Long-term air pollution exposure, greenness and health-related quality of life (HRQOL) in ECRHS

Abstract

<b>Introduction:</b> Association studies of long-term air pollution exposure and greenness with HRQOL are rare and none account for asthma-rhinitis status. <b>Aims:</b> To study the cross-sectional associations of long-term air pollution exposure and greenness with HRQOL and the modification effect of asthma-rhinitis status on these associations. <b>Methods:</b> Participants to the second (n=6542) and third (n=3686) phase of the European Community Respiratory Health Survey (ECRHS), with data on SF-36 Physical and Mental Component Summary (PCS, MCS), annual mean residential air pollution exposures (NO₂, PM_2.5 and PM₁₀) and greenness (Normalized Difference Vegetation Index (NDVI) in a 300m buffer) were included. For each exposure variable, we fitted mixed linear models for PCS and MCS, accounted for centre effect and repeated data, and adjusted for age, gender, BMI, smoking, occupation, and chronic diseases. Interaction terms between exposures and asthma and/or rhinitis status were further added. <b>Results:</b> 48% were men and the mean(SD) age of the ECRHSII and III participants were 43(7) and 54(7) years. Mean(SD) PCS and MCS were 49(10) and 50(11) at ECRHSII, and 47(11) and 51(10) at ECRHSIII. MCS was inversely associated with NO₂, PM_2.5 and PM₁₀, and positively associated with NDVI (regression coefficients (95%CI) for one IQR change in exposure were -0.70 (-1.17; -0.23), -1.84 (-2.83; -0.85), -1.80 (-2.89; -0.71) and 0.91 (0.34; 1.48), respectively). No association was found for PCS. Similar association patterns were observed for each asthma-rhinitis phenotype. <b>Conclusion:</b> Higher long-term air pollution exposure and lower greenness were associated with higher MCS but not PCS, regardless of asthma-rhinitis status.