELAPSE. Applying a harmonized analytical approach marginally reduced difference in the observed associations across the three studies. Magnitude of the association was affected by the adjusted covariates, exposure assessment methodology, age of the population, and marginally by outcome definition. Shape of the CRFs differed across cohorts but generally showed associations down to the lowest observed PM 2.5 levels. A common CRF suggested a monotonically increased risk down to the lowest exposure level. https://doi.org/10.1289/EHP12141.
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Affiliation(s)
- Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Danielle Braun
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tanya Christidis
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Michael Cork
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodstrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodstrian University of Athens, Athens, Greece
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Weiran Yuchi
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Zorana J. Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard Atkinson
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole A.H. Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodstrian University of Athens, Athens, Greece
- MRC Center for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - Jochem O. Klompmaker
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Doris Tove Kristoffersen
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bente Oftedal
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maciej Strak
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Wolf K, Rodopoulou S, Chen J, Andersen ZJ, Atkinson RW, Bauwelinck M, Janssen NAH, Kristoffersen DT, Lim YH, Oftedal B, Strak M, Vienneau D, Zhang J, Brunekreef B, Hoek G, Stafoggia M, Samoli E. Comparison of traditional Cox regression and causal modeling to investigate the association between long-term air pollution exposure and natural-cause mortality within European cohorts. Environ Pollut 2023; 327:121515. [PMID: 36967008 DOI: 10.1016/j.envpol.2023.121515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/14/2023] [Accepted: 03/24/2023] [Indexed: 06/18/2023]
Abstract
Most studies investigating the health effects of long-term exposure to air pollution used traditional regression models, although causal inference approaches have been proposed as alternative. However, few studies have applied causal models and comparisons with traditional methods are sparse. We therefore compared the associations between natural-cause mortality and exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) using traditional Cox and causal models in a large multicenter cohort setting. We analysed data from eight well-characterized cohorts (pooled cohort) and seven administrative cohorts from eleven European countries. Annual mean PM2.5 and NO2 from Europe-wide models were assigned to baseline residential addresses and dichotomized at selected cut-off values (PM2.5: 10, 12, 15 μg/m³; NO2: 20, 40 μg/m³). For each pollutant, we estimated the propensity score as the conditional likelihood of exposure given available covariates, and derived corresponding inverse-probability weights (IPW). We applied Cox proportional hazards models i) adjusting for all covariates ("traditional Cox") and ii) weighting by IPW ("causal model"). Of 325,367 and 28,063,809 participants in the pooled and administrative cohorts, 47,131 and 3,580,264 died from natural causes, respectively. For PM2.5 above vs. below 12 μg/m³, the hazard ratios (HRs) of natural-cause mortality were 1.17 (95% CI 1.13-1.21) and 1.15 (1.11-1.19) for the traditional and causal models in the pooled cohort, and 1.03 (1.01-1.06) and 1.02 (0.97-1.09) in the administrative cohorts. For NO2 above vs below 20 μg/m³, the HRs were 1.12 (1.09-1.14) and 1.07 (1.05-1.09) for the pooled and 1.06 (95% CI 1.03-1.08) and 1.05 (1.02-1.07) for the administrative cohorts. In conclusion, we observed mostly consistent associations between long-term air pollution exposure and natural-cause mortality with both approaches, though estimates partly differed in individual cohorts with no systematic pattern. The application of multiple modelling methods might help to improve causal inference. 299 of 300 words.
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Affiliation(s)
- Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Neuherberg, Germany.
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bente Oftedal
- Department of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Maciek Strak
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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5
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So R, Chen J, Stafoggia M, de Hoogh K, Katsouyanni K, Vienneau D, Samoli E, Rodopoulou S, Loft S, Lim YH, Westendorp RGJ, Amini H, Cole-Hunter T, Bergmann M, Shahri SMT, Zhang J, Maric M, Mortensen LH, Bauwelinck M, Klompmaker JO, Atkinson RW, Janssen NAH, Oftedal B, Renzi M, Forastiere F, Strak M, Brunekreef B, Hoek G, Andersen ZJ. Long-term exposure to elemental components of fine particulate matter and all-natural and cause-specific mortality in a Danish nationwide administrative cohort study. Environ Res 2023; 224:115552. [PMID: 36822536 DOI: 10.1016/j.envres.2023.115552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) is a well-recognized risk factor for premature death. However, evidence on which PM2.5 components are most relevant is unclear. METHODS We evaluated the associations between mortality and long-term exposure to eight PM2.5 elemental components [copper (Cu), iron (Fe), zinc (Zn), sulfur (S), nickel (Ni), vanadium (V), silicon (Si), and potassium (K)]. Studied outcomes included death from diabetes, chronic kidney disease (CKD), dementia, and psychiatric disorders as well as all-natural causes, cardiovascular disease (CVD), respiratory diseases (RD), and lung cancer. We followed all residents in Denmark (aged ≥30 years) from January 1, 2000 to December 31, 2017. We used European-wide land-use regression models at a 100 × 100 m scale to estimate the residential annual mean levels of exposure to PM2.5 components. The models were developed with supervised linear regression (SLR) and random forest (RF). The associations were evaluated by Cox proportional hazard models adjusting for individual- and area-level socioeconomic factors and total PM2.5 mass. RESULTS Of 3,081,244 individuals, we observed 803,373 death from natural causes during follow-up. We found significant positive associations between all-natural mortality with Si and K from both exposure modeling approaches (hazard ratios; 95% confidence intervals per interquartile range increase): SLR-Si (1.04; 1.03-1.05), RF-Si (1.01; 1.00-1.02), SLR-K (1.03; 1.02-1.04), and RF-K (1.06; 1.05-1.07). Strong associations of K and Si were detected with most causes of mortality except CKD and K, and diabetes and Si (the strongest associations for psychiatric disorders mortality). In addition, Fe was relevant for mortality from RD, lung cancer, CKD, and psychiatric disorders; Zn with mortality from CKD, RD, and lung cancer, and; Ni and V with lung cancer mortality. CONCLUSIONS We present novel results of the relevance of different PM2.5 components for different causes of death, with K and Si seeming to be most consistently associated with mortality in Denmark.
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Affiliation(s)
- Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rudi G J Westendorp
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Bergmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Matija Maric
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust H Mortensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Denmark Statistics, Copenhagen, Denmark
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Richard W Atkinson
- Population Health Research Institute, St George's University of London, London, UK
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bente Oftedal
- Department of air quality and noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Science Policy & Epidemiology Environmental Research Group King's College London, London, UK
| | - Maciek Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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6
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Vienneau D, Stafoggia M, Rodopoulou S, Chen J, Atkinson RW, Bauwelinck M, Klompmaker JO, Oftedal B, Andersen ZJ, Janssen NAH, So R, Lim YH, Flückiger B, Ducret-Stich R, Röösli M, Probst-Hensch N, Künzli N, Strak M, Samoli E, de Hoogh K, Brunekreef B, Hoek G. Association between exposure to multiple air pollutants, transportation noise and cause-specific mortality in adults in Switzerland. Environ Health 2023; 22:29. [PMID: 36967400 PMCID: PMC10041702 DOI: 10.1186/s12940-023-00983-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/13/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Long-term exposure to air pollution and noise is detrimental to health; but studies that evaluated both remain limited. This study explores associations with natural and cause-specific mortality for a range of air pollutants and transportation noise. METHODS Over 4 million adults in Switzerland were followed from 2000 to 2014. Exposure to PM2.5, PM2.5 components (Cu, Fe, S and Zn), NO2, black carbon (BC) and ozone (O3) from European models, and transportation noise from source-specific Swiss models, were assigned at baseline home addresses. Cox proportional hazards models, adjusted for individual and area-level covariates, were used to evaluate associations with each exposure and death from natural, cardiovascular (CVD) or non-malignant respiratory disease. Analyses included single and two exposure models, and subset analysis to study lower exposure ranges. RESULTS During follow-up, 661,534 individuals died of natural causes (36.6% CVD, 6.6% respiratory). All exposures including the PM2.5 components were associated with natural mortality, with hazard ratios (95% confidence intervals) of 1.026 (1.015, 1.038) per 5 µg/m3 PM2.5, 1.050 (1.041, 1.059) per 10 µg/m3 NO2, 1.057 (1.048, 1.067) per 0.5 × 10-5/m BC and 1.045 (1.040, 1.049) per 10 dB Lden total transportation noise. NO2, BC, Cu, Fe and noise were consistently associated with CVD and respiratory mortality, whereas PM2.5 was only associated with CVD mortality. Natural mortality associations persisted < 20 µg/m3 for PM2.5 and NO2, < 1.5 10-5/m BC and < 53 dB Lden total transportation noise. The O3 association was inverse for all outcomes. Including noise attenuated all outcome associations, though many remained significant. Across outcomes, noise was robust to adjustment to air pollutants (e.g. natural mortality 1.037 (1.033, 1.042) per 10 dB Lden total transportation noise, after including BC). CONCLUSION Long-term exposure to air pollution and transportation noise in Switzerland contribute to premature mortality. Considering co-exposures revealed the importance of local traffic-related pollutants such as NO2, BC and transportation noise.
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Affiliation(s)
- Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, 1165, Denmark
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, 1165, Denmark
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, 1165, Denmark
| | - Benjamin Flückiger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Regina Ducret-Stich
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Maciek Strak
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
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7
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So R, Andersen ZJ, Chen J, Stafoggia M, de Hoogh K, Katsouyanni K, Vienneau D, Rodopoulou S, Samoli E, Lim YH, Jørgensen JT, Amini H, Cole-Hunter T, Mahmood Taghavi Shahri S, Maric M, Bergmann M, Liu S, Azam S, Loft S, Westendorp RGJ, Mortensen LH, Bauwelinck M, Klompmaker JO, Atkinson R, Janssen NAH, Oftedal B, Renzi M, Forastiere F, Strak M, Thygesen LC, Brunekreef B, Hoek G, Mehta AJ. Long-term exposure to air pollution and mortality in a Danish nationwide administrative cohort study: Beyond mortality from cardiopulmonary disease and lung cancer. Environ Int 2022; 164:107241. [PMID: 35544998 DOI: 10.1016/j.envint.2022.107241] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The association between long-term exposure to air pollution and mortality from cardiorespiratory diseases is well established, yet the evidence for other diseases remains limited. OBJECTIVES To examine the associations of long-term exposure to air pollution with mortality from diabetes, dementia, psychiatric disorders, chronic kidney disease (CKD), asthma, acute lower respiratory infection (ALRI), as well as mortality from all-natural and cardiorespiratory causes in the Danish nationwide administrative cohort. METHODS We followed all residents aged ≥ 30 years (3,083,227) in Denmark from 1 January 2000 until 31 December 2017. Annual mean concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC), and ozone (warm season) were estimated using European-wide hybrid land-use regression models (100 m × 100 m) and assigned to baseline residential addresses. We used Cox proportional hazard models to evaluate the association between air pollution and mortality, accounting for demographic and socioeconomic factors. We additionally applied indirect adjustment for smoking and body mass index (BMI). RESULTS During 47,023,454 person-years of follow-up, 803,881 people died from natural causes. Long-term exposure to PM2.5 (mean: 12.4 µg/m3), NO2 (20.3 µg/m3), and/or BC (1.0 × 10-5/m) was statistically significantly associated with all studied mortality outcomes except CKD. A 5 µg/m3 increase in PM2.5 was associated with higher mortality from all-natural causes (hazard ratio 1.11; 95% confidence interval 1.09-1.13), cardiovascular disease (1.09; 1.07-1.12), respiratory disease (1.11; 1.07-1.15), lung cancer (1.19; 1.15-1.24), diabetes (1.10; 1.04-1.16), dementia (1.05; 1.00-1.10), psychiatric disorders (1.38; 1.27-1.50), asthma (1.13; 0.94-1.36), and ALRI (1.14; 1.09-1.20). Associations with long-term exposure to ozone (mean: 80.2 µg/m3) were generally negative but became significantly positive for several endpoints in two-pollutant models. Generally, associations were attenuated but remained significant after indirect adjustment for smoking and BMI. CONCLUSION Long-term exposure to PM2.5, NO2, and/or BC in Denmark were associated with mortality beyond cardiorespiratory diseases, including diabetes, dementia, psychiatric disorders, asthma, and ALRI.
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Affiliation(s)
- Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Heresh Amini
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tom Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Matija Maric
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Bergmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Shadi Azam
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rudi G J Westendorp
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Laust H Mortensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Denmark Statistics, Copenhagen, Denmark
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Richard Atkinson
- Population Health Research Institute, St George's University of London, London, UK
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Bente Oftedal
- Department of Air Quality and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Science Policy & Epidemiology Environmental Research Group King's College London, London, UK
| | - Maciek Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Denmark Statistics, Copenhagen, Denmark
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8
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Rodopoulou S, Stafoggia M, Chen J, de Hoogh K, Bauwelinck M, Mehta AJ, Klompmaker JO, Oftedal B, Vienneau D, Janssen NAH, Strak M, Andersen ZJ, Renzi M, Cesaroni G, Nordheim CF, Bekkevold T, Atkinson R, Forastiere F, Katsouyanni K, Brunekreef B, Samoli E, Hoek G. Long-term exposure to fine particle elemental components and mortality in Europe: Results from six European administrative cohorts within the ELAPSE project. Sci Total Environ 2022; 809:152205. [PMID: 34890671 DOI: 10.1016/j.scitotenv.2021.152205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 05/25/2023]
Abstract
Evidence for the association between long-term exposure to ambient particulate matter components and mortality from natural causes is sparse and inconsistent. We evaluated this association in six large administrative cohorts in the framework of the Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) project. We analyzed data from country-wide administrative cohorts in Norway, Denmark, the Netherlands, Belgium, Switzerland and in Rome (Italy). Annual 2010 mean concentrations of copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V) and zinc (Zn) in fine particulate matter (PM2.5) were estimated using 100 × 100 m Europe-wide hybrid land use regression models assigned to the participants' residential addresses. We applied cohort-specific Cox proportional hazard models controlling for area- and individual-level covariates to evaluate associations with natural mortality. Two pollutant models adjusting for PM2.5 total mass or nitrogen dioxide (NO2) were also applied. We pooled cohort-specific estimates using a random effects meta-analysis. We included almost 27 million participants contributing more than 240 million person-years. All components except Zn were significantly associated with natural mortality [pooled Hazard Ratios (HRs) (95% CI): 1.037 (1.014, 1.060) per 5 ng/m3 Cu; 1.069 (1.031, 1.108) per 100 ng/m3 Fe; 1.039 (1.018, 1.062) per 50 ng/m3 K; 1.024 (1.006, 1.043) per 1 ng/m3 Ni; 1.036 (1.016, 1.057) per 200 ng/m3 S; 1.152 (1.048, 1.266) per 100 ng/m3 Si; 1.020 (1.006, 1.034) per 2 ng/m3 V]. Only K and Si were robust to PM2.5 or NO2 adjustment [pooled HRs (95% CI) per 50 ng/m3 in K: 1.025 (1.008, 1.044), 1.020 (0.999, 1.042) and per 100 ng/m3 in Si: 1.121 (1.039, 1.209), 1.068 (1.022, 1.117) adjusted for PM2.5 and NO2 correspondingly]. Our findings indicate an association of natural mortality with most components, which was reduced after adjustment for PM2.5 and especially NO2.
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Affiliation(s)
- Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Methodology and Analysis, Statistics Denmark, Copenhagen, Denmark.
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Maciej Strak
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Institute for Risk Assessment Sciences, Utrecht University, the Netherlands.
| | - Zorana J Andersen
- Section of Environmental and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy.
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy.
| | - Carl Fredrik Nordheim
- Department of Zoonotic, Food- and Waterborne Infections, Norwegian Institute of Public Health, Oslo, Norway.
| | - Terese Bekkevold
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway.
| | - Richard Atkinson
- Population Health Research, Institute St George's, University of London, London, UK.
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Science Policy & Epidemiology Environmental Research Group, King's College London, London, UK
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, UK.
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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9
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Bauwelinck M, Chen J, de Hoogh K, Katsouyanni K, Rodopoulou S, Samoli E, Andersen ZJ, Atkinson R, Casas L, Deboosere P, Demoury C, Janssen N, Klompmaker JO, Lefebvre W, Mehta AJ, Nawrot TS, Oftedal B, Renzi M, Stafoggia M, Strak M, Vandenheede H, Vanpoucke C, Van Nieuwenhuyse A, Vienneau D, Brunekreef B, Hoek G. Variability in the association between long-term exposure to ambient air pollution and mortality by exposure assessment method and covariate adjustment: A census-based country-wide cohort study. Sci Total Environ 2022; 804:150091. [PMID: 34517316 DOI: 10.1016/j.scitotenv.2021.150091] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/02/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions. METHODS We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43). RESULTS We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 μg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 μg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3]. CONCLUSION Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method.
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Affiliation(s)
- Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group Imperial College, London, London, UK.
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Zorana J Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Richard Atkinson
- Population Health Research, Institute St George's, University of London, London, UK.
| | - Lidia Casas
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Medical Sociology and Health Policy, Department of Epidemiology and Social Medicine, University of Antwerp, Wilrijk, Belgium.
| | - Patrick Deboosere
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Claire Demoury
- Risk and Health Impact Assessment Unit, Sciensano, Brussels, Belgium.
| | - Nicole Janssen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Wouter Lefebvre
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium.
| | - Amar Jayant Mehta
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Tim S Nawrot
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Centre for Environmental Sciences, University of Hasselt, Diepenbeek, Belgium.
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Maciek Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Hadewijch Vandenheede
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
| | | | - An Van Nieuwenhuyse
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Risk and Health Impact Assessment Unit, Sciensano, Brussels, Belgium.
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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10
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Stafoggia M, Oftedal B, Chen J, Rodopoulou S, Renzi M, Atkinson RW, Bauwelinck M, Klompmaker JO, Mehta A, Vienneau D, Andersen ZJ, Bellander T, Brandt J, Cesaroni G, de Hoogh K, Fecht D, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Jöckel KH, Jørgensen JT, Katsouyanni K, Ketzel M, Kristoffersen DT, Lager A, Leander K, Liu S, Ljungman PLS, Nagel G, Pershagen G, Peters A, Raaschou-Nielsen O, Rizzuto D, Schramm S, Schwarze PE, Severi G, Sigsgaard T, Strak M, van der Schouw YT, Verschuren M, Weinmayr G, Wolf K, Zitt E, Samoli E, Forastiere F, Brunekreef B, Hoek G, Janssen NAH. Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project. Lancet Planet Health 2022; 6:e9-e18. [PMID: 34998464 DOI: 10.1016/s2542-5196(21)00277-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Long-term exposure to ambient air pollution has been associated with premature mortality, but associations at concentrations lower than current annual limit values are uncertain. We analysed associations between low-level air pollution and mortality within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE). METHODS In this multicentre longitudinal study, we analysed seven population-based cohorts of adults (age ≥30 years) within ELAPSE, from Belgium, Denmark, England, the Netherlands, Norway, Rome (Italy), and Switzerland (enrolled in 2000-11; follow-up until 2011-17). Mortality registries were used to extract the underlying cause of death for deceased individuals. Annual average concentrations of fine particulate matter (PM2·5), nitrogen dioxide (NO2), black carbon, and tropospheric warm-season ozone (O3) from Europe-wide land use regression models at 100 m spatial resolution were assigned to baseline residential addresses. We applied cohort-specific Cox proportional hazard models with adjustment for area-level and individual-level covariates to evaluate associations with non-accidental mortality, as the main outcome, and with cardiovascular, non-malignant respiratory, and lung cancer mortality. Subset analyses of participants living at low pollutant concentrations (as per predefined values) and natural splines were used to investigate the concentration-response function. Cohort-specific effect estimates were pooled in a random-effects meta-analysis. FINDINGS We analysed 28 153 138 participants contributing 257 859 621 person-years of observation, during which 3 593 741 deaths from non-accidental causes occurred. We found significant positive associations between non-accidental mortality and PM2·5, NO2, and black carbon, with a hazard ratio (HR) of 1·053 (95% CI 1·021-1·085) per 5 μg/m3 increment in PM2·5, 1·044 (1·019-1·069) per 10 μg/m3 NO2, and 1·039 (1·018-1·059) per 0·5 × 10-5/m black carbon. Associations with PM2·5, NO2, and black carbon were slightly weaker for cardiovascular mortality, similar for non-malignant respiratory mortality, and stronger for lung cancer mortality. Warm-season O3 was negatively associated with both non-accidental and cause-specific mortality. Associations were stronger at low concentrations: HRs for non-accidental mortality at concentrations lower than the WHO 2005 air quality guideline values for PM2·5 (10 μg/m3) and NO2 (40 μg/m3) were 1·078 (1·046-1·111) per 5 μg/m3 PM2·5 and 1·049 (1·024-1·075) per 10 μg/m3 NO2. Similarly, the association between black carbon and non-accidental mortality was highest at low concentrations, with a HR of 1·061 (1·032-1·092) for exposure lower than 1·5× 10-5/m, and 1·081 (0·966-1·210) for exposure lower than 1·0× 10-5/m. INTERPRETATION Long-term exposure to concentrations of PM2·5 and NO2 lower than current annual limit values was associated with non-accidental, cardiovascular, non-malignant respiratory, and lung cancer mortality in seven large European cohorts. Continuing research on the effects of low concentrations of air pollutants is expected to further inform the process of setting air quality standards in Europe and other global regions. FUNDING Health Effects Institute.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography-Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Amar Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate Aarhus University Interdisciplinary Centre for Climate Change, Aarhus, Denmark
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Daniela Fecht
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - John Gulliver
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Centre for Environmental Health and Sustainability and School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Bioscience, Aarhus University, Roskilde, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research, University of Surrey, Guildford, UK
| | | | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Ludwig Maximilians Universität München, Munich, Germany
| | - Ole Raaschou-Nielsen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Germany
| | - Per E Schwarze
- Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gianluca Severi
- Exposome and Heredity Team, University Paris-Saclay, UVSQ, INSERM, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Italy
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Maciek Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands; National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service, ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
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Strak M, Weinmayr G, Rodopoulou S, Chen J, de Hoogh K, Andersen ZJ, Atkinson R, Bauwelinck M, Bekkevold T, Bellander T, Boutron-Ruault MC, Brandt J, Cesaroni G, Concin H, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Janssen NAH, Jöckel KH, Jørgensen JT, Ketzel M, Klompmaker JO, Lager A, Leander K, Liu S, Ljungman P, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Rizzuto D, van der Schouw YT, Schramm S, Severi G, Sigsgaard T, Sørensen M, Stafoggia M, Tjønneland A, Verschuren WMM, Vienneau D, Wolf K, Katsouyanni K, Brunekreef B, Hoek G, Samoli E. Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis. BMJ 2021; 374:n1904. [PMID: 34470785 PMCID: PMC8409282 DOI: 10.1136/bmj.n1904] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. DESIGN Pooled analysis of eight cohorts. SETTING Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries. PARTICIPANTS 325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM2.5), nitrogen dioxide, ozone, and black carbon. MAIN OUTCOME MEASURES Deaths due to natural causes and cause specific mortality. RESULTS Of 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 µg/m3 in PM2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 µg/m3 increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 µg/m3 an increase of 5 µg/m3 in PM2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths. CONCLUSIONS Our study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about revision of air quality limits, guidelines, and standards, and future assessments by the Global Burden of Disease.
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Affiliation(s)
- Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Zorana J Andersen
- Department of Public Health, Section of Environment and Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Terese Bekkevold
- Department of Method Development and Analytics, Norwegian Institute of Public Health, Oslo, Norway
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Hans Concin
- Agency for Preventive and Social Medicine (AKS), Bregenz, Austria
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Science Policy and Epidemiology Environmental Research Group King's College London, London, UK
| | - John Gulliver
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Centre for Environmental Health and Sustainability and School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Bioscience, Aarhus University, Roskilde, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social, and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry, and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Jeanette T Jørgensen
- Department of Public Health, Section of Environment and Health, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, UK
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shuo Liu
- Department of Public Health, Section of Environment and Health, University of Copenhagen, Copenhagen, Denmark
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amar J Mehta
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Ludwig Maximilians Universität München, Munich, Germany
| | | | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Sara Schramm
- Institute for Medical Informatics, Biometry, and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Gianluca Severi
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, Paris, France
- Department of Statistics, Computer Science and Applications "G Parenti" (DISIA), University of Florence, Italy
| | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | | | - W M Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Science Policy and Epidemiology Environmental Research Group King's College London, London, UK
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology, and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Brunekreef B, Strak M, Chen J, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, Boutron MC, Brandt J, Carey I, Cesaroni G, Forastiere F, Fecht D, Gulliver J, Hertel O, Hoffmann B, de Hoogh K, Houthuijs D, Hvidtfeldt U, Janssen N, Jorgensen J, Katsouyanni K, Ketzel M, Klompmaker J, Hjertager Krog N, Liu S, Ljungman P, Mehta A, Nagel G, Oftedal B, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Rodopoulou S, Samoli E, Schwarze P, Sigsgaard T, Stafoggia M, Vienneau D, Weinmayr G, Wolf K, Hoek G. Mortality and Morbidity Effects of Long-Term Exposure to Low-Level PM 2.5, BC, NO 2, and O 3: An Analysis of European Cohorts in the ELAPSE Project. Res Rep Health Eff Inst 2021; 2021:1-127. [PMID: 36106702 PMCID: PMC9476567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Epidemiological cohort studies have consistently found associations between long-term exposure to outdoor air pollution and a range of morbidity and mortality endpoints. Recent evaluations by the World Health Organization and the Global Burden of Disease study have suggested that these associations may be nonlinear and may persist at very low concentrations. Studies conducted in North America in particular have suggested that associations with mortality persisted at concentrations of particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) well below current air quality standards and guidelines. The uncertainty about the shape of the concentration-response function at the low end of the concentration distribution, related to the scarcity of observations in the lowest range, was the basis of the current project. Previous studies have focused on PM2.5, but increasingly associations with nitrogen dioxide (NO2) are being reported, particularly in studies that accounted for the fine spatial scale variation of NO2. Very few studies have evaluated the effects of long-term exposure to low concentrations of ozone (O3). Health effects of black carbon (BC), representing primary combustion particles, have not been studied in most large cohort studies of PM2.5. Cohort studies assessing health effects of particle composition, including elements from nontailpipe traffic emissions (iron, copper, and zinc) and secondary aerosol (sulfur) have been few in number and reported inconsistent results. The overall objective of our study was to investigate the shape of the relationship between long-term exposure to four pollutants (PM2.5, NO2, BC, and O3) and four broad health effect categories using a number of different methods to characterize the concentration-response function (i.e., linear, nonlinear, or threshold). The four health effect categories were (1) natural- and cause-specific mortality including cardiovascular and nonmalignant as well as malignant respiratory and diabetes mortality; and morbidity measured as (2) coronary and cerebrovascular events; (3) lung cancer incidence; and (4) asthma and chronic obstructive pulmonary disease (COPD) incidence. We additionally assessed health effects of PM2.5 composition, specifically the copper, iron, zinc, and sulfur content of PM2,5. METHODS We focused on analyses of health effects of air pollutants at low concentrations, defined as less than current European Union (EU) Limit Values, U.S. Environmental Protection Agency (U.S. EPA), National Ambient Air Quality Standards (NAAQS), and/or World Health Organization (WHO) Air Quality Guideline values for PM2.5, NO2, and O3. We address the health effects at low air pollution levels by performing new analyses within selected cohorts of the ESCAPE study (European Study of Cohorts for Air Pollution Effects; Beelen et al. 2014a) and within seven very large European administrative cohorts. By combining well-characterized ESCAPE cohorts and large administrative cohorts in one study the strengths and weaknesses of each approach can be addressed. The large administrative cohorts are more representative of national or citywide populations, have higher statistical power, and can efficiently control for area-level confounders, but have fewer possibilities to control for individual-level confounders. The ESCAPE cohorts have detailed information on individual confounders, as well as country-specific information on area-level confounding. The data from the seven included ESCAPE cohorts and one additional non-ESCAPE cohort have been pooled and analyzed centrally. More than 300,000 adults were included in the pooled cohort from existing cohorts in Sweden, Denmark, Germany, the Netherlands, Austria, France, and Italy. Data from the administrative cohorts have been analyzed locally, without transfer to a central database. Privacy regulations prevented transfer of data from administrative cohorts to a central database. More than 28 million adults were included from national administrative cohorts in Belgium, Denmark, England, the Netherlands, Norway, and Switzerland as well as an administrative cohort in Rome, Italy. We developed central exposure assessment using Europewide hybrid land use regression (LUR) models, which incorporated European routine monitoring data for PM2.5, NO2, and O3, and ESCAPE monitoring data for BC and PM2.5 composition, land use, and traffic data supplemented with satellite observations and chemical transport model estimates. For all pollutants, we assessed exposure at a fine spatial scale, 100 × 100 m grids. These models have been applied to individual addresses of all cohorts including the administrative cohorts. In sensitivity analyses, we applied the PM2.5 models developed within the companion HEI-funded Canadian MAPLE study (Brauer et al. 2019) and O3 exposures on a larger spatial scale for comparison with previous studies. Identification of outcomes included linkage with mortality, cancer incidence, hospital discharge registries, and physician-based adjudication of cases. We analyzed natural-cause, cardiovascular, ischemic heart disease, stroke, diabetes, cardiometabolic, respiratory, and COPD mortality. We also analyzed lung cancer incidence, incidence of coronary and cerebrovascular events, and incidence of asthma and COPD (pooled cohort only). We applied the Cox proportional hazard model with increasing control for individual- and area-level covariates to analyze the associations between air pollution and mortality and/or morbidity for both the pooled cohort and the individual administrative cohorts. Age was used as the timescale because of evidence that this results in better adjustment for potential confounding by age. Censoring occurred at the time of the event of interest, death from other causes, emigration, loss to follow-up for other reasons, or at the end of follow-up, whichever came first. A priori we specified three confounder models, following the modeling methods of the ESCAPE study. Model 1 included only age (time axis), sex (as strata), and calendar year of enrollment. Model 2 added individual-level variables that were consistently available in the cohorts contributing to the pooled cohort or all variables available in the administrative cohorts, respectively. Model 3 further added area-level socioeconomic status (SES) variables. A priori model 3 was selected as the main model. All analyses in the pooled cohort were stratified by subcohort. All analyses in the administrative cohorts accounted for clustering of the data in neighborhoods by adjusting the variance of the effect estimates. The main exposure variable we analyzed was derived from the Europewide hybrid models based on 2010 monitoring data. Sensitivity analyses were conducted using earlier time periods, time-varying exposure analyses, local exposure models, and the PM2.5 models from the Canadian MAPLE project. We first specified linear single-pollutant models. Two-pollutant models were specified for all combinations of the four main pollutants. Two-pollutant models for particle composition were analyzed with PM2.5 and NO2 as the second pollutant. We then investigated the shape of the concentration-response function using natural splines with two, three, and four degrees of freedom; penalized splines with the degrees of freedom determined by the algorithm and shape-constrained health impact functions (SCHIF) using confounder model 3. Additionally, we specified linear models in subsets of the concentration range, defined by removing concentrations above a certain value from the analysis, such as for PM2.5 25 μg/m3 (EU limit value), 20, 15, 12 μg/m3 (U.S. EPA National Ambient Air Quality Standard), and 10 μg/m3 (WHO Air Quality Guideline value). Finally, threshold models were evaluated to investigate whether the associations persisted below specific concentration values. For PM2.5, we evaluated 10, 7.5, and 5 μg/m3 as potential thresholds. Performance of threshold models versus the corresponding no-threshold linear model were evaluated using the Akaike information criterion (AIC). RESULTS In the pooled cohort, virtually all subjects in 2010 had PM2.5 and NO2 annual average exposures below the EU limit values (25 μg/m3 and 40 μg/m3, respectively). More than 50,000 had a residential PM2.5 exposure below the U.S. EPA NAAQS (12 μg/m3). More than 25,000 subjects had a residential PM2.5 exposure below the WHO guideline (10 μg/m3). We found significant positive associations between PM2.5, NO2, and BC and natural-cause, respiratory, cardiovascular, and diabetes mortality. In our main model, the hazard ratios (HRs) (95% [confidence interval] CI) were 1.13 (CI = 1.11, 1.16) for an increase of 5 μg/m3 PM2.5, 1.09 (CI = 1.07, 1.10) for an increase of 10 μg/m3 NO2, and 1.08 (CI = 1.06, 1.10) for an increase of 0.5 × 10-5/m BC for natural-cause mortality. The highest HRs were found for diabetes mortality. Associations with O3 were negative, both in the fine spatial scale of the main ELAPSE model and in large spatial scale exposure models. For PM2.5, NO2, and BC, we generally observed a supralinear association with steeper slopes at low exposures and no evidence of a concentration below which no association was found. Subset analyses further confirmed that these associations remained at low levels: below 10 μg/m3 for PM2.5 and 20 μg/m3 for NO2. HRs were similar to the full cohort HRs for subjects with exposures below the EU limit values for PM2.5 and NO2, the U.S. NAAQS values for PM2.5, and the WHO guidelines for PM2.5 and NO2. The mortality associations were robust to alternative specifications of exposure, including different time periods, PM2.5 from the MAPLE project, and estimates from the local ESCAPE model. Time-varying exposure natural spline analyses confirmed associations at low pollution levels. HRs in two-pollutant models were attenuated but remained elevated and statistically significant for PM2.5 and NO2. In two-pollutant models of PM2.5 and NO2 HRs for natural-cause mortality were 1.08 (CI = 1.05, 1.11) for PM2.5 and 1.05 (CI = 1.03, 1.07) for NO2. Associations with O3 were attenuated but remained negative in two-pollutant models with NO2, BC, and PM2.5. We found significant positive associations between PM2.5, NO2, and BC and incidence of stroke and asthma and COPD hospital admissions. Furthermore, NO2 was significantly related to acute coronary heart disease and PM2.5 was significantly related to lung cancer incidence. We generally observed linear to supralinear associations with no evidence of a threshold, with the exception of the association between NO2 and acute coronary heart disease, which was sublinear. Subset analyses documented that associations remained even with PM2.5 below 20 μg/m3 and possibly 12 μg/m3. Associations remained even when NO2 was below 30 μg/m3 and in some cases 20 μg/m3. In two-pollutant models, NO2 was most consistently associated with acute coronary heart disease, stroke, asthma, and COPD hospital admissions. PM2.5 was not associated with these outcomes in two-pollutant models with NO2. PM2.5 was the only pollutant that was associated with lung cancer incidence in two-pollutant models. Associations with O3 were negative though generally not statistically significant. In the administrative cohorts, virtually all subjects in 2010 had PM2.5 and NO2 annual average exposures below the EU limit values. More than 3.9 million subjects had a residential PM2.5 exposure below the U.S. EPA NAAQS (12 μg/m3) and more than 1.9 million had residential PM2.5 exposures below the WHO guideline (10 μg/m3). We found significant positive associations between PM2.5, NO2, and BC and natural-cause, respiratory, cardiovascular, and lung cancer mortality, with moderate to high heterogeneity between cohorts. We found positive but statistically nonsignificant associations with diabetes mortality. In our main model meta-analysis, the HRs (95% CI) for natural-cause mortality were 1.05 (CI = 1.02, 1.09) for an increase of 5 μg/m3 PM2.5, 1.04 (CI = 1.02, 1.07) for an increase of 10 μg/m3 NO2, and 1.04 (CI = 1.02, 1.06) for an increase of 0.5 × 10-5/m BC, and 0.95 (CI = 0.93, 0.98) for an increase of 10 μg/m3 O3. The shape of the concentration-response functions differed between cohorts, though the associations were generally linear to supralinear, with no indication of a level below which no associations were found. Subset analyses documented that these associations remained at low levels: below 10 μg/m3 for PM2.5 and 20 μg/m3 for NO2. BC and NO2 remained significantly associated with mortality in two-pollutant models with PM2.5 and O3. The PM2.5 HR attenuated to unity in a two-pollutant model with NO2. The negative O3 association was attenuated to unity and became nonsignificant. The mortality associations were robust to alternative specifications of exposure, including time-varying exposure analyses. Time-varying exposure natural spline analyses confirmed associations at low pollution levels. Effect estimates in the youngest participants (<65 years at baseline) were much larger than in the elderly (>65 years at baseline). Effect estimates obtained with the ELAPSE PM2.5 model did not differ from the MAPLE PM2.5 model on average, but in individual cohorts, substantial differences were found. CONCLUSIONS Long-term exposure to PM2.5, NO2, and BC was positively associated with natural-cause and cause-specific mortality in the pooled cohort and the administrative cohorts. Associations were found well below current limit values and guidelines for PM2.5 and NO2. Associations tended to be supralinear, with steeper slopes at low exposures with no indication of a threshold. Two-pollutant models documented the importance of characterizing the ambient mixture with both NO2 and PM2.5. We mostly found negative associations with O3. In two-pollutant models with NO2, the negative associations with O3 were attenuated to essentially unity in the mortality analysis of the administrative cohorts and the incidence analyses in the pooled cohort. In the mortality analysis of the pooled cohort, significant negative associations with O3 remained in two-pollutant models. Long-term exposure to PM2.5, NO2, and BC was also positively associated with morbidity outcomes in the pooled cohort. For stroke, asthma, and COPD, positive associations were found for PM2.5, NO2, and BC. For acute coronary heart disease, an increased HR was observed for NO2. For lung cancer, an increased HR was found only for PM2.5. Associations mostly showed steeper slopes at low exposures with no indication of a threshold.
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Affiliation(s)
- Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Zorana J Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard Atkinson
- Population Health Research, Institute St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography-Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, and Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | | | - Jorgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Iain Carey
- Population Health Research, Institute St George's, University of London, London, UK
| | - Giulia Cesaroni
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
- Science Policy & Epidemiology Environmental Research Group King's College London, London, UK
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - John Gulliver
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, University of Duesseldorf, Duesseldorf, Germany
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Danny Houthuijs
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Nicole Janssen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Klea Katsouyanni
- Science Policy & Epidemiology Environmental Research Group King's College London, London, UK
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jochem Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Norun Hjertager Krog
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Shuo Liu
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, and Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Amar Mehta
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Methods and Analysis, Statistics Denmark, Copenhagen, Denmark
| | - Gabriele Nagel
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Goran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, and Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany
| | | | - Matteo Renzi
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evi Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Per Schwarze
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Torben Sigsgaard
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
| | | | - Gudrun Weinmayr
- Methods and Analysis, Statistics Denmark, Copenhagen, Denmark
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
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13
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Wolf K, Hoffmann B, Andersen ZJ, Atkinson RW, Bauwelinck M, Bellander T, Brandt J, Brunekreef B, Cesaroni G, Chen J, de Faire U, de Hoogh K, Fecht D, Forastiere F, Gulliver J, Hertel O, Hvidtfeldt UA, Janssen NAH, Jørgensen JT, Katsouyanni K, Ketzel M, Klompmaker JO, Lager A, Liu S, MacDonald CJ, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pedersen NL, Pershagen G, Raaschou-Nielsen O, Renzi M, Rizzuto D, Rodopoulou S, Samoli E, van der Schouw YT, Schramm S, Schwarze P, Sigsgaard T, Sørensen M, Stafoggia M, Strak M, Tjønneland A, Verschuren WMM, Vienneau D, Weinmayr G, Hoek G, Peters A, Ljungman PLS. Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease: a pooled analysis of six European cohorts within the ELAPSE project. Lancet Planet Health 2021; 5:e620-e632. [PMID: 34508683 DOI: 10.1016/s2542-5196(21)00195-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we investigated the associations of long-term exposures to fine particulate matter (PM2·5), nitrogen dioxide (NO2), black carbon, and warm-season ozone (O3) with the incidence of stroke and acute coronary heart disease. METHODS We did a pooled analysis of individual data from six population-based cohort studies within ELAPSE, from Sweden, Denmark, the Netherlands, and Germany (recruited 1992-2004), and harmonised individual and area-level variables between cohorts. Participants (all adults) were followed up until migration from the study area, death, or incident stroke or coronary heart disease, or end of follow-up (2011-15). Mean 2010 air pollution concentrations from centrally developed European-wide land use regression models were assigned to participants' baseline residential addresses. We used Cox proportional hazards models with increasing levels of covariate adjustment to investigate the association of air pollution exposure with incidence of stroke and coronary heart disease. We assessed the shape of the concentration-response function and did subset analyses of participants living at pollutant concentrations lower than predefined values. FINDINGS From the pooled ELAPSE cohorts, data on 137 148 participants were analysed in our fully adjusted model. During a median follow-up of 17·2 years (IQR 13·8-19·5), we observed 6950 incident events of stroke and 10 071 incident events of coronary heart disease. Incidence of stroke was associated with PM2·5 (hazard ratio 1·10 [95% CI 1·01-1·21] per 5 μg/m3 increase), NO2 (1·08 [1·04-1·12] per 10 μg/m3 increase), and black carbon (1·06 [1·02-1·10] per 0·5 10-5/m increase), whereas coronary heart disease incidence was only associated with NO2 (1·04 [1·01-1·07]). Warm-season O3 was not associated with an increase in either outcome. Concentration-response curves indicated no evidence of a threshold below which air pollutant concentrations are not harmful for cardiovascular health. Effect estimates for PM2·5 and NO2 remained elevated even when restricting analyses to participants exposed to pollutant concentrations lower than the EU limit values of 25 μg/m3 for PM2·5 and 40 μg/m3 for NO2. INTERPRETATION Long-term air pollution exposure was associated with incidence of stroke and coronary heart disease, even at pollutant concentrations lower than current limit values. FUNDING Health Effects Institute.
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Affiliation(s)
- Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate, Interdisciplinary Centre for Climate Change, Aarhus University, Denmark
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Giulia Cesaroni
- Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ulf de Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Daniela Fecht
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Francesco Forastiere
- Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - John Gulliver
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK; School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Bioscience, Aarhus University, Roskilde, Denmark
| | | | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klea Katsouyanni
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research, University of Surrey, Surrey, UK
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Conor J MacDonald
- INSERM U1018, CESP, Institut Gustave Roussy, Université Paris-Saclay, Université Paris-Sud, Villejuif, France
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Ole Raaschou-Nielsen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Matteo Renzi
- Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Per Schwarze
- Global Health Cluster, Norwegian Institute of Public Health, Oslo, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Maciek Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands; National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | | | - W M Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Ludwig Maximilians Universität München, Munich, Germany
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
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14
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Liu S, Jørgensen JT, Ljungman P, Pershagen G, Bellander T, Leander K, Magnusson PKE, Rizzuto D, Hvidtfeldt UA, Raaschou-Nielsen O, Wolf K, Hoffmann B, Brunekreef B, Strak M, Chen J, Mehta A, Atkinson RW, Bauwelinck M, Varraso R, Boutron-Ruault MC, Brandt J, Cesaroni G, Forastiere F, Fecht D, Gulliver J, Hertel O, de Hoogh K, Janssen NAH, Katsouyanni K, Ketzel M, Klompmaker JO, Nagel G, Oftedal B, Peters A, Tjønneland A, Rodopoulou SP, Samoli E, Kristoffersen DT, Sigsgaard T, Stafoggia M, Vienneau D, Weinmayr G, Hoek G, Andersen ZJ. Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project. Eur Respir J 2021; 57:57/6/2003099. [PMID: 34088754 DOI: 10.1183/13993003.03099-2020] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/17/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 µm (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in adults. 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.
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Affiliation(s)
- Shuo Liu
- Dept of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K E Magnusson
- Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Dept of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,The Stockholm Gerontology Research Center, Stockholm, Sweden
| | | | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Dept of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Maciej Strak
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.,National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Amar Mehta
- Dept of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography, Dept of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Raphaëlle Varraso
- CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Jørgen Brandt
- Dept of Environmental Science, Aarhus University, Roskilde, Denmark.,iClimate, Aarhus University Interdisciplinary Center for Climate Change, Roskilde, Denmark
| | - Giulia Cesaroni
- Dept of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | | | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - John Gulliver
- UK Small Area Health Statistics Unit, Dept of Epidemiology and Biostatistics, Imperial College London, London, UK.,Centre for Environmental Health and Sustainability and School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Dept of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Klea Katsouyanni
- Dept of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Matthias Ketzel
- Dept of Environmental Science, Aarhus University, Roskilde, Denmark.,Global Centre for Clean Air Research, University of Surrey, Guildford, UK
| | - Jochem O Klompmaker
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.,National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Dept of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.,Epidemiology, Faculty of Medicine, Ludwig Maximilians Universität München, Munich, Germany
| | - Anne Tjønneland
- Dept of Public Health, University of Copenhagen, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Sophia P Rodopoulou
- Dept of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Dept of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Torben Sigsgaard
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | | | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Zorana Jovanovic Andersen
- Dept of Public Health, University of Copenhagen, Copenhagen, Denmark .,Center for Epidemiological Research, Nykøbing F Hospital, Nykøbing F, Denmark
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15
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Chen J, Rodopoulou S, de Hoogh K, Strak M, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, Brandt J, Cesaroni G, Concin H, Fecht D, Forastiere F, Gulliver J, Hertel O, Hoffmann B, Hvidtfeldt UA, Janssen NAH, Jöckel KH, Jørgensen J, Katsouyanni K, Ketzel M, Klompmaker JO, Lager A, Leander K, Liu S, Ljungman P, MacDonald CJ, Magnusson PK, Mehta A, Nagel G, Oftedal B, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Rizzuto D, Samoli E, van der Schouw YT, Schramm S, Schwarze P, Sigsgaard T, Sørensen M, Stafoggia M, Tjønneland A, Vienneau D, Weinmayr G, Wolf K, Brunekreef B, Hoek G. Long-Term Exposure to Fine Particle Elemental Components and Natural and Cause-Specific Mortality-a Pooled Analysis of Eight European Cohorts within the ELAPSE Project. Environ Health Perspect 2021; 129:47009. [PMID: 33844598 PMCID: PMC8041432 DOI: 10.1289/ehp8368] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/18/2021] [Accepted: 03/15/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Inconsistent associations between long-term exposure to particles with an aerodynamic diameter ≤ 2.5 μ m [fine particulate matter (PM 2.5 )] components and mortality have been reported, partly related to challenges in exposure assessment. OBJECTIVES We investigated the associations between long-term exposure to PM 2.5 elemental components and mortality in a large pooled European cohort; to compare health effects of PM 2.5 components estimated with two exposure modeling approaches, namely, supervised linear regression (SLR) and random forest (RF) algorithms. METHODS We pooled data from eight European cohorts with 323,782 participants, average age 49 y at baseline (1985-2005). Residential exposure to 2010 annual average concentration of eight PM 2.5 components [copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V), and zinc (Zn)] was estimated with Europe-wide SLR and RF models at a 100 × 100 m scale. We applied Cox proportional hazards models to investigate the associations between components and natural and cause-specific mortality. In addition, two-pollutant analyses were conducted by adjusting each component for PM 2.5 mass and nitrogen dioxide (NO 2 ) separately. RESULTS We observed 46,640 natural-cause deaths with 6,317,235 person-years and an average follow-up of 19.5 y. All SLR-modeled components were statistically significantly associated with natural-cause mortality in single-pollutant models with hazard ratios (HRs) from 1.05 to 1.27. Similar HRs were observed for RF-modeled Cu, Fe, K, S, V, and Zn with wider confidence intervals (CIs). HRs for SLR-modeled Ni, S, Si, V, and Zn remained above unity and (almost) significant after adjustment for both PM 2.5 and NO 2 . HRs only remained (almost) significant for RF-modeled K and V in two-pollutant models. The HRs for V were 1.03 (95% CI: 1.02, 1.05) and 1.06 (95% CI: 1.02, 1.10) for SLR- and RF-modeled exposures, respectively, per 2 ng / m 3 , adjusting for PM 2.5 mass. Associations with cause-specific mortality were less consistent in two-pollutant models. CONCLUSION Long-term exposure to V in PM 2.5 was most consistently associated with increased mortality. Associations for the other components were weaker for exposure modeled with RF than SLR in two-pollutant models. https://doi.org/10.1289/EHP8368.
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Affiliation(s)
- Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Zorana J. Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard Atkinson
- Population Health Research, St George’s, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Denmark
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Daniela Fecht
- Medical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
- Science Policy and Epidemiology Environmental Research Group, King’s College London, London, UK
| | - John Gulliver
- Medical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Centre for Environmental Health and Sustainability, School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | | | - Nicole A. H. Janssen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Jeanette Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Science Policy and Epidemiology Environmental Research Group, King’s College London, London, UK
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Denmark
- Global Centre for Clean Air Research, University of Surrey, Guildford, UK
| | - Jochem O. Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Conor J. MacDonald
- Centre de recherche en Epidémiologie et Santé des Populations, Faculté de Medicine, Université Paris-Saclay, Villejuif, France
- Department of Statistics, Computer Science and Applications, University of Florence, Florence, Italy
| | - Patrik K.E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amar Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany
| | | | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Per Schwarze
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Torben Sigsgaard
- Department of Public Health, Section of Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | | | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
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16
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Ausland JHL, Engdahl B, Oftedal B, Steingrímsdóttir ÓA, Nielsen CS, Hopstock LA, Johnsen M, Friborg O, Rosenvinge JH, Eggen AE, Krog NH. Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015-2016). PLoS One 2021; 16:e0247880. [PMID: 33651844 PMCID: PMC7924755 DOI: 10.1371/journal.pone.0247880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, and tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in tinnitus patients to provide a more comprehensive treatment of tinnitus.
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Affiliation(s)
- Jannike H-L Ausland
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- * E-mail:
| | - Bo Engdahl
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Ólöf A. Steingrímsdóttir
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Christopher S. Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Magnar Johnsen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Jan H. Rosenvinge
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Anne E. Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Norun H. Krog
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
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17
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Samoli E, Rodopoulou S, Hvidtfeldt UA, Wolf K, Stafoggia M, Brunekreef B, Strak M, Chen J, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, Brandt J, Cesaroni G, Forastiere F, Fecht D, Gulliver J, Hertel O, Hoffmann B, de Hoogh K, Janssen NAH, Ketzel M, Klompmaker JO, Liu S, Ljungman P, Nagel G, Oftedal B, Pershagen G, Peters A, Raaschou-Nielsen O, Renzi M, Kristoffersen DT, Severi G, Sigsgaard T, Vienneau D, Weinmayr G, Hoek G, Katsouyanni K. Modeling multi-level survival data in multi-center epidemiological cohort studies: Applications from the ELAPSE project. Environ Int 2021; 147:106371. [PMID: 33422970 DOI: 10.1016/j.envint.2020.106371] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND We evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). METHODS We applied five approaches in a multivariable Cox model to account for the first level of clustering corresponding to cohort specification: (1) not accounting for the cohort or using (2) indicator variables, (3) strata, (4) a frailty term in frailty Cox models, (5) a random intercept under a mixed Cox, for cohort identification. We accounted for the second level of clustering due to common characteristics in the residential area by (1) a random intercept per small area or (2) applying variance correction. We assessed the stratified, frailty and mixed Cox approach through simulations under different scenarios for heterogeneity in the underlying hazards and the air pollution effects. RESULTS Effect estimates were stable under approaches used to adjust for cohort but substantially differed when no adjustment was applied. Further adjustment for the small area grouping increased the effect estimates' standard errors. Simulations confirmed identical results between the stratified and frailty models. In ELAPSE we selected a stratified multivariable Cox model to account for between-cohort heterogeneity without adjustment for small area level, due to the small number of subjects and events in the latter. CONCLUSIONS Our study supports the need to account for between-cohort heterogeneity in multi-center collaborations using pooled individual level data.
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Affiliation(s)
- Evangelia Samoli
- Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Sophia Rodopoulou
- Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | | | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands
| | - Maciej Strak
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, the Netherlands
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands
| | - Zorana J Andersen
- University of Copenhagen, Department of Public Health, Section of Environmental Health, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Richard Atkinson
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, Roskilde, Denmark
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- NIHR HPRU Health Impact of Environmental Hazards, Environmental Research Group, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Daniela Fecht
- Small Area Health Statistics Unit, MRC Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
| | - John Gulliver
- Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, Roskilde, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Germany
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nicole A H Janssen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford GU2 7XH, UK
| | - Jochem O Klompmaker
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, the Netherlands
| | - Shuo Liu
- University of Copenhagen, Department of Public Health, Section of Environmental Health, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Centre, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, Roskilde, Denmark
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy
| | - Doris T Kristoffersen
- Cluster for Health Services Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Gianluca Severi
- Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands
| | - Klea Katsouyanni
- Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece; NIHR HPRU Health Impact of Environmental Hazards, Environmental Research Group, Analytical, Environmental & Forensic Sciences, King's College London, UK
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18
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Hvidtfeldt UA, Chen J, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, Brandt J, Brunekreef B, Cesaroni G, Concin H, Fecht D, Forastiere F, van Gils CH, Gulliver J, Hertel O, Hoek G, Hoffmann B, de Hoogh K, Janssen N, Jørgensen JT, Katsouyanni K, Jöckel KH, Ketzel M, Klompmaker JO, Lang A, Leander K, Liu S, Ljungman PLS, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pershagen G, Peter RS, Peters A, Renzi M, Rizzuto D, Rodopoulou S, Samoli E, Schwarze PE, Severi G, Sigsgaard T, Stafoggia M, Strak M, Vienneau D, Weinmayr G, Wolf K, Raaschou-Nielsen O. Long-term exposure to fine particle elemental components and lung cancer incidence in the ELAPSE pooled cohort. Environ Res 2021; 193:110568. [PMID: 33278469 DOI: 10.1016/j.envres.2020.110568] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/20/2020] [Accepted: 11/29/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study builds on recent findings from the "Effects of Low-level Air Pollution: A Study in Europe" (ELAPSE) collaboration and addresses the potential association between specific elemental components of PM2.5 and lung cancer incidence. METHODS We pooled seven cohorts from across Europe and assigned exposure estimates for eight components of PM2.5 representing non-tail pipe emissions (copper (Cu), iron (Fe), and zinc (Zn)), long-range transport (sulfur (S)), oil burning/industry emissions (nickel (Ni), vanadium (V)), crustal material (silicon (Si)), and biomass burning (potassium (K)) to cohort participants' baseline residential address based on 100 m by 100 m grids from newly developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). RESULTS The pooled study population comprised 306,550 individuals with 3916 incident lung cancer events during 5,541,672 person-years of follow-up. We observed a positive association between exposure to all eight components and lung cancer incidence, with adjusted HRs of 1.10 (95% CI 1.05, 1.16) per 50 ng/m3 PM2.5 K, 1.09 (95% CI 1.02, 1.15) per 1 ng/m3 PM2.5 Ni, 1.22 (95% CI 1.11, 1.35) per 200 ng/m3 PM2.5 S, and 1.07 (95% CI 1.02, 1.12) per 200 ng/m3 PM2.5 V. Effect estimates were largely unaffected by adjustment for nitrogen dioxide (NO2). After adjustment for PM2.5 mass, effect estimates of K, Ni, S, and V were slightly attenuated, whereas effect estimates of Cu, Si, Fe, and Zn became null or negative. CONCLUSIONS Our results point towards an increased risk of lung cancer in connection with sources of combustion particles from oil and biomass burning and secondary inorganic aerosols rather than non-exhaust traffic emissions. Specific limit values or guidelines targeting these specific PM2.5 components may prove helpful in future lung cancer prevention strategies.
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Affiliation(s)
| | - Jie Chen
- Institute of Risk Assessment Sciences, University of Utrecht, P.O. Box 80177, Utrecht, NL 3508 TD, the Netherlands.
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1014, Denmark.
| | - Richard Atkinson
- Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK.
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium.
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm, SE-171 77, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Plan 10, Stockholm, SE-113 65, Sweden.
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, Roskilde, 4000, Denmark; IClimate - Aarhus University Interdisciplinary Centre for Climate Change, Frederiksborgvej 399, P.O.Box 358, Roskilde, 4000, Denmark.
| | - Bert Brunekreef
- Institute of Risk Assessment Sciences, University of Utrecht, P.O. Box 80177, Utrecht, NL 3508 TD, the Netherlands.
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via Cristoforo Colombo 112, Rome, 00147, Italy.
| | - Hans Concin
- Agency for Preventive and Social Medicine, Rheinstraße 61, Bregenz, 6900, Austria.
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, W2 1PG, UK.
| | - Francesco Forastiere
- Institute for Biomedical Research and Innovation (IRIB), National Research Council, Palermo, 90146, Italy; Environmental Research Group, Imperial College, London, W12 0BZ, UK.
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, GA, Utrecht, 3508, the Netherlands.
| | - John Gulliver
- Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, LE1 7RH, UK.
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, Roskilde, 4000, Denmark.
| | - Gerard Hoek
- Institute of Risk Assessment Sciences, University of Utrecht, P.O. Box 80177, Utrecht, NL 3508 TD, the Netherlands.
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University, Gurlittstraße 55, Dusseldorf, 40223, Germany.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel, 4051, Switzerland; University of Basel, Petersplatz 1, Postfach, Basel, 4001, Switzerland.
| | - Nicole Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Jeanette Therming Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1014, Denmark.
| | - Klea Katsouyanni
- Dept. of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School 75, Mikras Asias Street, Athens, 115 27, Greece; NIHR HPRU Health Impact of Environmental Hazards, School of Public Health, Imperial College, London, UK.
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, 45147, Germany.
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, Roskilde, 4000, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, United Kingdom.
| | - Jochem O Klompmaker
- Institute of Risk Assessment Sciences, University of Utrecht, P.O. Box 80177, Utrecht, NL 3508 TD, the Netherlands; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, 45147, Germany.
| | - Alois Lang
- Cancer Registry Vorarlberg, Agency for Preventive and Social Medicine, Rheinstraße 61, Bregenz, 6900, Austria.
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm, SE-171 77, Sweden.
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, 1014, Denmark.
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm, SE-171 77, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77 Stockholm, Sweden.
| | - Amar Jayant Mehta
- Statistics Denmark, Sejrøgade 11, 2100, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine, Rheinstraße 61, Bregenz, 6900, Austria; Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081, Ulm, Germany.
| | - Bente Oftedal
- Section of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213, Oslo, Norway.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm, SE-171 77, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, Plan 10, Stockholm, SE-113 65, Sweden.
| | - Raphael Simon Peter
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081, Ulm, Germany.
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany.
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via Cristoforo Colombo 112, Rome, 00147, Italy.
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, 17165, Sweden; Stockholm Gerontology Research Center, Stockholm, 11346, Sweden.
| | - Sophia Rodopoulou
- Dept. of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School 75, Mikras Asias Street, Athens, 115 27, Greece.
| | - Evangelia Samoli
- Dept. of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School 75, Mikras Asias Street, Athens, 115 27, Greece.
| | - Per Everhard Schwarze
- Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Gianluca Severi
- CESP, UMR 1018, Université Paris-Saclay, Inserm, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy.
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark.
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm, SE-171 77, Sweden; Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via Cristoforo Colombo 112, Rome, 00147, Italy.
| | - Maciej Strak
- Institute of Risk Assessment Sciences, University of Utrecht, P.O. Box 80177, Utrecht, NL 3508 TD, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Danielle Vienneau
- University of Basel, Petersplatz 1, Postfach, Basel, 4001, Switzerland; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081, Ulm, Germany.
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen, 2100, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, Roskilde, 4000, Denmark.
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19
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Klompmaker JO, Janssen N, Andersen ZJ, Atkinson R, Bauwelinck M, Chen J, de Hoogh K, Houthuijs D, Katsouyanni K, Marra M, Oftedal B, Rodopoulou S, Samoli E, Stafoggia M, Strak M, Swart W, Wesseling J, Vienneau D, Brunekreef B, Hoek G. Comparison of associations between mortality and air pollution exposure estimated with a hybrid, a land-use regression and a dispersion model. Environ Int 2021; 146:106306. [PMID: 33395948 DOI: 10.1016/j.envint.2020.106306] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/04/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION To characterize air pollution exposure at a fine spatial scale, different exposure assessment methods have been applied. Comparison of associations with health from different exposure methods are scarce. The aim of this study was to evaluate associations of air pollution based on hybrid, land-use regression (LUR) and dispersion models with natural cause and cause-specific mortality. METHODS We followed a Dutch national cohort of approximately 10.5 million adults aged 29+ years from 2008 until 2012. We used Cox proportional hazard models with age as underlying time scale and adjusted for several potential individual and area-level socio-economic status confounders to evaluate associations of annual average residential NO2, PM2.5 and BC exposure estimates based on two stochastic models (Dutch LUR, European-wide hybrid) and deterministic Dutch dispersion models. RESULTS Spatial variability of PM2.5 and BC exposure was smaller for LUR compared to hybrid and dispersion models. NO2 exposure variability was similar for the three methods. Pearson correlations between hybrid, LUR and dispersion modeled NO2 and BC ranged from 0.72 to 0.83; correlations for PM2.5 were slightly lower (0.61-0.72). In general, all three models showed stronger associations of air pollutants with respiratory disease and lung cancer mortality than with natural cause and cardiovascular disease mortality. The strength of the associations differed between the three exposure models. Associations of air pollutants estimated by LUR were generally weaker compared to associations of air pollutants estimated by hybrid and dispersion models. For natural cause mortality, we found a hazard ratio (HR) of 1.030 (95% confidence interval (CI): 1.019, 1.041) per 10 µg/m3 for hybrid modeled NO2, a HR of 1.003 (95% CI: 0.993, 1.013) per 10 µg/m3 for LUR modeled NO2 and a HR of 1.015 (95% CI: 1.005, 1.024) per 10 µg/m3 for dispersion modeled NO2. CONCLUSION Air pollution was positively associated with natural cause and cause-specific mortality, but the strength of the associations differed between the three exposure models. Our study documents that the selected exposure model may contribute to heterogeneity in effect estimates of associations between air pollution and health.
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Affiliation(s)
- Jochem O Klompmaker
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Institute for Risk Assessment Sciences, Utrecht University, Netherlands.
| | - Nicole Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Klea Katsouyanni
- Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; NIHR HPRU Health Impact of Environmental Hazards & MRC Centre for Environment and Health Environmental Research Group, School of Public Health, Imperial College London, UK
| | - Marten Marra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Sophia Rodopoulou
- Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Dept. of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maciej Strak
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Institute for Risk Assessment Sciences, Utrecht University, Netherlands
| | - Wim Swart
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joost Wesseling
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Netherlands
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20
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Liu S, Jørgensen JT, Ljungman P, Pershagen G, Bellander T, Leander K, Magnusson PKE, Rizzuto D, Hvidtfeldt UA, Raaschou-Nielsen O, Wolf K, Hoffmann B, Brunekreef B, Strak M, Chen J, Mehta A, Atkinson RW, Bauwelinck M, Varraso R, Boutron-Ruault MC, Brandt J, Cesaroni G, Forastiere F, Fecht D, Gulliver J, Hertel O, de Hoogh K, Janssen NAH, Katsouyanni K, Ketzel M, Klompmaker JO, Nagel G, Oftedal B, Peters A, Tjønneland A, Rodopoulou SP, Samoli E, Bekkevold T, Sigsgaard T, Stafoggia M, Vienneau D, Weinmayr G, Hoek G, Andersen ZJ. Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project. Environ Int 2021; 146:106267. [PMID: 33276316 DOI: 10.1016/j.envint.2020.106267] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 05/26/2023]
Abstract
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.
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Affiliation(s)
- Shuo Liu
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T Jørgensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; The Stockholm Gerontology Research Center, Stockholm, Sweden
| | | | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Maciej Strak
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jie Chen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Amar Mehta
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Raphaëlle Varraso
- CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France; Gustave Roussy, Villejuif, France
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate, Aarhus University Interdisciplinary Center for Climate Change, Roskilde, Denmark
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - John Gulliver
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, Imperial College London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research, University of Surrey, Guildford, United Kingdom
| | - Jochem O Klompmaker
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany
| | - Anne Tjønneland
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Sophia P Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Terese Bekkevold
- Department of Infectious Diseases Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | | | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Zorana J Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Epidemiological Research, Nykøbing F Hospital, Nykøbing F, Denmark.
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21
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Hvidtfeldt UA, Severi G, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, Boutron-Ruault MC, Brandt J, Brunekreef B, Cesaroni G, Chen J, Concin H, Forastiere F, van Gils CH, Gulliver J, Hertel O, Hoek G, Hoffmann B, de Hoogh K, Janssen N, Jöckel KH, Jørgensen JT, Katsouyanni K, Ketzel M, Klompmaker JO, Krog NH, Lang A, Leander K, Liu S, Ljungman PLS, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pershagen G, Peter RS, Peters A, Renzi M, Rizzuto D, Rodopoulou S, Samoli E, Schwarze PE, Sigsgaard T, Simonsen MK, Stafoggia M, Strak M, Vienneau D, Weinmayr G, Wolf K, Raaschou-Nielsen O, Fecht D. Long-term low-level ambient air pollution exposure and risk of lung cancer - A pooled analysis of 7 European cohorts. Environ Int 2021; 146:106249. [PMID: 33197787 DOI: 10.1016/j.envint.2020.106249] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/15/2020] [Accepted: 10/26/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND/AIM Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. METHODS The "Effects of Low-level Air Pollution: a Study in Europe" (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O3) to assign exposure to cohort participants' residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. RESULTS The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O3 (warm season) were 24.2 µg/m3 (19.5, 29.7), 15.4 µg/m3 (12.8, 17.3), 1.6 10-5m-1 (1.3, 1.8), and 86.6 µg/m3 (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 µg/m3). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset of subjects with exposure below the EU limit value of 25 µg/m3. We did not observe associations between NO2, BC or O3 and lung cancer incidence. CONCLUSIONS Long-term ambient PM2.5 exposure is associated with lung cancer incidence even at concentrations below current EU limit values and possibly WHO Air Quality Guidelines.
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Affiliation(s)
| | - Gianluca Severi
- CESP, UMR 1018, Université Paris-Saclay, Inserm, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy.
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Richard Atkinson
- Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK.
| | - Mariska Bauwelinck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, 4000 Roskilde, Denmark; iClimate - Aarhus University Interdisciplinary Centre for Climate Change, Frederiksborgvej 399, P.O.Box 358, 4000 Roskilde, Denmark.
| | - Bert Brunekreef
- Institute of Risk Assessment Sciences (IRAS), University of Utrecht, P.O. Box 80177, NL 3508 TD Utrecht, the Netherlands
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy.
| | - Jie Chen
- Institute of Risk Assessment Sciences (IRAS), University of Utrecht, P.O. Box 80177, NL 3508 TD Utrecht, the Netherlands.
| | - Hans Concin
- Agency for Preventive and Social Medicine, Rheinstraße 61, 6900 Bregenz, Austria.
| | - Francesco Forastiere
- Institute for Biomedical Research and Innovation (IRIB), National Research Council, 90146 Palermo, Italy; Environmental Research Group, King's College, London SE1 9NH, UK
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508 GA Utrecht, the Netherlands.
| | - John Gulliver
- Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, LE1 7RH, UK.
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, 4000 Roskilde, Denmark.
| | - Gerard Hoek
- Institute of Risk Assessment Sciences (IRAS), University of Utrecht, P.O. Box 80177, NL 3508 TD Utrecht, the Netherlands.
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University, Gurlittstraße 55, 40223 Dusseldorf, Germany.
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland; University of Basel, Petersplatz 1, Postfach, 4001 Basel, Switzerland.
| | - Nicole Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
| | - Jeanette Therming Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Klea Katsouyanni
- Dept. of Hygiene, Epidemiology and Medical Statistics, National and Kapodstrian University of Athens, Medical School 75, Mikras Asias Street 115 27 Athens, Greece; NIHR HPRU Health Impact of Environmental Hazards, Environmental Research Group, School of Public Health, Imperial College, London, UK.
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, 4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, United Kingdom.
| | - Jochem O Klompmaker
- Institute of Risk Assessment Sciences (IRAS), University of Utrecht, P.O. Box 80177, NL 3508 TD Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Norun Hjertager Krog
- Section of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Alois Lang
- Cancer Registry Vorarlberg, Agency for Preventive and Social Medicine, Rheinstraße 61, Bregenz 6900, Austria.
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Amar Jayant Mehta
- Statistics Denmark, Sejrøgade 11, 2100 Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine, Rheinstraße 61, 6900 Bregenz, Austria; Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081 Ulm, Germany.
| | - Bente Oftedal
- Section of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213 Oslo, Norway.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Raphael Simon Peter
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081 Ulm, Germany.
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany.
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy.
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm 17165, Sweden; Stockholm Gerontology Research Center, Stockholm 11346, Sweden.
| | - Sophia Rodopoulou
- Dept. of Hygiene, Epidemiology and Medical Statistics, National and Kapodstrian University of Athens, Medical School 75, Mikras Asias Street 115 27 Athens, Greece.
| | - Evangelia Samoli
- Dept. of Hygiene, Epidemiology and Medical Statistics, National and Kapodstrian University of Athens, Medical School 75, Mikras Asias Street 115 27 Athens, Greece.
| | - Per Everhard Schwarze
- Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark.
| | | | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy.
| | - Maciek Strak
- Institute of Risk Assessment Sciences (IRAS), University of Utrecht, P.O. Box 80177, NL 3508 TD Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland; University of Basel, Petersplatz 1, Postfach, 4001 Basel, Switzerland.
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081 Ulm, Germany.
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany.
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, P.O.Box 358, 4000 Roskilde, Denmark.
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, School of Public Health, Imperial College London, W2 1PG London, UK.
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Liu S, Jørgensen JT, Ljungman P, Pershagen G, Bellander T, Leander K, Magnusson PK, Rizzuto D, Hvidtfeldt UA, Raaschou-Nielsen O, Wolf K, Hoffmann B, Brunekreef B, Strak M, Chen J, Mehta A, Atkinson RW, Bauwelinck M, Varraso R, Boutron-Ruault MC, Brandt J, Cesaroni G, Forastiere F, Fecht D, Gulliver J, Hertel O, de Hoogh K, Janssen NA, Katsouyanni K, Ketzel M, Klompmaker JO, Nagel G, Oftedal B, Peters A, Tjønneland A, Rodopoulou SP, Samoli E, Kristoffersen DT, Sigsgaard T, Stafoggia M, Vienneau D, Weinmayr G, Hoek G, Andersen ZJ. Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project. Eur Respir J 2020. [DOI: 10.1183/13993003.030992020] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BackgroundLong-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 µm (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in adults.MethodsWe 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.ResultsOf 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.ConclusionsLong-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.
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23
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Granum B, Oftedal B, Agier L, Siroux V, Bird P, Casas M, Warembourg C, Wright J, Chatzi L, de Castro M, Donaire D, Grazuleviciene R, Småstuen Haug L, Maitre L, Robinson O, Tamayo-Uria I, Urquiza J, Nieuwenhuijsen M, Slama R, Thomsen C, Vrijheid M. Multiple environmental exposures in early-life and allergy-related outcomes in childhood. Environ Int 2020; 144:106038. [PMID: 32854059 PMCID: PMC8768577 DOI: 10.1016/j.envint.2020.106038] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/10/2020] [Accepted: 08/03/2020] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Early onset and high prevalence of allergic diseases result in high individual and socio-economic burdens. Several studies provide evidence for possible effects of environmental factors on allergic diseases, but these are mainly single-exposure studies. The exposome provides a novel holistic approach by simultaneously studying a large set of exposures. The aim of the study was to evaluate the association between a broad range of prenatal and childhood environmental exposures and allergy-related outcomes in children. MATERIAL AND METHODS Analyses of associations between 90 prenatal and 107 childhood exposures and allergy-related outcomes (last 12 months: rhinitis and itchy rash; ever: doctor-diagnosed eczema and food allergy) in 6-11 years old children (n = 1270) from the European Human Early-Life Exposome cohort were performed. Initially, we used an exposome-wide association study (ExWAS) considering the exposures independently, followed by a deletion-substitution-addition selection (DSA) algorithm considering all exposures simultaneously. All the exposure variables selected in the DSA were included in a final multi-exposure model using binomial general linear model (GLM). RESULTS In ExWAS, no exposures were associated with the outcomes after correction for multiple comparison. In multi-exposure models for prenatal exposures, lower distance of residence to nearest road and higher di-iso-nonyl phthalate level were associated with increased risk of rhinitis, and particulate matter absorbance (PMabs) was associated with a decreased risk. Furthermore, traffic density on nearest road was associated with increased risk of itchy rash and diethyl phthalate with a reduced risk. DSA selected no associations of childhood exposures, or between prenatal exposures and eczema or food allergy. DISCUSSION This first comprehensive and systematic analysis of many environmental exposures suggests that prenatal exposure to traffic-related variables, PMabs and phthalates are associated with rhinitis and itchy rash.
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Affiliation(s)
- Berit Granum
- Norwegian Institute of Public Health, Oslo, Norway.
| | | | - Lydiane Agier
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Valerie Siroux
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | - Philippa Bird
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford UK
| | - Maribel Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Charline Warembourg
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford UK
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA; Department of Social Medicine, University of Crete, Greece; Department of Genetics & Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Donaire
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Regina Grazuleviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, Kaunas, Lithuania
| | | | - Lea Maitre
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Oliver Robinson
- ISGlobal, Barcelona, Spain; MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | | | | | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Remy Slama
- Team of Environmental Epidemiology, IAB, Institute for Advanced Biosciences, Inserm, CNRS, CHU-Grenoble-Alpes, University Grenoble-Alpes, Grenoble, France
| | | | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Evandt J, Skurtveit S, Oftedal B, Krog NH, Nafstad P, Skovlund E, Schwarze PE, Aasvang GM. Agreement between self‐reported and registry‐based use of sleep medications and tranquilizers. Pharmacoepidemiol Drug Saf 2019; 28:1336-1343. [DOI: 10.1002/pds.4854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/06/2019] [Accepted: 06/17/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Jorunn Evandt
- Division of Infection Control and Environmental Health, Department of Air Pollution and NoiseNorwegian Institute of Public Health Oslo Norway
| | - Svetlana Skurtveit
- Division of Mental and Physical Health, Department of Mental DisordersNorwegian Institute of Public Health Oslo Norway
- Norwegian Centre for Addiction Research (SERAF)University of Oslo Oslo Norway
| | - Bente Oftedal
- Division of Infection Control and Environmental Health, Department of Air Pollution and NoiseNorwegian Institute of Public Health Oslo Norway
| | - Norun Hjertager Krog
- Division of Infection Control and Environmental Health, Department of Air Pollution and NoiseNorwegian Institute of Public Health Oslo Norway
| | - Per Nafstad
- Faculty of Medicine, Department of Community Medicine and Global HealthUniversity of Oslo Oslo Norway
- Division of Mental and Physical Health, Department of Noncommunicable DiseasesNorwegian Institute of Public Health Oslo Norway
| | - Eva Skovlund
- Division of Mental and Physical Health, Department of Mental DisordersNorwegian Institute of Public Health Oslo Norway
- Faculty of Medicine and Health Sciences, Department of Public Health and NursingNorwegian University of Science and Technology Trondheim Norway
| | - Per E. Schwarze
- Division of Infection Control and Environmental Health, Department of Air Pollution and NoiseNorwegian Institute of Public Health Oslo Norway
| | - Gunn Marit Aasvang
- Division of Infection Control and Environmental Health, Department of Air Pollution and NoiseNorwegian Institute of Public Health Oslo Norway
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25
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Agier L, Basagaña X, Maitre L, Granum B, Bird PK, Casas M, Oftedal B, Wright J, Andrusaityte S, de Castro M, Cequier E, Chatzi L, Donaire-Gonzalez D, Grazuleviciene R, Haug LS, Sakhi AK, Leventakou V, McEachan R, Nieuwenhuijsen M, Petraviciene I, Robinson O, Roumeliotaki T, Sunyer J, Tamayo-Uria I, Thomsen C, Urquiza J, Valentin A, Slama R, Vrijheid M, Siroux V. Early-life exposome and lung function in children in Europe: an analysis of data from the longitudinal, population-based HELIX cohort. Lancet Planet Health 2019; 3:e81-e92. [PMID: 30737192 DOI: 10.1016/s2542-5196(19)30010-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/21/2018] [Accepted: 01/04/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Several single-exposure studies have documented possible effects of environmental factors on lung function, but none has relied on an exposome approach. We aimed to evaluate the association between a broad range of prenatal and postnatal lifestyle and environmental exposures and lung function in children. METHODS In this analysis, we used data from 1033 mother-child pairs from the European Human Early-Life Exposome (HELIX) cohort (consisting of six existing longitudinal birth cohorts in France, Greece, Lithuania, Norway, Spain, and the UK of children born between 2003 and 2009) for whom a valid spirometry test was recorded for the child. 85 prenatal and 125 postnatal exposures relating to outdoor, indoor, chemical, and lifestyle factors were assessed, and lung function was measured by spirometry in children at age 6-12 years. Two agnostic linear regression methods, a deletion-substitution-addition (DSA) algorithm considering all exposures simultaneously, and an exposome-wide association study (ExWAS) considering exposures independently, were applied to test the association with forced expiratory volume in 1 s percent predicted values (FEV1%). We tested for two-way interaction between exposures and corrected for confounding by co-exposures. FINDINGS In the 1033 children (median age 8·1 years, IQR 6·5-9·0), mean FEV1% was 98·8% (SD 13·2). In the ExWAS, prenatal perfluorononanoate (p=0·034) and perfluorooctanoate (p=0·030) exposures were associated with lower FEV1%, and inverse distance to nearest road during pregnancy (p=0·030) was associated with higher FEV1%. Nine postnatal exposures were associated with lower FEV1%: copper (p=0·041), ethyl-paraben (p=0·029), five phthalate metabolites (mono-2-ethyl 5-carboxypentyl phthalate [p=0·016], mono-2-ethyl-5-hydroxyhexyl phthalate [p=0·023], mono-2-ethyl-5-oxohexyl phthalate [p=0·0085], mono-4-methyl-7-oxooctyl phthalate [p=0·040], and the sum of di-ethylhexyl phthalate metabolites [p=0·014]), house crowding (p=0·015), and facility density around schools (p=0·027). However, no exposure passed the significance threshold when corrected for multiple testing in ExWAS, and none was selected with the DSA algorithm, including when testing for exposure interactions. INTERPRETATION Our systematic exposome approach identified several environmental exposures, mainly chemicals, that might be associated with lung function. Reducing exposure to these ubiquitous chemicals could help to prevent the development of chronic respiratory disease. FUNDING European Community's Seventh Framework Programme (HELIX project).
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Affiliation(s)
- Lydiane Agier
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lea Maitre
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Berit Granum
- Norwegian Institute of Public Health, Oslo, Norway
| | - Philippa K Bird
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Maribel Casas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Social Medicine, University of Crete, Heraklion, Greece; Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - David Donaire-Gonzalez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Line S Haug
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Vasiliki Leventakou
- Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Inga Petraviciene
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Oliver Robinson
- ISGlobal, Barcelona, Spain; MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Theano Roumeliotaki
- Department of Genetics and Cell Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ibon Tamayo-Uria
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Jose Urquiza
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antonia Valentin
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rémy Slama
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Valérie Siroux
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Inserm, CNRS, University Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209 Joint Research Center, Grenoble, France.
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26
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Andersen ZJ, Pedersen M, Weinmayr G, Stafoggia M, Galassi C, Jørgensen JT, Sommar JN, Forsberg B, Olsson D, Oftedal B, Aasvang GM, Schwarze P, Pyko A, Pershagen G, Korek M, Faire UD, Östenson CG, Fratiglioni L, Eriksen KT, Poulsen AH, Tjønneland A, Bräuner EV, Peeters PH, Bueno-de-Mesquita B, Jaensch A, Nagel G, Lang A, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Migliore E, Vermeulen R, Sokhi R, Keuken M, de Hoogh K, Beelen R, Vineis P, Cesaroni G, Brunekreef B, Hoek G, Raaschou-Nielsen O. Long-term exposure to ambient air pollution and incidence of brain tumor: the European Study of Cohorts for Air Pollution Effects (ESCAPE). Neuro Oncol 2019; 20:420-432. [PMID: 29016987 PMCID: PMC5817954 DOI: 10.1093/neuonc/nox163] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
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Affiliation(s)
- Zorana J Andersen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Pedersen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RM1, Rome, Italy.,Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jeanette T Jørgensen
- Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johan N Sommar
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Per Schwarze
- Norwegian Institute of Public Health, Oslo, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institute, Stockholm, Sweden
| | - Kirsten T Eriksen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Aslak H Poulsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg Hospital, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Biomarkers and Clinical Resreach in Eating Disorders, Ballerup Center for Mental Health Services, Capitol Region of Denmark, Rigshospitalt- Ballerup, Denmark
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands.,MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Bas Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.,Vorarlberg Cancer Registry, Bregenz, Austria
| | - Alois Lang
- Vorarlberg Cancer Registry, Bregenz, Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ming-Yi Tsai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.,Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.,Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands.,MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, UK
| | - Menno Keuken
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland, University of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.,National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.,Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RM1, Rome, Italy
| | - Bert Brunekreef
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands.,Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Weinmayr G, Pedersen M, Stafoggia M, Andersen ZJ, Galassi C, Munkenast J, Jaensch A, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Rizzuto D, Sørensen M, Tjønneland A, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Concin H, Lang A, Wang M, Tsai MY, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, de Hoogh K, Beelen R, Vineis P, Kooter I, Sokhi R, Brunekreef B, Hoek G, Raaschou-Nielsen O, Nagel G. Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE). Environ Int 2018; 120:163-171. [PMID: 30096610 DOI: 10.1016/j.envint.2018.07.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Previous analysis from the large European multicentre ESCAPE study showed an association of ambient particulate matter <2.5 μm (PM2.5) air pollution exposure at residence with the incidence of gastric cancer. It is unclear which components of PM are most relevant for gastric and also upper aerodigestive tract (UADT) cancer and some of them may not be strongly correlated with PM mass. We evaluated the association between long-term exposure to elemental components of PM2.5 and PM10 and gastric and UADT cancer incidence in European adults. METHODS Baseline addresses of individuals were geocoded and exposure was assessed by land-use regression models for copper (Cu), iron (Fe) and zinc (Zn) representing non-tailpipe traffic emissions; sulphur (S) indicating long-range transport; nickel (Ni) and vanadium (V) for mixed oil-burning and industry; silicon (Si) for crustal material and potassium (K) for biomass burning. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. RESULTS Ten cohorts in six countries contributed data on 227,044 individuals with an average follow-up of 14.9 years with 633 incident cases of gastric cancer and 763 of UADT cancer. The combined hazard ratio (HR) for an increase of 200 ng/m3 of PM2.5_S was 1.92 (95%-confidence interval (95%-CI) 1.13;3.27) for gastric cancer, with no indication of heterogeneity between cohorts (I2 = 0%), and 1.63 (95%-CI 0.88;3.01) for PM2.5_Zn (I2 = 70%). For the other elements in PM2.5 and all elements in PM10 including PM10_S, non-significant HRs between 0.78 and 1.21 with mostly wide CIs were seen. No association was found between any of the elements and UADT cancer. The HR for PM2.5_S and gastric cancer was robust to adjustment for additional factors, including diet, and restriction to study participants with stable addresses over follow-up resulted in slightly higher effect estimates with a decrease in precision. In a two-pollutant model, the effect estimate for total PM2.5 decreased whereas that for PM2.5_S was robust. CONCLUSION This large multicentre cohort study shows a robust association between gastric cancer and long-term exposure to PM2.5_S but not PM10_S, suggesting that S in PM2.5 or correlated air pollutants may contribute to the risk of gastric cancer.
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Affiliation(s)
- Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - Marie Pedersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jule Munkenast
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Norun H Krog
- Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Department of Public Health Science, LANDSAM, NMBU, Ås, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mette Sørensen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Marloes Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Alois Lang
- Vorarlberg cancer registry; Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy; Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Paolo Vineis
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Ingeborg Kooter
- Netherlands Organization for Applied Scientific Research, Utrecht, the Netherlands
| | - Ranjeet Sokhi
- Centre for Atmospheric and Climate Physics Research (CACP), University of Hertfordshire, Hatfield, UK
| | - Bert Brunekreef
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz (aks), Austria
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28
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Nagel G, Stafoggia M, Pedersen M, Andersen ZJ, Galassi C, Munkenast J, Jaensch A, Sommar J, Forsberg B, Olsson D, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Sørensen M, Tjønneland A, Peeters PH, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Plusquin M, Key TJ, Concin H, Lang A, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, Tamayo-Uria I, Amiano P, Dorronsoro M, de Hoogh K, Beelen R, Vineis P, Brunekreef B, Hoek G, Raaschou-Nielsen O, Weinmayr G. Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Int J Cancer 2018; 143:1632-1643. [PMID: 29696642 DOI: 10.1002/ijc.31564] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/30/2018] [Accepted: 02/07/2018] [Indexed: 01/17/2023]
Abstract
Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-use regression models for particulate matter (PM) below 10 µm (PM10 ), below 2.5 µm (PM2.5 ), between 2.5 and 10 µm (PMcoarse ), PM2.5 absorbance and nitrogen oxides (NO2 and NOX ) as well as approximated by traffic indicators. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastric cancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5 µg/m3 of PM2.5 was 1.38 (95% CI 0.99; 1.92) for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures considered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influence markedly the effect estimate for PM2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5 was found in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study shows an association between long-term exposure to PM2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk.
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Affiliation(s)
- Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marie Pedersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Danish Cancer Society Research Ce, nter, Copenhagen, Denmark
| | - Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jule Munkenast
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Johan Sommar
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | | | - Norun H Krog
- Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology Care Science and Society, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mette Sørensen
- The Danish Cancer Society Research Ce, nter, Copenhagen, Denmark
| | - Anne Tjønneland
- The Danish Cancer Society Research Ce, nter, Copenhagen, Denmark
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Bas Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Roel Vermeulen
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marloes Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Michelle Plusquin
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Alois Lang
- Vorarlberg cancer registry; Agency for Preventive and Social Medicine, Bregenz (aks), Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
- University of Basel, Basel, Switzerland
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Ibon Tamayo-Uria
- ISGlobal Institute de Salut Global Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Pilar Amiano
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Miren Dorronsoro
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Ce, nter, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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29
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Siroux V, Agier L, Basagaña X, Urquiza J, Sunyer J, Casas M, Robinson O, Granum B, Oftedal B, Thomsen C, De Castro M, Nieuwenhuijsen M, Wright J, Mceachan R, Bird P, Uphoff N, Grazuleviciene R, Andrusaityte S, Petraviciene I, Roumeliotaki T, Leventakou V, Chatzi L, Vrijheid M, Slama R. Early life exposome and lung function in children from the HELIX cohort. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.oa5184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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30
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Robinson O, Tamayo I, de Castro M, Valentin A, Giorgis-Allemand L, Hjertager Krog N, Marit Aasvang G, Ambros A, Ballester F, Bird P, Chatzi L, Cirach M, Dėdelė A, Donaire-Gonzalez D, Gražuleviciene R, Iakovidis M, Ibarluzea J, Kampouri M, Lepeule J, Maitre L, McEachan R, Oftedal B, Siroux V, Slama R, Stephanou EG, Sunyer J, Urquiza J, Vegard Weyde K, Wright J, Vrijheid M, Nieuwenhuijsen M, Basagaña X. The Urban Exposome during Pregnancy and Its Socioeconomic Determinants. Environ Health Perspect 2018; 126:077005. [PMID: 30024382 PMCID: PMC6108870 DOI: 10.1289/ehp2862] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 05/31/2018] [Accepted: 06/03/2018] [Indexed: 05/15/2023]
Abstract
BACKGROUND The urban exposome is the set of environmental factors that are experienced in the outdoor urban environment and that may influence child development. OBJECTIVE The authors' goal was to describe the urban exposome among European pregnant women and understand its socioeconomic determinants. METHODS Using geographic information systems, remote sensing and spatio-temporal modeling we estimated exposure during pregnancy to 28 environmental indicators in almost 30,000 women from six population-based birth cohorts, in nine urban areas from across Europe. Exposures included meteorological factors, air pollutants, traffic noise, traffic indicators, natural space, the built environment, public transport, facilities, and walkability. Socioeconomic position (SEP), assessed at both the area and individual level, was related to the exposome through an exposome-wide association study and principal component (PC) analysis. RESULTS Mean±standard deviation (SD) NO2 levels ranged from 13.6±5.1 μg/m3 (in Heraklion, Crete) to 43.2±11 μg/m3 (in Sabadell, Spain), mean±SD walkability score ranged from 0.22±0.04 (Kaunas, Lithuania) to 0.32±0.07 (Valencia, Spain) and mean±SD Normalized Difference Vegetation Index ranged from 0.21±0.05 in Heraklion to 0.51±0.1 in Oslo, Norway. Four PCs explained more than half of variation in the urban exposome. There was considerable heterogeneity in social patterning of the urban exposome across cities. For example, high-SEP (based on family education) women lived in greener, less noisy, and less polluted areas in Bradford, UK (0.39 higher PC1 score, 95% confidence interval (CI): 0.31, 0.47), but the reverse was observed in Oslo (-0.57 PC1 score, 95% CI: -0.73, -0.41). For most cities, effects were stronger when SEP was assessed at the area level: In Bradford, women living in high SEP areas had a 1.34 higher average PC1 score (95% CI: 1.21, 1.48). CONCLUSIONS The urban exposome showed considerable variability across Europe. Pregnant women of low SEP were exposed to higher levels of environmental hazards in some cities, but not others, which may contribute to inequities in child health and development. https://doi.org/10.1289/EHP2862.
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Affiliation(s)
- Oliver Robinson
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, UK
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ibon Tamayo
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Montserrat de Castro
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Antonia Valentin
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Lise Giorgis-Allemand
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institut national de la santé et de la recherche médicale (Inserm), Institute for Advanced Biosciences (IAB), Inserm, CNRS, University Grenoble-Alpes, Grenoble, France
| | | | | | - Albert Ambros
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Ferran Ballester
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO–Universitat Jaume I–Universitat de Valencia, Valencia, Spain
| | - Pippa Bird
- Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), Bradford Institute for Health Research, Bradford, UK
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Department of Genetics & Cell Biology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Marta Cirach
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Audrius Dėdelė
- Department of Environmental Sciences, Vytautas Magnus University, Kaunus, Lithuania
| | - David Donaire-Gonzalez
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Minas Iakovidis
- Environmental Chemical Processes Laboratory (ECPL), Chemistry Department, University of Crete, Heraklion, Crete, Greece
| | - Jesus Ibarluzea
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Health Research Institute (BIODONOSTIA), San Sebastian, Spain
- School of Psychology, University of the Basque Country, San Sebastián, Spain
- Public Health Department, Basque Government, San Sebastián, Spain
| | - Mariza Kampouri
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Johanna Lepeule
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institut national de la santé et de la recherche médicale (Inserm), Institute for Advanced Biosciences (IAB), Inserm, CNRS, University Grenoble-Alpes, Grenoble, France
| | - Léa Maitre
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Rosie McEachan
- Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), Bradford Institute for Health Research, Bradford, UK
| | - Bente Oftedal
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Valerie Siroux
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institut national de la santé et de la recherche médicale (Inserm), Institute for Advanced Biosciences (IAB), Inserm, CNRS, University Grenoble-Alpes, Grenoble, France
| | - Remy Slama
- Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Institut national de la santé et de la recherche médicale (Inserm), Institute for Advanced Biosciences (IAB), Inserm, CNRS, University Grenoble-Alpes, Grenoble, France
| | - Euripides G Stephanou
- Environmental Chemical Processes Laboratory (ECPL), Chemistry Department, University of Crete, Heraklion, Crete, Greece
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jose Urquiza
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), Bradford Institute for Health Research, Bradford, UK
| | - Martine Vrijheid
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Basagaña X, Pedersen M, Barrera-Gómez J, Gehring U, Giorgis-Allemand L, Hoek G, Stafoggia M, Nieuwenhuijsen MJ, Brunekreef B, Slama R, Ballester F, Cesaroni G, Charles MA, Chatzi L, Danileviciute A, de Hoogh K, Dedele A, Estarlich M, Fernández-Somoano A, Forastiere F, Grazuleviciene R, Gruzieva O, Heude B, Iñiguez C, Jaddoe VWV, Lepeule J, Lerchundi A, Andersen AMN, Oftedal B, Porta D, Raaschou-Nielsen O, Rudnai P, Schikowski T, Schwarze P, Sørensen M, Sunyer J, Pershagen G, Kogevinas M. Analysis of multicentre epidemiological studies: contrasting fixed or random effects modelling and meta-analysis. Int J Epidemiol 2018; 47:1343-1354. [DOI: 10.1093/ije/dyy117] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Xavier Basagaña
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marie Pedersen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Inserm, CNRS, University Grenoble Alpes, IAB Joint Research Center, Grenoble, La Tronche, France
| | - Jose Barrera-Gómez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lise Giorgis-Allemand
- Inserm, CNRS, University Grenoble Alpes, IAB Joint Research Center, Grenoble, La Tronche, France
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mark J Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Rémy Slama
- Inserm, CNRS, University Grenoble Alpes, IAB Joint Research Center, Grenoble, La Tronche, France
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Myhre O, Låg M, Villanger GD, Oftedal B, Øvrevik J, Holme JA, Aase H, Paulsen RE, Bal-Price A, Dirven H. Early life exposure to air pollution particulate matter (PM) as risk factor for attention deficit/hyperactivity disorder (ADHD): Need for novel strategies for mechanisms and causalities. Toxicol Appl Pharmacol 2018; 354:196-214. [PMID: 29550511 DOI: 10.1016/j.taap.2018.03.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/14/2018] [Accepted: 03/12/2018] [Indexed: 12/11/2022]
Abstract
Epidemiological studies have demonstrated that air pollution particulate matter (PM) and adsorbed toxicants (organic compounds and trace metals) may affect child development already in utero. Recent studies have also indicated that PM may be a risk factor for neurodevelopmental disorders (NDDs). A pattern of increasing prevalence of attention deficit/hyperactivity disorder (ADHD) has been suggested to partly be linked to environmental pollutants exposure, including PM. Epidemiological studies suggest associations between pre- or postnatal exposure to air pollution components and ADHD symptoms. However, many studies are cross-sectional without possibility to reveal causality. Cohort studies are often small with poor exposure characterization, and confounded by traffic noise and socioeconomic factors, possibly overestimating the study associations. Furthermore, the mechanistic knowledge how exposure to PM during early brain development may contribute to increased risk of ADHD symptoms or cognitive deficits is limited. The closure of this knowledge gap requires the combined use of well-designed longitudinal cohort studies, supported by mechanistic in vitro studies. As ADHD has profound consequences for the children affected and their families, the identification of preventable risk factors such as air pollution exposure should be of high priority.
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Affiliation(s)
- Oddvar Myhre
- Department of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway.
| | - Marit Låg
- Department of Air pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Gro D Villanger
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Bente Oftedal
- Department of Air pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Johan Øvrevik
- Department of Air pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Jørn A Holme
- Department of Air pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild E Paulsen
- Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Norway
| | - Anna Bal-Price
- European Commission, Joint Research Centre, Ispra, Italy
| | - Hubert Dirven
- Department of Toxicology and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
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Pedersen M, Stafoggia M, Weinmayr G, Andersen ZJ, Galassi C, Sommar J, Forsberg B, Olsson D, Oftedal B, Krog NH, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Sørensen M, Eriksen KT, Tjønneland A, Peeters PH, Bueno-de-Mesquita B, Vermeulen R, Eeftens M, Plusquin M, Key TJ, Jaensch A, Nagel G, Concin H, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Ranzi A, Cesaroni G, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Stayner LT, Kogevinas M, Nieuwenhuijsen MJ, Sokhi R, de Hoogh K, Beelen R, Vineis P, Brunekreef B, Hoek G, Raaschou-Nielsen O. Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts. Eur Urol Focus 2018; 4:113-120. [PMID: 28753823 DOI: 10.1016/j.euf.2016.11.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/01/2016] [Accepted: 11/16/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population. OBJECTIVE To evaluate the association between long-term exposure to ambient air pollution and BC incidence. DESIGN, SETTING, AND PARTICIPANTS We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10μm (PM10), <2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10), PM2.5absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence. RESULTS AND LIMITATIONS During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m3 increase in NO2 and 5-μg/m3 increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure. CONCLUSIONS There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC. PATIENT SUMMARY We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk.
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Affiliation(s)
- Marie Pedersen
- The Danish Cancer Society Research Center, Copenhagen, Denmark; Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University Hospital and Center for Cancer Prevention, Turin, Italy
| | - Johan Sommar
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | | | - Norun H Krog
- Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institute, Stockholm, Sweden
| | - Mette Sørensen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Bas Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Roel Vermeulen
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marloes Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Michelle Plusquin
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andrea Jaensch
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Gabriele Nagel
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Unit of Epidemiology, Regional Health Service, Grugliasco, Italy
| | - Carlotta Sacerdote
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Ibon Tamayo
- Institute de Salut Global Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Pilar Amiano
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Miren Dorronsoro
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Leslie T Stayner
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Manolis Kogevinas
- Institute de Salut Global Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Institute de Salut Global Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, Hatfield, UK
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; National Institute for Public Health (RIVM), Bilthoven, The Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK; Molecular and Epidemiology Unit, Human Genetics Foundation, Turin, Italy
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Weyde KV, Krog NH, Oftedal B, Magnus P, Øverland S, Stansfeld S, Nieuwenhuijsen MJ, Vrijheid M, de Castro Pascual M, Aasvang GM. Road traffic noise and children's inattention. Environ Health 2017; 16:127. [PMID: 29162109 PMCID: PMC5698983 DOI: 10.1186/s12940-017-0337-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/03/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND An increasing number of children are exposed to road traffic noise levels that may lead to adverse effects on health and daily functioning. Childhood is a period of intense growth and brain maturation, and children may therefore be especially vulnerable to road traffic noise. The objective of the present study was to examine whether road traffic noise was associated with reported inattention symptoms in children, and whether this association was mediated by sleep duration. METHODS This study was based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Parental reports of children's inattention at age 8 were linked to modelled levels of residential road traffic noise. We investigated the association between inattention and noise exposure during pregnancy (n = 1934), noise exposure averaged over 5 years (age 3 to 8 years; n = 1384) and noise exposure at age 8 years (n = 1384), using fractional logit response models. The participants were children from Oslo, Norway. RESULTS An association with inattention at age 8 years was found for road traffic noise exposure at age 8 years (coef = .0083, CI = [.0012, .0154]; 1.2% point increase in inattention score per 10 dB increase in noise level), road traffic noise exposure average for the last 5 years (coef = .0090, CI = [.0016, .0164]; 1.3% point increase/10 dB), and for pregnancy road traffic noise exposure for boys (coef = .0091, CI = [.0010, .0171]), but not girls (coef = -.0021, CI = [-.0094, .0053]). Criteria for doing mediation analyses were not fulfilled. CONCLUSION Results indicate that road traffic noise has a negative impact on children's inattention. We found no mediation by sleep duration.
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Affiliation(s)
- Kjell Vegard Weyde
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Pb. 4404 Nydalen, 0403 Oslo, Norway
| | - Norun Hjertager Krog
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Bente Oftedal
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Magnus
- Domain of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Simon Øverland
- Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway
- Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Stephen Stansfeld
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Mark J. Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia Spain
- Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Catalonia Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Montserrat de Castro Pascual
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia Spain
- Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Catalonia Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gunn Marit Aasvang
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
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Evandt J, Oftedal B, Hjertager Krog N, Nafstad P, Schwarze PE, Marit Aasvang G. A Population-Based Study on Nighttime Road Traffic Noise and Insomnia. Sleep 2017; 40:2662183. [PMID: 28364487 DOI: 10.1093/sleep/zsw055] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 11/13/2022] Open
Abstract
Study Objectives The aims of the present study were to investigate how nighttime road traffic noise relates to self-reported symptoms of insomnia and sleep medication use. Methods We used questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009-2010; n = 13019). The insomnia symptoms difficulties falling asleep, awakenings during the night, and waking up too early in the morning as well as self-reported sleep medication use were included as outcomes. Modeled noise levels (Lnight) were assigned to each participant's home address. For selecting covariates to the statistical model, we used a directed acyclic graph. The associations between noise and sleep were analyzed using logistic regression models. Results After adjustment for potential confounders, we found an odds ratio (OR) of 1.05 (95% confidence interval [CI]: 1.01-1.09) for the association between traffic noise and difficulties falling asleep, in the total study population. For the association between traffic noise and awakenings during the night, the OR was 1.04 (95% CI: 1.00-1.08) and for waking up too early, the OR was 1.06 (95% CI: 1.02-1.11). The effect estimates are given per 5-dB increase in traffic noise level (Lnight). Self-reported sleep medication use was not statistically significantly associated with traffic noise exposure. Conclusions In an adult population from Oslo, traffic noise was associated with difficulties falling asleep and waking up too early. These findings indicate that sleep quantity may be compromised for individuals living in areas highly exposed to nighttime traffic noise.
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Affiliation(s)
- Jorunn Evandt
- Domain for Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health,Oslo, Norway
| | - Bente Oftedal
- Domain for Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health,Oslo, Norway
| | - Norun Hjertager Krog
- Domain for Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health,Oslo, Norway
| | - Per Nafstad
- Department of Community Medicine, University of Oslo, Oslo, Norway.,Domain for Mental and Physical Health, Department of Noncommunicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Per E Schwarze
- Domain for Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health,Oslo, Norway
| | - Gunn Marit Aasvang
- Domain for Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health,Oslo, Norway
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36
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Evandt J, Oftedal B, Krog NH, Skurtveit S, Nafstad P, Schwarze PE, Skovlund E, Houthuijs D, Aasvang GM. Road traffic noise and registry based use of sleep medication. Environ Health 2017; 16:110. [PMID: 29078795 PMCID: PMC5660445 DOI: 10.1186/s12940-017-0330-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Road traffic noise has been associated with adverse health effects including sleep disturbances. Use of sleep medication as an indicator of sleeping problems has rarely been explored in studies of the effects of traffic noise. Furthermore, using registry data on sleep medications provides an opportunity to study the effects of noise on sleep where attribution of sleep problems to noise is not possible. METHODS We used questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009-10) (n = 13,019). Individual data on sleep medications was obtained from the Norwegian Prescription Database (NorPD). Noise levels (L night) were modeled for the most exposed façade of the building at each participant's home address. Logistic regression models adjusted for potential confounders were used to analyze the association between traffic noise and sleep medication use both for one whole year and for the summer season. The results were reported as changes in the effect estimate per 5 decibel (dB) increase in noise level. RESULTS We observed no association between traffic noise and sleep medication use during one year [odds ratio (OR) = 1.00; 95% confidence interval (CI): 0.96, 1.04]. For sleep medication use in the summer season, there was a positive, however non-significant association (OR = 1.04; 95% CI: 0.99, 1.10). Among individuals sleeping with the bedroom window open, the association increased slightly and was borderline statistically significant (OR = 1.06; 95% CI: 1.00, 1.12). CONCLUSIONS We found no evidence of an association between traffic noise and sleep medication use during one year. However, for the summer season, there was some suggestive evidence of an association. These findings indicate that season may play a role in the association between traffic noise and sleep, possibly because indoor traffic noise levels are likely to be higher during summer due to more frequent window opening. More studies are, however, necessary in order to confirm this.
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Affiliation(s)
- Jorunn Evandt
- Division of Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Bente Oftedal
- Division of Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Norun Hjertager Krog
- Division of Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Svetlana Skurtveit
- Division of Mental and Physical Health, Department of Mental Disorders, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
- Norwegian Centre for Addiction Research (SERAF), University of Oslo, P.O. Box N-1039 Blindern, 0315 Oslo, Norway
| | - Per Nafstad
- Department of Community Medicine and Global Health, University of Oslo, Faculty of Medicine, P.O. Box N-1130 Blindern, 0318 Oslo, Norway
- Division of Mental and Physical Health, Department of Noncommunicable Diseases, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Per E. Schwarze
- Division of Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Eva Skovlund
- Division of Mental and Physical Health, Department of Mental Disorders, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, P.O. Box 8905, N-7491 Trondheim, Norway
| | - Danny Houthuijs
- The Dutch National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Gunn Marit Aasvang
- Division of Infection Control and Environmental Health, Department of Air Pollution and Noise, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
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37
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Andersen ZJ, Stafoggia M, Weinmayr G, Pedersen M, Galassi C, Jørgensen JT, Oudin A, Forsberg B, Olsson D, Oftedal B, Aasvang GM, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Eriksen KT, Tjønneland A, Peeters PH, Bueno-de-Mesquita B, Plusquin M, Key TJ, Jaensch A, Nagel G, Lang A, Wang M, Tsai MY, Fournier A, Boutron-Ruault MC, Baglietto L, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Migliore E, Tamayo-Uria I, Amiano P, Dorronsoro M, Vermeulen R, Sokhi R, Keuken M, de Hoogh K, Beelen R, Vineis P, Cesaroni G, Brunekreef B, Hoek G, Raaschou-Nielsen O. Long-Term Exposure to Ambient Air Pollution and Incidence of Postmenopausal Breast Cancer in 15 European Cohorts within the ESCAPE Project. Environ Health Perspect 2017; 125:107005. [PMID: 29033383 PMCID: PMC5933325 DOI: 10.1289/ehp1742] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 08/04/2017] [Accepted: 08/12/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts – Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) ≤2.5μm, ≤10μm, and 2.5–10μm in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 {hazard ratio (HR)=1.08 [95% confidence interval (CI): 0.77, 1.51] per 5 μg/m3}, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 μg/m3], PMcoarse[1.20 (95% CI: 0.96, 1.49 per 5 μg/m3], and NO2 [1.02 (95% CI: 0.98, 1.07 per 10 μg/m3], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 μg/m3, p=0.04]. CONCLUSIONS We found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women. https://doi.org/10.1289/EHP1742.
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Affiliation(s)
- Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Azienda Sanitaria Locale Roma 1 (ASL RM1), Rome, Italy
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Marie Pedersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jeanette T Jørgensen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Oudin
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Geir Aamodt
- Norwegian Institute of Public Health, Oslo, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institute, Stockholm, Sweden
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Bas Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michelle Plusquin
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Alois Lang
- Vorarlberg Cancer Registry, Agency for Preventive and Social Medicine (aks, Bregenz, Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Ming-Yi Tsai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Agnes Fournier
- Centre de recherche en Épidémiologie et Santé des Populations (CESP) "Health across Generations", Institut national de la santé et de la recherche médicale (Inserm), Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Centre de recherche en Épidémiologie et Santé des Populations (CESP) "Health across Generations", Institut national de la santé et de la recherche médicale (Inserm), Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Laura Baglietto
- Centre de recherche en Épidémiologie et Santé des Populations (CESP) "Health across Generations", Institut national de la santé et de la recherche médicale (Inserm), Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione Istituto di ricovero e cura a carattere scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione Istituto di ricovero e cura a carattere scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
- Unit of Epidemiology, Regional Health Service Azienda Sanitaria Locale Torino 3 (ASL TO3), Grugliasco, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Ibon Tamayo-Uria
- ISGlobal Institute de Salut Global Barcelona, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Miren Dorronsoro
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, Hatfield, UK
| | - Menno Keuken
- Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Molecular and Epidemiology Unit, Human Genetics Foundation (HuGeF), Torino, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Azienda Sanitaria Locale Roma 1 (ASL RM1), Rome, Italy
| | - Bert Brunekreef
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Gerard Hoek
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
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38
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Fuks KB, Weinmayr G, Basagaña X, Gruzieva O, Hampel R, Oftedal B, Sørensen M, Wolf K, Aamodt G, Aasvang GM, Aguilera I, Becker T, Beelen R, Brunekreef B, Caracciolo B, Cyrys J, Elosua R, Eriksen KT, Foraster M, Fratiglioni L, Hilding A, Houthuijs D, Korek M, Künzli N, Marrugat J, Nieuwenhuijsen M, Östenson CG, Penell J, Pershagen G, Raaschou-Nielsen O, Swart WJR, Peters A, Hoffmann B. Long-term exposure to ambient air pollution and traffic noise and incident hypertension in seven cohorts of the European study of cohorts for air pollution effects (ESCAPE). Eur Heart J 2017; 38:983-990. [PMID: 28417138 DOI: 10.1093/eurheartj/ehw413] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/11/2016] [Indexed: 12/28/2022] Open
Abstract
Aims We investigated whether traffic-related air pollution and noise are associated with incident hypertension in European cohorts. Methods and results We included seven cohorts of the European study of cohorts for air pollution effects (ESCAPE). We modelled concentrations of particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), ≤10 µm (PM10), >2.5, and ≤10 µm (PMcoarse), soot (PM2.5 absorbance), and nitrogen oxides at the addresses of participants with land use regression. Residential exposure to traffic noise was modelled at the facade according to the EU Directive 2002/49/EC. We assessed hypertension as (i) self-reported and (ii) measured (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or intake of BP lowering medication (BPLM). We used Poisson regression with robust variance estimation to analyse associations of traffic-related exposures with incidence of hypertension, controlling for relevant confounders, and combined the results from individual studies with random-effects meta-analysis. Among 41 072 participants free of self-reported hypertension at baseline, 6207 (15.1%) incident cases occurred within 5-9 years of follow-up. Incidence of self-reported hypertension was positively associated with PM2.5 (relative risk (RR) 1.22 [95%-confidence interval (CI):1.08; 1.37] per 5 µg/m³) and PM2.5 absorbance (RR 1.13 [95% CI:1.02; 1.24] per 10 - 5m - 1). These estimates decreased slightly upon adjustment for road traffic noise. Road traffic noise was weakly positively associated with the incidence of self-reported hypertension. Among 10 896 participants at risk, 3549 new cases of measured hypertension occurred. We found no clear associations with measured hypertension. Conclusion Long-term residential exposures to air pollution and noise are associated with increased incidence of self-reported hypertension.
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Affiliation(s)
- Kateryna B Fuks
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Heinrich-Heine-University of Düsseldorf, University Hospital of Düsseldorf, AG Umweltepidemiologie, P.O. Box 101007, 40001 Düsseldorf, Germany
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstraße 22, D 89081 Ulm, Germany
| | - Xavier Basagaña
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL). C/ Doctor Aiguader 88, 08003 Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Olena Gruzieva
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Regina Hampel
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany
| | - Bente Oftedal
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Mette Sørensen
- Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Kathrin Wolf
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany
| | - Geir Aamodt
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Gunn Marit Aasvang
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Inmaculada Aguilera
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Thomas Becker
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - Rob Beelen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80.178, NL-3508 TD Utrecht, the Netherlands
| | - Bert Brunekreef
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80.178, NL-3508 TD Utrecht, the Netherlands.,Julius Center for Primary Care and Health Sciences, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, the Netherlands
| | - Barbara Caracciolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Gävlegatan 16, 113 30 Stockholm, Sweden.,Stockholm University, Universitetsvägen 10, 114 18 Stockholm, Sweden
| | - Josef Cyrys
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.,Environmental Science Center, the University of Augsburg, Universitätsstraße 1a, 86159 Augsburg, Germany
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Kirsten Thorup Eriksen
- Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Maria Foraster
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Gävlegatan 16, 113 30 Stockholm, Sweden.,Stockholm University, Universitetsvägen 10, 114 18 Stockholm, Sweden.,Stockholm Gerontology Research Center, Gävlegatan 16, 8 trappor, 113 30 Stockholm, Sweden
| | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Michal Korek
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Jaume Marrugat
- Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL). C/ Doctor Aiguader 88, 08003 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain.,Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute (IMIM), Carrer del Dr. Aiguader, 88, 08003 Barcelona, Spain
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), SE-171 76 Stockholm, Sweden
| | - Johanna Penell
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Göran Pershagen
- Department of Environmental Medicine, Karolinska Institutet, P.O. Box 210, SE-171 77 Stockholm, Sweden
| | - Ole Raaschou-Nielsen
- Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Wim J R Swart
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, the Netherlands
| | - Annette Peters
- Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.,Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislaufforschung e.V. (partner-site Munich), Biedersteiner Strasse 29, 80802 Munich, Germany
| | - Barbara Hoffmann
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Heinrich-Heine-University of Düsseldorf, University Hospital of Düsseldorf, AG Umweltepidemiologie, P.O. Box 101007, 40001 Düsseldorf, Germany
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39
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Del Risco Kollerud R, Blaasaas KG, Claussen B, Oftedal B, Næss Ø. The risk of cancer in the offspring and parental length of life. Cancer Epidemiol 2017; 48:8-15. [DOI: 10.1016/j.canep.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/26/2017] [Accepted: 02/28/2017] [Indexed: 10/20/2022]
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40
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Weyde KV, Krog NH, Oftedal B, Evandt J, Magnus P, Øverland S, Clark C, Stansfeld S, Aasvang GM. Nocturnal Road Traffic Noise Exposure and Children's Sleep Duration and Sleep Problems. Int J Environ Res Public Health 2017; 14:ijerph14050491. [PMID: 28481249 PMCID: PMC5451942 DOI: 10.3390/ijerph14050491] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 04/28/2017] [Accepted: 05/04/2017] [Indexed: 01/13/2023]
Abstract
Almost half of the European Union (EU)’s population is exposed to road traffic noise above levels that constitute a health risk. Associations between road traffic noise and impaired sleep in adults have consistently been reported. Less is known about effects of noise on children’s sleep. The aim of this study was to examine the association between nocturnal road traffic noise exposure and children’s parental-reported sleep duration and sleep problems. The present cross-sectional study used data from The Norwegian Mother and Child Cohort Study. Parental report of children’s sleep duration and sleep problems at age 7 was linked to modelled levels of residential night-time road traffic noise. The study population included 2665 children from Oslo, Norway. No association was found between road traffic noise and sleep duration in the total study population (odds ratio (OR): 1.05, 95% confidence interval (CI): [0.94, 1.17]), but a statistically significant association was observed in girls (OR: 1.21, 95% CI: [1.04, 1.41]). For sleep problems, the associations were similar (OR: 1.36, 95% CI: [0.85, 2.16]) in girls. The ORs are presented for an increase of 10 dB. The findings suggest there is an association between road traffic noise and sleep for girls, underlining the importance of protecting children against excessive noise levels.
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Affiliation(s)
- Kjell Vegard Weyde
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.
| | - Norun Hjertager Krog
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.
| | - Bente Oftedal
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.
| | - Jorunn Evandt
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.
| | - Per Magnus
- Domain of Health Data and Digitalization, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Pb 1130 Blindern, 0318 Oslo, Norway.
| | - Simon Øverland
- Division of Mental Health, Norwegian Institute of Public Health, Zander Kaaes gate 7, 5015 Bergen, Norway.
- Faculty of Psychology, University of Bergen, Pb 7807, 5020 Bergen, Norway.
| | - Charlotte Clark
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
| | - Stephen Stansfeld
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
| | - Gunn Marit Aasvang
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403 Oslo, Norway.
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41
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Raaschou-Nielsen O, Pedersen M, Stafoggia M, Weinmayr G, Andersen ZJ, Galassi C, Sommar J, Forsberg B, Olsson D, Oftedal B, Krog NH, Aasvang GM, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Sørensen M, Eriksen KT, Tjønneland A, Peeters PH, Bueno-de-Mesquita HBA, Plusquin M, Key TJ, Jaensch A, Nagel G, Föger B, Wang M, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Migliore E, Tamayo I, Amiano P, Dorronsoro M, Sokhi R, Kooter I, de Hoogh K, Beelen R, Eeftens M, Vermeulen R, Vineis P, Brunekreef B, Hoek G. Outdoor air pollution and risk for kidney parenchyma cancer in 14 European cohorts. Int J Cancer 2017; 140:1528-1537. [PMID: 28006861 DOI: 10.1002/ijc.30587] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/21/2016] [Accepted: 12/08/2016] [Indexed: 01/20/2023]
Abstract
Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutants, although not consistently. It was the aim to investigate possible associations between outdoor air pollution at the residence and the incidence of kidney parenchyma cancer in the general population. We used data from 14 European cohorts from the ESCAPE study. We geocoded and assessed air pollution concentrations at baseline addresses by land-use regression models for particulate matter (PM10 , PM2.5 , PMcoarse , PM2.5 absorbance (soot)) and nitrogen oxides (NO2 , NOx ), and collected data on traffic. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses to calculate summary hazard ratios (HRs). The 289,002 cohort members contributed 4,111,908 person-years at risk. During follow-up (mean 14.2 years) 697 incident cancers of the kidney parenchyma were diagnosed. The meta-analyses showed higher HRs in association with higher PM concentration, e.g. HR = 1.57 (95%CI: 0.81-3.01) per 5 μg/m3 PM2.5 and HR = 1.36 (95%CI: 0.84-2.19) per 10-5 m-1 PM2.5 absorbance, albeit never statistically significant. The HRs in association with nitrogen oxides and traffic density on the nearest street were slightly above one. Sensitivity analyses among participants who did not change residence during follow-up showed stronger associations, but none were statistically significant. Our study provides suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.
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Affiliation(s)
- Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Marie Pedersen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Centre for Epidemiology and Screening, University of Copenhagen, Copenhagen, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RM1, Rome, Italy
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Zorana J Andersen
- Department of Public Health, Centre for Epidemiology and Screening, University of Copenhagen, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Johan Sommar
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Bente Oftedal
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Norun H Krog
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunn Marit Aasvang
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Laura Fratiglioni
- Department of Neurobiology Care Science and Society, Aging Research Center, Karolinska Institute, Stockholm, Sweden
| | - Mette Sørensen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - H B As Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michelle Plusquin
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Bernhard Föger
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Ming-Yi Tsai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Ibon Tamayo
- ISGlobal Institute de Salut Global Barcelona, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Miren Dorronsoro
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, United Kingdom
| | - Ingeborg Kooter
- Netherlands Organization for Applied Scientific Research (TNO), Utrecht, The Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Roel Vermeulen
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Raaschou-Nielsen O, Beelen R, Wang M, Hoek G, Andersen ZJ, Hoffmann B, Stafoggia M, Samoli E, Weinmayr G, Dimakopoulou K, Nieuwenhuijsen M, Xun WW, Fischer P, Eriksen KT, Sørensen M, Tjønneland A, Ricceri F, de Hoogh K, Key T, Eeftens M, Peeters PH, Bueno-de-Mesquita HB, Meliefste K, Oftedal B, Schwarze PE, Nafstad P, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Penell J, De Faire U, Korek M, Pedersen N, Östenson CG, Pershagen G, Fratiglioni L, Concin H, Nagel G, Jaensch A, Ineichen A, Naccarati A, Katsoulis M, Trichpoulou A, Keuken M, Jedynska A, Kooter IM, Kukkonen J, Brunekreef B, Sokhi RS, Katsouyanni K, Vineis P. Particulate matter air pollution components and risk for lung cancer. Environ Int 2016; 87:66-73. [PMID: 26641521 DOI: 10.1016/j.envint.2015.11.007] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/05/2015] [Accepted: 11/09/2015] [Indexed: 05/06/2023]
Abstract
BACKGROUND Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. METHODS We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. RESULTS The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant. In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 1.25; 95% CI, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m(3)), PM10 S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10 K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PM10 and PM2.5 and lung cancer were largely explained by PM2.5 S. CONCLUSIONS This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.
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Affiliation(s)
- O Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark.
| | - R Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - M Wang
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - G Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Z J Andersen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - B Hoffmann
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany
| | - M Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - E Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - G Weinmayr
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - K Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M Nieuwenhuijsen
- Center for Research in Environmental Epidemiology, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - W W Xun
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - P Fischer
- National Institute for Public Health and the Environment, Center for Sustainability and Environmental Health, Bilthoven, The Netherlands
| | - K T Eriksen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - M Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - F Ricceri
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - K de Hoogh
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - T Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - M Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - P H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands; School of Public Health, Imperial College London, London, United Kingdom
| | - H B Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K Meliefste
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - B Oftedal
- Norwegian Institute of Public Health, Oslo, Norway
| | - P E Schwarze
- Norwegian Institute of Public Health, Oslo, Norway
| | - P Nafstad
- Norwegian Institute of Public Health, Oslo, Norway; Institute of Health and Society, University of Oslo, Oslo, Norway
| | - C Galassi
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - E Migliore
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - A Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - G Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - C Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - F Forastiere
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RME, Rome, Italy
| | - J Penell
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - U De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - M Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - N Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - C-G Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - G Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - G Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria
| | - A Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - A Ineichen
- Human Genetics Foundation, Molecular and Genetic Epidemiology Unit, Turin, Italy
| | - A Naccarati
- Human Genetics Foundation, Molecular and Genetic Epidemiology Unit, Turin, Italy
| | | | | | - M Keuken
- Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - A Jedynska
- Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - I M Kooter
- Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - J Kukkonen
- Finnish Meteorological Institute, Helsinki, Finland
| | - B Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - R S Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, United Kingdom
| | - K Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Department of Primary Care and Public Health Sciences and Environmental Research Group, King's College London, United Kingdom
| | - P Vineis
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
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Beelen R, Hoek G, Raaschou-Nielsen O, Stafoggia M, Andersen ZJ, Weinmayr G, Hoffmann B, Wolf K, Samoli E, Fischer PH, Nieuwenhuijsen MJ, Xun WW, Katsouyanni K, Dimakopoulou K, Marcon A, Vartiainen E, Lanki T, Yli-Tuomi T, Oftedal B, Schwarze PE, Nafstad P, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Penell J, Korek M, Pershagen G, Eriksen KT, Overvad K, Sørensen M, Eeftens M, Peeters PH, Meliefste K, Wang M, Bueno-de-Mesquita HB, Sugiri D, Krämer U, Heinrich J, de Hoogh K, Key T, Peters A, Hampel R, Concin H, Nagel G, Jaensch A, Ineichen A, Tsai MY, Schaffner E, Probst-Hensch NM, Schindler C, Ragettli MS, Vilier A, Clavel-Chapelon F, Declercq C, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Katsoulis M, Trichopoulou A, Keuken M, Jedynska A, Kooter IM, Kukkonen J, Sokhi RS, Vineis P, Brunekreef B. Natural-cause mortality and long-term exposure to particle components: an analysis of 19 European cohorts within the multi-center ESCAPE project. Environ Health Perspect 2015; 123:525-33. [PMID: 25712504 PMCID: PMC4455583 DOI: 10.1289/ehp.1408095] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 02/20/2015] [Indexed: 05/19/2023]
Abstract
BACKGROUND Studies have shown associations between mortality and long-term exposure to particulate matter air pollution. Few cohort studies have estimated the effects of the elemental composition of particulate matter on mortality. OBJECTIVES Our aim was to study the association between natural-cause mortality and long-term exposure to elemental components of particulate matter. METHODS Mortality and confounder data from 19 European cohort studies were used. Residential exposure to eight a priori-selected components of particulate matter (PM) was characterized following a strictly standardized protocol. Annual average concentrations of copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc within PM size fractions ≤ 2.5 μm (PM2.5) and ≤ 10 μm (PM10) were estimated using land-use regression models. Cohort-specific statistical analyses of the associations between mortality and air pollution were conducted using Cox proportional hazards models using a common protocol followed by meta-analysis. RESULTS The total study population consisted of 291,816 participants, of whom 25,466 died from a natural cause during follow-up (average time of follow-up, 14.3 years). Hazard ratios were positive for almost all elements and statistically significant for PM2.5 sulfur (1.14; 95% CI: 1.06, 1.23 per 200 ng/m3). In a two-pollutant model, the association with PM2.5 sulfur was robust to adjustment for PM2.5 mass, whereas the association with PM2.5 mass was reduced. CONCLUSIONS Long-term exposure to PM2.5 sulfur was associated with natural-cause mortality. This association was robust to adjustment for other pollutants and PM2.5.
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Affiliation(s)
- Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Pyko A, Eriksson C, Oftedal B, Hilding A, Östenson CG, Krog NH, Julin B, Aasvang GM, Pershagen G. Exposure to traffic noise and markers of obesity. Occup Environ Med 2015; 72:594-601. [PMID: 26009579 DOI: 10.1136/oemed-2014-102516] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 02/02/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Limited evidence suggests adverse effects of traffic noise exposure on the metabolic system. This study investigates the association between road traffic noise and obesity markers as well as the role of combined exposure to multiple sources of traffic noise. METHODS In a cross-sectional study performed in 2002-2006, we assessed exposure to noise from road traffic, railways and aircraft at the residences of 5075 Swedish men and women, primarily from suburban and semirural areas of Stockholm County. A detailed questionnaire and medical examination provided information on markers of obesity and potential confounders. Multiple linear and logistic regression models were used to assess associations between traffic noise and body mass index (BMI), waist circumference and waist-hip ratio using WHO definitions of obesity. RESULTS Road traffic noise was significantly related to waist circumference with a 0.21 cm (95% CI 0.01 to 0.41) increase per 5 dB(A) rise in L(den). The OR for central obesity among those exposed to road traffic noise ≥ 45 dB(A) was 1.18 (95% CI 1.03 to 1.34) in comparison to those exposed below this level. Similar results were seen for waist-hip ratio (OR 1.29; 95% CI 1.14 to 1.45) but not for BMI (OR 0.89; 95% CI 0.76 to 1.04). Central obesity was also associated with exposure to railway and aircraft noise, and a particularly high risk was seen for combined exposure to all three sources of traffic noise (OR 1.95; 95% CI 1.24 to 3.05). CONCLUSIONS Our results suggest that traffic noise exposure can increase the risk of central obesity. Combined exposure to different sources of traffic noise may convey a particularly high risk.
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Affiliation(s)
- Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Charlotta Eriksson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | | | - Agneta Hilding
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | - Bettina Julin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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45
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Oftedal B, Krog NH, Pyko A, Eriksson C, Graff-Iversen S, Haugen M, Schwarze P, Pershagen G, Aasvang GM. Road traffic noise and markers of obesity - a population-based study. Environ Res 2015; 138:144-153. [PMID: 25710788 DOI: 10.1016/j.envres.2015.01.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 12/19/2014] [Accepted: 01/12/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Noise has been found to be associated with endocrine changes and cardiovascular disease. Increased cortisol levels and chronic sleep problems due to noise may increase the risk of obesity. OBJECTIVES We investigated the relationship between road traffic noise and obesity markers. Furthermore, we explored the modifying role of noise sensitivity, noise annoyance, and sleep disturbances. METHODS We used data from a population-based study, HUBRO (N=15,085), and its follow-up study HELMILO (N=8410) conducted in Oslo, Norway. Measurements were used to define body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and these binary outcomes: BMI≥30kg/m(2), WC≥102cm (men)/88cm (women), and WHR≥0.90 (men)/0.85 (women). Modelled levels of road traffic noise (Lden) were assigned to each participant's home address. Linear and logistic regression models were used to examine the associations. RESULTS The results indicated no significant associations between road traffic noise and obesity markers in the total populations. However, in highly noise sensitive women (n=1106) a 10dB increase in noise level was associated with a slope (=beta) of 1.02 (95% confidence interval (CI): 1.01, 1.03) for BMI, 1.01 (CI: 1.00, 1.02) for WC, and an odds ratio (OR) of 1.24 (CI: 1.01, 1.53) for WHR ≥0.85. The associations appeared weaker in highly noise sensitive men. We found no effect modification of noise annoyance or sleep disturbances. In a sub-population with bedroom facing a road, the associations increased in men (e.g. an OR of 1.25 (CI: 0.88, 1.78) for BMI ≥30kg/m(2)), but not in women. Among long-term residents the associations increased for BMI ≥30kg/m(2) (OR of 1.07 (CI: 0.93, 1.24) in men and 1.10 (CI: 0.97, 1.26) in women), but not for the other outcomes. CONCLUSION In an adult urban Scandinavian population, road traffic noise was positively associated with obesity markers among highly noise sensitive women. The associations appeared stronger among men with bedroom facing a street, representing a population with more accurately assigned exposure.
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Affiliation(s)
- Bente Oftedal
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway.
| | - Norun Hjertager Krog
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-17177 Stockholm, Sweden
| | - Charlotta Eriksson
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-17177 Stockholm, Sweden; Center for occupational and environmental medicine, Stockholm county council, stockholm, Sweden
| | - Sidsel Graff-Iversen
- Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway
| | - Margaretha Haugen
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway
| | - PerE Schwarze
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, SE-17177 Stockholm, Sweden
| | - Gunn Marit Aasvang
- Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway
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Fuks KB, Weinmayr G, Foraster M, Dratva J, Hampel R, Houthuijs D, Oftedal B, Oudin A, Panasevich S, Penell J, Sommar JN, Sørensen M, Tiittanen P, Wolf K, Xun WW, Aguilera I, Basagaña X, Beelen R, Bots ML, Brunekreef B, Bueno-de-Mesquita HB, Caracciolo B, Cirach M, de Faire U, de Nazelle A, Eeftens M, Elosua R, Erbel R, Forsberg B, Fratiglioni L, Gaspoz JM, Hilding A, Jula A, Korek M, Krämer U, Künzli N, Lanki T, Leander K, Magnusson PKE, Marrugat J, Nieuwenhuijsen MJ, Ostenson CG, Pedersen NL, Pershagen G, Phuleria HC, Probst-Hensch NM, Raaschou-Nielsen O, Schaffner E, Schikowski T, Schindler C, Schwarze PE, Søgaard AJ, Sugiri D, Swart WJR, Tsai MY, Turunen AW, Vineis P, Peters A, Hoffmann B. Arterial blood pressure and long-term exposure to traffic-related air pollution: an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Environ Health Perspect 2014; 122:896-905. [PMID: 24835507 PMCID: PMC4154218 DOI: 10.1289/ehp.1307725] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 05/15/2014] [Indexed: 05/03/2023]
Abstract
BACKGROUND Long-term exposure to air pollution has been hypothesized to elevate arterial blood pressure (BP). The existing evidence is scarce and country specific. OBJECTIVES We investigated the cross-sectional association of long-term traffic-related air pollution with BP and prevalent hypertension in European populations. METHODS We analyzed 15 population-based cohorts, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). We modeled residential exposure to particulate matter and nitrogen oxides with land use regression using a uniform protocol. We assessed traffic exposure with traffic indicator variables. We analyzed systolic and diastolic BP in participants medicated and nonmedicated with BP-lowering medication (BPLM) separately, adjusting for personal and area-level risk factors and environmental noise. Prevalent hypertension was defined as ≥ 140 mmHg systolic BP, or ≥ 90 mmHg diastolic BP, or intake of BPLM. We combined cohort-specific results using random-effects meta-analysis. RESULTS In the main meta-analysis of 113,926 participants, traffic load on major roads within 100 m of the residence was associated with increased systolic and diastolic BP in nonmedicated participants [0.35 mmHg (95% CI: 0.02, 0.68) and 0.22 mmHg (95% CI: 0.04, 0.40) per 4,000,000 vehicles × m/day, respectively]. The estimated odds ratio (OR) for prevalent hypertension was 1.05 (95% CI: 0.99, 1.11) per 4,000,000 vehicles × m/day. Modeled air pollutants and BP were not clearly associated. CONCLUSIONS In this first comprehensive meta-analysis of European population-based cohorts, we observed a weak positive association of high residential traffic exposure with BP in nonmedicated participants, and an elevated OR for prevalent hypertension. The relationship of modeled air pollutants with BP was inconsistent.
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Affiliation(s)
- Kateryna B Fuks
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
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Haugen M, Brantsæter AL, Winkvist A, Lissner L, Alexander J, Oftedal B, Magnus P, Meltzer HM. Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study. BMC Pregnancy Childbirth 2014; 14:201. [PMID: 24917037 PMCID: PMC4062904 DOI: 10.1186/1471-2393-14-201] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 05/30/2014] [Indexed: 12/03/2022] Open
Abstract
Background Excessive gestational weight gain (GWG) is associated with pregnancy complications, and Norwegian Health Authorities have adopted the GWG recommendations of the US Institute of Medicine and National Research Council (IOM). The aim of this study was to evaluate if a GWG outside the IOM recommendation in a Norwegian population is associated with increased risk of pregnancy complications like hypertension, low and high birth weight, preeclampsia, emergency caesarean delivery, and maternal post-partum weight retention (PPWR) at 6 and 18 months. Methods This study was performed in 56 101 pregnant women included in the prospective national Norwegian Mother and Child Cohort Study (MoBa) in the years 1999 to 2008. Women who delivered a singleton live born child during gestational week 37 to 42 were included. Maternal prepregnant and postpartum weight was collected from questionnaires at 17th week of gestation and 6 and 18 months postpartum. Results A weight gain less than the IOM recommendations (GWG < IOM rec.) increased the risk for giving birth to a low weight baby among normal weight nulliparous women. A weight gain higher than the IOM recommendations (GWG > IOM rec.) significantly increased the risk of pregnancy hypertension, a high birth weight baby, preeclampsia and emergency cesarean delivery in both nulliparous and parous normal weight women. Similar results were found for overweight women except for no increased risk for gestational hypertension in parous women with GWG > IOM rec. Seventy-four percent of the overweight nulliparous women and 66% of the obese women had a GWG > IOM rec. A GWG > IOM rec. resulted in increased risk of PPWR > 2 kg in all weight classes, but most women attained their prepregnant weight class by 18 months post-partum. Conclusions For prepregnant normal weight and overweight women a GWG > IOM rec. increased the risk for unfavorable birth outcomes in both nulliparous and parous women. A GWG > IOM rec. increased the risk of a PPWR > 2 kg at 18 months in all weight classes. This large study supports the Norwegian Health authorities’ recommendations for normal weight and overweight women to comply with the IOM rec.
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Affiliation(s)
- Margaretha Haugen
- Division of Environmental Medicine, Norwegian Institute of Public Health, P,O, Box 4404, Nydalen NO-0403 Oslo, Norway.
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48
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Beelen R, Stafoggia M, Raaschou-Nielsen O, Andersen ZJ, Xun WW, Katsouyanni K, Dimakopoulou K, Brunekreef B, Weinmayr G, Hoffmann B, Wolf K, Samoli E, Houthuijs D, Nieuwenhuijsen M, Oudin A, Forsberg B, Olsson D, Salomaa V, Lanki T, Yli-Tuomi T, Oftedal B, Aamodt G, Nafstad P, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Penell J, Korek M, Pyko A, Eriksen KT, Tjønneland A, Becker T, Eeftens M, Bots M, Meliefste K, Wang M, Bueno-de-Mesquita B, Sugiri D, Krämer U, Heinrich J, de Hoogh K, Key T, Peters A, Cyrys J, Concin H, Nagel G, Ineichen A, Schaffner E, Probst-Hensch N, Dratva J, Ducret-Stich R, Vilier A, Clavel-Chapelon F, Stempfelet M, Grioni S, Krogh V, Tsai MY, Marcon A, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Katsoulis M, Trichopoulou A, Vineis P, Hoek G. Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts. Epidemiology 2014; 25:368-78. [PMID: 24589872 DOI: 10.1097/ede.0000000000000076] [Citation(s) in RCA: 190] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. METHODS Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. RESULTS The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. CONCLUSION In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.
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Affiliation(s)
- Rob Beelen
- From the aInstitute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; bDepartment of Epidemiology, Lazio Regional Health Service, Rome, Italy; cDanish Cancer Society Research Center, Copenhagen, Denmark; dCenter for Epidemiology and Screening, Department of Public Health, University of Copenhagen, CSS, København K, Denmark; eMRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, London, United Kingdom; fUniversity College London, CeLSIUS, London, United Kingdom; gDepartment of Hygiene, Epidemiology, and Medical Statistics, Medical School, University of Athens, Athens, Greece; hJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; iInstitute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; jIUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany, and Medical Faculty, University of Düsseldorf, Düsseldorf, Germany; kInstitute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; lNational Institute for Public Health and the Environment, Bilthoven, The Netherlands; mCentre for Research in Environmental Epidemiology (CREAL), Barcelona, and Parc de Recerca Biomèdica de Barcelona-PRBB (office 183.05) C. Doctor Aiguader, Barcelona, Spain; nConsortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Melchor Fernández Almagro 3-5, Madrid, Spain; oDivision of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; pNational Institute for Health and Welfare, Kuopio, Finland; qNorwegian Institute of Public Health, Oslo, Norway; rInstitute of Health and Society, University of Oslo, Oslo, Norway; sInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; tDepartm
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Sygna K, Aasvang GM, Aamodt G, Oftedal B, Krog NH. Road traffic noise, sleep and mental health. Environ Res 2014; 131:17-24. [PMID: 24637180 DOI: 10.1016/j.envres.2014.02.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/21/2013] [Accepted: 02/19/2014] [Indexed: 06/03/2023]
Abstract
This study examines the relationship between road traffic noise, self-reported sleep quality and mental health. The study is cross-sectional and based on data from a survey conducted in Oslo, Norway, in 2000. Psychological distress (Hopkins Symptom Checklist, HSCL-25) was measured along with self-reported somatic health, sleep quality, noise sensitivity and socioeconomic variables. Questionnaire data were combined with modeled estimates of noise exposure. The total study sample consisted of 2898 respondents. After adjustment for potential confounders and stratifying for sleep quality, we found a positive, but not statistically significant association between noise exposure and symptoms of psychological distress among participants with poor sleep quality (slope=0.06, 95% CI: -0.02 to 0.13, per 10 dB increase in noise exposure). In the same sleep quality group, we found a borderline statistically significant association between noise exposure and a symptom level indicating a probable mental disorder (HSCL≥1.55) (odds ratio=1.47, 95% CI: 0.99-1.98, per 10 dB increase in noise exposure). We found no association between road traffic noise and mental health among subjects reporting good and medium sleep quality. The results suggest that road traffic noise may be associated with poorer mental health among subjects with poor sleep. Individuals with poor sleep quality may be more vulnerable to effects of road traffic noise on mental health than individuals with better sleep quality.
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Affiliation(s)
- Karin Sygna
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway; Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway
| | - Gunn Marit Aasvang
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Geir Aamodt
- Department of Mathematical Sciences and Technology, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway; Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Bente Oftedal
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway
| | - Norun Hjertager Krog
- Department of Air Pollution and Noise, Division of Environmental Medicine, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway.
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50
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Wang M, Beelen R, Stafoggia M, Raaschou-Nielsen O, Andersen ZJ, Hoffmann B, Fischer P, Houthuijs D, Nieuwenhuijsen M, Weinmayr G, Vineis P, Xun WW, Dimakopoulou K, Samoli E, Laatikainen T, Lanki T, Turunen AW, Oftedal B, Schwarze P, Aamodt G, Penell J, De Faire U, Korek M, Leander K, Pershagen G, Pedersen NL, Östenson CG, Fratiglioni L, Eriksen KT, Sørensen M, Tjønneland A, Bueno-de-Mesquita B, Eeftens M, Bots ML, Meliefste K, Krämer U, Heinrich J, Sugiri D, Key T, de Hoogh K, Wolf K, Peters A, Cyrys J, Jaensch A, Concin H, Nagel G, Tsai MY, Phuleria H, Ineichen A, Künzli N, Probst-Hensch N, Schaffner E, Vilier A, Clavel-Chapelon F, Declerq C, Ricceri F, Sacerdote C, Marcon A, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Katsoulis M, Trichopoulou A, Keuken M, Jedynska A, Kooter IM, Kukkonen J, Sokhi RS, Brunekreef B, Katsouyanni K, Hoek G. Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: results from the ESCAPE and TRANSPHORM projects. Environ Int 2014; 66:97-106. [PMID: 24561271 DOI: 10.1016/j.envint.2014.01.026] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 01/16/2014] [Accepted: 01/27/2014] [Indexed: 05/26/2023]
Abstract
BACKGROUND Associations between long-term exposure to ambient particulate matter (PM) and cardiovascular (CVD) mortality have been widely recognized. However, health effects of long-term exposure to constituents of PM on total CVD mortality have been explored in a single study only. AIMS The aim of this study was to examine the association of PM composition with cardiovascular mortality. METHODS We used data from 19 European ongoing cohorts within the framework of the ESCAPE (European Study of Cohorts for Air Pollution Effects) and TRANSPHORM (Transport related Air Pollution and Health impacts--Integrated Methodologies for Assessing Particulate Matter) projects. Residential annual average exposure to elemental constituents within particle matter smaller than 2.5 and 10 μm (PM2.5 and PM10) was estimated using Land Use Regression models. Eight elements representing major sources were selected a priori (copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc). Cohort-specific analyses were conducted using Cox proportional hazards models with a standardized protocol. Random-effects meta-analysis was used to calculate combined effect estimates. RESULTS The total population consisted of 322,291 participants, with 9545 CVD deaths. We found no statistically significant associations between any of the elemental constituents in PM2.5 or PM10 and CVD mortality in the pooled analysis. Most of the hazard ratios (HRs) were close to unity, e.g. for PM10 Fe the combined HR was 0.96 (0.84-1.09). Elevated combined HRs were found for PM2.5 Si (1.17, 95% CI: 0.93-1.47), and S in PM2.5 (1.08, 95% CI: 0.95-1.22) and PM10 (1.09, 95% CI: 0.90-1.32). CONCLUSION In a joint analysis of 19 European cohorts, we found no statistically significant association between long-term exposure to 8 elemental constituents of particles and total cardiovascular mortality.
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Affiliation(s)
- Meng Wang
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Zorana Jovanovic Andersen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Center for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Hoffmann
- IUF, Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany; University of Düsseldorf, Düsseldorf, Germany
| | - Paul Fischer
- National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Danny Houthuijs
- National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Mark Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Gudrun Weinmayr
- University of Düsseldorf, Düsseldorf, Germany; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Paolo Vineis
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Wei W Xun
- MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom; University College London, London, United Kingdom
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Kuopio, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Timo Lanki
- National Institute for Health and Welfare, Kuopio, Finland
| | - Anu W Turunen
- National Institute for Health and Welfare, Kuopio, Finland
| | | | - Per Schwarze
- Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Norwegian Institute of Public Health, Oslo, Norway
| | - Johanna Penell
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Bas Bueno-de-Mesquita
- National Institute of Public Health and the Environment, Bilthoven, The Netherlands; School of Public Health, Imperial College London, London, United Kingdom
| | - Marloes Eeftens
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kees Meliefste
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ursula Krämer
- IUF, Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center of Environmental Health, Neuherberg, Germany
| | - Dorothea Sugiri
- IUF, Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Timothy Key
- Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Kees de Hoogh
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Kathrin Wolf
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Josef Cyrys
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; University of Augsburg, Environmental Science Center, Augsburg, Germany
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Harish Phuleria
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Alex Ineichen
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nino Künzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Alice Vilier
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris Sud, UMRS 1018, Villejuif, France; IGR, Villejuif, France
| | - Françoise Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, Villejuif, France; University Paris Sud, UMRS 1018, Villejuif, France; IGR, Villejuif, France
| | - Christophe Declerq
- French Institute for Public Health Surveillance (InVS) 12, Saint-Maurice, France
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Italy
| | - Claudia Galassi
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza, University of Turin and Center for Cancer Prevention, Turin, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | | | | | - Menno Keuken
- TNO, Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - Aleksandra Jedynska
- TNO, Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | - Ingeborg M Kooter
- TNO, Netherlands Organisation for Applied Scientific Research, Utrecht, The Netherlands
| | | | - Ranjeet S Sokhi
- University of Hertfordshire College Lane, Hatfield, United Kingdom
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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