Abstract
BackgroundEpidemiological research into the role of traffic pollution on chronic respiratory and allergic disease has focused primarily on children. Studies in adults, in particular those based on objective outcomes such as bronchial hyperresponsiveness, skin sensitisation, and lung function, are limited.MethodsWe have used an existing cohort of 2644 adults aged 18–70 living in Nottingham, UK, for whom baseline health and demographic data were collected in 1991 and computed two markers of exposure to traffic: distance between the home and nearest main road and modelled outdoor nitrogen dioxide (NO2) concentration at the home location. Using multiple regression techniques, we analysed cross-sectional associations with bronchial hyperresponsiveness, FEV1, spirometry-defined COPD, skin test positivity, total IgE and questionnaire-reported wheeze, asthma, eczema and hayfever in 2599 subjects, and longitudinal associations with decline in FEV1 in 1329 subjects followed-up nine years later in 2000.ResultsThere were no significant cross-sectional associations between home proximity to the roadside or NO2 level on any of the outcomes studied (adjusted OR of bronchial hyperresponsiveness in relation to living ≤150 m vs >150 m from a road = 0.92, 95% CI 0.68 to 1.24). Furthermore, neither exposure was associated with a significantly greater decline in FEV1 over time (adjusted mean difference in ΔFEV1 for living ≤150 m vs >150 m of a road = 10.03 ml, 95% CI, -33.98 to 54.04).ConclusionThis study found no evidence to suggest that living in close proximity to traffic is a major determinant of asthma, allergic disease or COPD in adults.
Highlights
Epidemiological research into the role of traffic pollution on chronic respiratory and allergic disease has focused primarily on children
FEV1 and forced vital capacity (FVC) were measured by a study nurse using a calibrated dry bellows spirometer (Vitalograph, Buckingham, UK) taking the best of three technically satisfactory manoeuvres with the subject seated; a methacholine challenge performed to determine bronchial hyperresponsiveness (BHR) using the technique described by Yan et al[14]; allergen skin tests to Dermatophagoides pteronyssinus, mixed grass pollen, cat fur, Aspergillus fumigatus, and Cladosporium herbarum (Bencard solutions, Brentford, UK) carried out; and a blood sample taken
The characteristics of our original 7106 adults sampled from the electoral role are not known, Table 2 shows how the age, sex and social deprivation (Carstairs) distribution of our participants compares with that of all Gedling residents in 1991, our target population, using census data from that year [20] (Table 2)
Summary
Epidemiological research into the role of traffic pollution on chronic respiratory and allergic disease has focused primarily on children. BMC Pulmonary Medicine 2009, 9:42 http://www.biomedcentral.com/1471-2466/9/42 roads is associated with an increased risk of wheeze [1,2,3], whilst others have shown no effect on wheeze or asthma [4,5,6,7,8,9] Some of this inconsistency may be due to the use of self-reported markers of asthma which are potentially biased, but use of objective markers such as bronchial hyperresponsiveness (BHR) is rare. Lung function measures such as one second forced expiratory volume (FEV1) have been investigated by a few in relation to traffic indices such as proximity to main roads or modelled trafficrelated pollutants, but again findings in adults are inconclusive and evidence of longitudinal effects lacking[10]. Investigations of allergy and atopy in adults have tended to rely on self-reported outcomes, and use of objective markers such as skin sensitisation or elevated immunoglobulin E (IgE) rare[6,8]
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