Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden

Anna Lindgren,Anna Axmon,Emilie Stroh,Kristina Jakobsson,Peter Montnémery,Ulf Nihlén

doi:10.1186/1476-072x-8-2

Anna Lindgren, Anna Axmon + Show 4 more

Open Access

https://doi.org/10.1186/1476-072x-8-2

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Abstract

BackgroundThere is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. We examined associations between residential traffic and asthma and COPD in adults in southern Sweden. A postal questionnaire in 2000 (n = 9319, 18–77 years) provided disease status, and self-reported exposure to traffic. A Geographical Information System (GIS) was used to link geocoded residential addresses to a Swedish road database and an emission database for NOx.ResultsLiving within 100 m of a road with >10 cars/minute (compared with having no heavy road within this distance) was associated with prevalence of asthma diagnosis (OR = 1.40, 95% CI = 1.04–1.89), and COPD diagnosis (OR = 1.64, 95%CI = 1.11–2.4), as well as asthma and chronic bronchitis symptoms. Self-reported traffic exposure was associated with asthma diagnosis and COPD diagnosis, and with asthma symptoms. Annual average NOx was associated with COPD diagnosis and symptoms of asthma and chronic bronchitis.ConclusionLiving close to traffic was associated with prevalence of asthma diagnosis, COPD diagnosis, and symptoms of asthma and bronchitis. This indicates that traffic-related air pollution has both long-term and short-term effects on chronic respiratory disease in adults, even in a region with overall low levels of air pollution.

Highlights

There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults
Inconsistencies between studies in the relation between air pollution and asthma/COPD could depend both on the presence of different competing risk factors, Table 10: Relation between the exposure proxies and modeled NOx as a continuous variable
(page number not for citation purposes) http://www.ij-healthgeographics.com/content/8/1/2 and on geographically different pollution mixtures acting on different regions of the respiratory tract

Summary

Introduction

There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. Long-term effects have been disputed, but there is growing evidence that traffic-related air pollution is related, at least among children, to asthma incidence [37], decreased lung function development [8,9], and incidence of bronchitic symptoms [4,10]. Chronic respiratory disease in adults is heterogenous and involves major exposures, such as personal smoking and occupational exposure, which do not directly affect children. This larger variety of risk factors may complicate research and contribute to inconclusive results in adults. Self-reports could be severely biased if people are more aware of (and over-report) exposures that are known to be potentially connected to disease, and may not be trustworthy if used as the only exposure estimate [21]

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