Lifelong exposure to air pollution and greenness in relation to asthma, rhinitis and lung function in adulthood

Ingrid Nordeide Kuiper,Jesper Heile Christensen,Lennart Bråbäck,Ane Johannessen,Cecilie Svanes,Mathias Holm,Torben Sigsgaard,Alessandro Marcon,Kees De Hoogh,Bertil Forsberg,Thomas Halvorsen,Ole Hertel,Iana Markevych,Joachim Heinrich,Christer Janson,Gerard Hoek,Simone Accordini,Roy Miodini Nilsen,Andreï Malinovschi ,Randi Jacobsen Bertelsen

doi:10.1016/j.envint.2020.106219

Abstract

ObjectivesTo investigate if air pollution and greenness exposure from birth till adulthood affects adult asthma, rhinitis and lung function. Methods: We analysed data from 3428 participants (mean age 28) in the RHINESSA study in Norway and Sweden. Individual mean annual residential exposures to nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5), black carbon (BC), ozone (O3) and greenness (normalized difference vegetation index (NDVI)) were averaged across susceptibility windows (0–10 years, 10–18 years, lifetime, adulthood (year before study participation)) and analysed in relation to physician diagnosed asthma (ever/allergic/non-allergic), asthma attack last 12 months, current rhinitis and low lung function (lower limit of normal (LLN), z-scores of forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC below 1.64). We performed logistic regression for asthma attack, rhinitis and LLN lung function (clustered with family and study centre), and conditional logistic regression with a matched case-control design for ever/allergic/non-allergic asthma. Multivariable models were adjusted for parental asthma and education. Results: Childhood, adolescence and adult exposure to NO2, PM10 and O3 were associated with an increased risk of asthma attacks (ORs between 1.29 and 2.25), but not with physician diagnosed asthma. For rhinitis, adulthood exposures seemed to be most important. Childhood and adolescence exposures to PM2.5 and O3 were associated with lower lung function, in particular FEV1 (range ORs 2.65 to 4.21). No associations between NDVI and asthma or rhinitis were revealed, but increased NDVI was associated with lower FEV1 and FVC in all susceptibility windows (range ORs 1.39 to 1.74). Conclusions: Air pollution exposures in childhood, adolescence and adulthood were associated with increased risk of asthma attacks, rhinitis and low lung function in adulthood. Greenness was not associated with asthma or rhinitis, but was a risk factor for low lung function.

Highlights

Air pollution is one of the world’s largest known environmental health threats and an important cause of both respiratory mortality and morbidity (World Health Organization (WHO), 2005)
The majority (58%) of participants were female with a median age for the total study population of 28.4 years, ranging from 18 to 40 years
O3 was associ ated with less risk for non-allergic asthma (OR 0.91 (0.84–1.00))

Summary

Introduction

Air pollution is one of the world’s largest known environmental health threats and an important cause of both respiratory mortality and morbidity (World Health Organization (WHO), 2005). How ever, the effects of greenness on respiratory health and allergy are limited and results are heterogeneous depending on whether residence is in urban or rural areas (Fuertes et al, 2014; Dadvand et al, 2014; Lambert et al, 2017). Both local vegetation and season may affect population exposure to allergenic pollen and fungal spores, which at least partly can explain the varying associations in different locations (Fuertes et al, 2014; Ghiani et al, 2012). Regarding lung function the results are heterogeneous; a recent study found an association with higher lung function after growing up nearby green spaces (Fuertes et al, 2020), while other studies did not find any associations (Boeyen et al, 2017)

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