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van Kersen W, de Rooij MMT, Portengen L, Diez NS, Pieterson I, Tewis M, Boer JMA, Koppelman G, Vonk JM, Vermeulen R, Gehring U, Huss A, Smit LAM. Impact of COVID-19 containment measures on perceived health and health-protective behavior: a longitudinal study. Sci Rep 2024; 14:419. [PMID: 38172539 PMCID: PMC10764319 DOI: 10.1038/s41598-023-50542-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
This longitudinal study aimed to assess the impact of COVID-19 containment measures on perceived health, health protective behavior and risk perception, and investigate whether chronic disease status and urbanicity of the residential area modify these effects. Participants (n = 5420) were followed for up to 14 months (September 2020-October 2021) by monthly questionnaires. Chronic disease status was obtained at baseline. Urbanicity of residential areas was assessed based on postal codes or neighborhoods. Exposure to containment measures was assessed using the Containment and Health Index (CHI). Bayesian multilevel-models were used to assess effect modification of chronic disease status and urbanicity by CHI. CHI was associated with higher odds for worse physical health in people with chronic disease (OR = 1.09, 95% credibility interval (CrI) = 1.01, 1.17), but not in those without (OR = 1.01, Crl = 0.95, 1.06). Similarly, the association of CHI with higher odds for worse mental health in urban dwellers (OR = 1.31, Crl = 1.23, 1.40) was less pronounced in rural residents (OR = 1.20, Crl = 1.13, 1.28). Associations with behavior and risk perception also differed between groups. Our study suggests that individuals with chronic disease and those living in urban areas are differentially affected by government measures put in place to manage the COVID-19 pandemic. This highlights the importance of considering vulnerable subgroups in decision making regarding containment measures.
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Affiliation(s)
- Warner van Kersen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Myrna M T de Rooij
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Nekane Sandoval Diez
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Inka Pieterson
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Marjan Tewis
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands
| | - Gerard Koppelman
- Department of Paediatric Pulmonology and Paediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute of Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Groningen Research Institute of Asthma and COPD (GRIAC), Groningen, The Netherlands
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
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Saucy A, Gehring U, Olmos S, Delpierre C, de Bont J, Gruzieva O, de Hoogh K, Huss A, Ljungman P, Melén E, Persson Å, Pieterson I, Tewis M, Yu Z, Vermeulen R, Vlaanderen J, Tonne C. Effect of residential relocation on environmental exposures in European cohorts: An exposome-wide approach. Environ Int 2023; 173:107849. [PMID: 36889121 DOI: 10.1016/j.envint.2023.107849] [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: 12/01/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Residential relocation is increasingly used as a natural experiment in epidemiological studies to assess the health impact of changes in environmental exposures. Since the likelihood of relocation can be influenced by individual characteristics that also influence health, studies may be biased if the predictors of relocation are not appropriately accounted for. Using data from Swedish and Dutch adults (SDPP, AMIGO), and birth cohorts (BAMSE, PIAMA), we investigated factors associated with relocation and changes in multiple environmental exposures across life stages. We used logistic regression to identify baseline predictors of moving, including sociodemographic and household characteristics, health behaviors and health. We identified exposure clusters reflecting three domains of the urban exposome (air pollution, grey surface, and socioeconomic deprivation) and conducted multinomial logistic regression to identify predictors of exposome trajectories among movers. On average, 7 % of the participants relocated each year. Before relocating, movers were consistently exposed to higher levels of air pollution than non-movers. Predictors of moving differed between the adult and birth cohorts, highlighting the importance of life stages. In the adult cohorts, moving was associated with younger age, smoking, and lower education and was independent of cardio-respiratory health indicators (hypertension, BMI, asthma, COPD). Contrary to adult cohorts, higher parental education and household socioeconomic position were associated with a higher probability of relocation in birth cohorts, alongside being the first child and living in a multi-unit dwelling. Among movers in all cohorts, those with a higher socioeconomic position at baseline were more likely to move towards healthier levels of the urban exposome. We provide new insights into predictors of relocation and subsequent changes in multiple aspects of the urban exposome in four cohorts covering different life stages in Sweden and the Netherlands. These results inform strategies to limit bias due to residential self-selection in epidemiological studies using relocation as a natural experiment.
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Affiliation(s)
- Apolline Saucy
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sergio Olmos
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Cyrille Delpierre
- Centre for Epidemiology and Research in POPulation Health (CERPOP) UMR1295, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Danderyd Hospital, Department of Cardiology, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Persson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inka Pieterson
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marjan Tewis
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Zhebin Yu
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jelle Vlaanderen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Cathryn Tonne
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain.
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Milanzi EB, Koppelman GH, Oldenwening M, Augustijn S, Aalders-de Ruijter B, Farenhorst M, Vonk JM, Tewis M, Brunekreef B, Gehring U. Considerations in the use of different spirometers in epidemiological studies. Environ Health 2019; 18:39. [PMID: 31023382 PMCID: PMC6485068 DOI: 10.1186/s12940-019-0478-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/07/2018] [Accepted: 04/11/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND Spirometric lung function measurements have been proven to be excellent objective markers of respiratory morbidity. The use of different types of spirometers in epidemiological and clinical studies may present systematically different results affecting interpretation and implication of results. We aimed to explore considerations in the use of different spirometers in epidemiological studies by comparing forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) measurements between the Masterscreen pneumotachograph and EasyOne spirometers. We also provide a correction equation for correcting systematic differences using regression calibration. METHODS Forty-nine volunteers had lung function measured on two different spirometers in random order with at least three attempts on each spirometer. Data were analysed using correlation plots, Bland and Altman plots and formal paired t-tests. We used regression calibration to provide a correction equation. RESULTS The mean (SD) FEV1 and FVC was 3.78 (0.63) L and 4.78 (0.63) L for the Masterscreen pneumotachograph and 3.54 (0.60) L and 4.41 (0.83) L for the EasyOne spirometer. The mean FEV1 difference of 0.24 L and mean FVC difference of 0.37 L between the spirometers (corresponding to 6.3 and 8.4% difference, respectively) were statistically significant and consistent between younger (< 30 years) and older volunteers (> 30 years) and between males and females. Regression calibration indicated that an increase of 1 L in the EasyOne measurements corresponded to an average increase of 1.032 L in FEV1 and 1.005 L in FVC in the Masterscreen measurements. CONCLUSION Use of different types of spirometers may result in significant systematic differences in lung function values. Epidemiological researchers need to be aware of these potential systematic differences and correct for them in analyses using methods such as regression calibration.
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Affiliation(s)
- Edith B. Milanzi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Gerard H. Koppelman
- University Medical Center Groningen, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, University of Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Marieke Oldenwening
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Sonja Augustijn
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | | | - Martijn Farenhorst
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, The Netherlands
| | - Judith M. Vonk
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Marjan Tewis
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
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Tsai MY, Hoek G, Eeftens M, de Hoogh K, Beelen R, Beregszászi T, Cesaroni G, Cirach M, Cyrys J, De Nazelle A, de Vocht F, Ducret-Stich R, Eriksen K, Galassi C, Gražuleviciene R, Gražulevicius T, Grivas G, Gryparis A, Heinrich J, Hoffmann B, Iakovides M, Keuken M, Krämer U, Künzli N, Lanki T, Madsen C, Meliefste K, Merritt AS, Mölter A, Mosler G, Nieuwenhuijsen MJ, Pershagen G, Phuleria H, Quass U, Ranzi A, Schaffner E, Sokhi R, Stempfelet M, Stephanou E, Sugiri D, Taimisto P, Tewis M, Udvardy O, Wang M, Brunekreef B. Spatial variation of PM elemental composition between and within 20 European study areas--Results of the ESCAPE project. Environ Int 2015; 84:181-92. [PMID: 26342569 DOI: 10.1016/j.envint.2015.04.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [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: 10/29/2014] [Revised: 04/30/2015] [Accepted: 04/30/2015] [Indexed: 05/12/2023]
Abstract
An increasing number of epidemiological studies suggest that adverse health effects of air pollution may be related to particulate matter (PM) composition, particularly trace metals. However, we lack comprehensive data on the spatial distribution of these elements. We measured PM2.5 and PM10 in twenty study areas across Europe in three seasonal two-week periods over a year using Harvard impactors and standardized protocols. In each area, we selected street (ST), urban (UB) and regional background (RB) sites (totaling 20) to characterize local spatial variability. Elemental composition was determined by energy-dispersive X-ray fluorescence analysis of all PM2.5 and PM10 filters. We selected a priori eight (Cu, Fe, K, Ni, S, Si, V, Zn) well-detected elements of health interest, which also roughly represented different sources including traffic, industry, ports, and wood burning. PM elemental composition varied greatly across Europe, indicating different regional influences. Average street to urban background ratios ranged from 0.90 (V) to 1.60 (Cu) for PM2.5 and from 0.93 (V) to 2.28 (Cu) for PM10. Our selected PM elements were variably correlated with the main pollutants (PM2.5, PM10, PM2.5 absorbance, NO2 and NOx) across Europe: in general, Cu and Fe in all size fractions were highly correlated (Pearson correlations above 0.75); Si and Zn in the coarse fractions were modestly correlated (between 0.5 and 0.75); and the remaining elements in the various size fractions had lower correlations (around 0.5 or below). This variability in correlation demonstrated the distinctly different spatial distributions of most of the elements. Variability of PM10_Cu and Fe was mostly due to within-study area differences (67% and 64% of overall variance, respectively) versus between-study area and exceeded that of most other traffic-related pollutants, including NO2 and soot, signaling the importance of non-tailpipe (e.g., brake wear) emissions in PM.
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Affiliation(s)
- Ming-Yi Tsai
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland; Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Marloes Eeftens
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland; Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Timea Beregszászi
- Department of Air Hygiene, National Institute of Environmental Health, Budapest, Hungary
| | - Giulia Cesaroni
- Epidemiology Department, Lazio Regional Health Service, Rome, Italy
| | - Marta Cirach
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Josef Cyrys
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany; Environmental Science Center, Universität Augsburg, Augsburg, Germany
| | - Audrey De Nazelle
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Centre for Environmental Policy, Faculty of Natural Sciences, Imperial College London, London, United Kingdom
| | - Frank de Vocht
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, England, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, England, United Kingdom
| | - Regina Ducret-Stich
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland
| | | | - Claudia Galassi
- AOU Città della Salute e della Scienza - CPO Piemonte, Turin, Italy
| | | | | | - Georgios Grivas
- School of Chemical Engineering, National Technical University of Athens, Greece
| | - Alexandros Gryparis
- Division of Hygiene - Epidemiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Joachim Heinrich
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
| | - Barbara Hoffmann
- IUF Leibniz Research Institute for Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Minas Iakovides
- Environmental Chemical Processes Laboratory, Department of Chemistry, University of Crete, Heraklion, Greece
| | - Menno Keuken
- TNO, Applied Research Organization, The Netherlands
| | - Ursula Krämer
- IUF Leibniz Research Institute for Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland
| | - Timo Lanki
- Department of Environmental Health, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Christian Madsen
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Kees Meliefste
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Anne-Sophie Merritt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mölter
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, England, United Kingdom; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Gioia Mosler
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Mark J Nieuwenhuijsen
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Harish Phuleria
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland; Centre for Environmental Science and Engineering, Indian Institute of Technology Bombay Powai, Mumbai 400076, India
| | - Ulrich Quass
- Air Quality & Sustainable Nanotachnology, IUTA Institut für Energie- und Umwelttechnik e.V., Duisburg, Germany
| | - Andrea Ranzi
- Regional Reference Centre on Environment and Health, ARPA Emilia Romagna, Modena, Italy
| | - Emmanuel Schaffner
- Department of Epidemiology and Public Health, Swiss Tropical & Public Health Institute, 4002 Basel, Switzerland; University of Basel, 4003 Basel, Switzerland
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research (CAIR), University of Hertfordshire, College Lane, Hatfield, United Kingdom
| | - Morgane Stempfelet
- French Institute for Public Health Surveillance (InVS), Saint-Maurice Cedex, France
| | - Euripides Stephanou
- Environmental Chemical Processes Laboratory, Department of Chemistry, University of Crete, Heraklion, Greece
| | - Dorothea Sugiri
- IUF Leibniz Research Institute for Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Pekka Taimisto
- Department of Environmental Health, National Institute for Health and Welfare (THL), Kuopio, Finland
| | - Marjan Tewis
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands
| | - Orsolya Udvardy
- Department of Air Hygiene, National Institute of Environmental Health, Budapest, Hungary
| | - Meng Wang
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands; Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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