Residential exposure to air pollution in relation to respiratory health in adults

Abstract

Background and Aims Longitudinal studies on the long-term influence of air pollution on chronic respiratory disease in adults are rare. Workpackage 4 (WP4) of ESCAPE investigates in six adult cohort studies (ECRHS, EGEA, E3N, SAPALDIA, SALIA and NSHD) conducted in 12 European countries whether long-term exposure to traffic-related air pollution is associated with the a) prevalence of chronic bronchitis symptoms, b) prevalence and incidence of COPD, c) level and change of forced expiratory lung volumes, and d) the incidence of asthma. Methods Participants living at ESCAPE-sites of the geographically diverse population-based studies are included. Five studies have lung function data and all six studies questionnaire information about respiratory health outcomes. Datasets were harmonized to ensure consistency of statistical analysis (by study and meta-analyses). All participating cohorts assessed the spatial variability of PM10, PM2.5 and NOx within their communities based on the ESCAPE exposure protocol. Results There are 13’282 participants with at least two spirometric measures and 18’088 participants with questionnaire data about respiratory health information. The follow-up time varies between studies from 10 to 20 years and mean age from 42.6 to 73.5 years among studies. Long-term air pollution exposure to NOx , NO2 and high traffic intensity at the participants’ homes were associated with a decline in lung function based on five cohorts and the development of COPD based on four cohorts, while the risk of chronic bronchitis symptoms and Asthma incidence did not observe a similar risk.. Overall, we detected that lung function and COPD being impacted by traffic related exposures, while results were not statistically significant for chronic bronchitis symptoms and asthma incidence. ConclusionsOur findings are heterogeneous with partly positive and some null findings for the association between long-term exposure to air pollution and respiratory outcomes.