@article{3197047,
    title = "Long-term exposure to low-level air pollution and incidence of asthma:
the ELAPSE project",
    author = "Liu, Shuo and Jorgensen, Jeanette Therming and Ljungman, Petter and and Pershagen, Goran and Bellander, Tom and Leander, Karin and Magnusson, and Patrik K. E. and Rizzuto, Debora and Hvidtfeldt, Ulla A. and Nielsen, and Ole Raaschou and Wolf, Kathrin and Hoffmann, Barbara and Brnekree, Bert and and Strak, Maciej and Chen, Jie and Mehta, Amar and Atkinson, Richard W. and and Bauwelrick, Mariska and Varraso, Raphaelle and Boutron-Ruault, and Marie-Christine and Brandt, Jorgen and Cesaroni, Giulia and Forastiere, and Francesco and Fecht, Daniela and Gulliver, John and Herte, Ole and de and Hoogh, Kees and Janssen, Nicole A. H. and Katsouyanni, Klea and Ketzel, and Matthias and Klompmaker, Jochem O. and Nagel, Gabriele and Oftedal, and Bente and Peters, Annette and Tjonneland, Anne and Rodopoulou, Sophia P. and and Samoli, Evangelia and Kristoffersen, Doris Tove and Sigsgaard, and Torben and Stafoggia, Massimo and Vienneau, Danielle and Weinmayr, and Gudrun and Hoek, Gerard and Andersen, Zorana Jovanovic",
    journal = "The European respiratory journal",
    year = "2021",
    volume = "57",
    number = "6",
    publisher = "EUROPEAN RESPIRATORY SOC JOURNALS LTD",
    doi = "10.1183/13993003.030992020",
    abstract = "Background: Long-term exposure to ambient air pollution has been linked
to childhood-onset asthma, although evidence is still insufficient.
Within the multicentre project Effects of Low-Level Air Pollution: A
Study in Europe (ELAPSE), we examined the associations of long-term
exposures to particulate matter with a diameter <2.5 mu m (PM2.5),
nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in
adults.
Methods: We pooled data from three cohorts in Denmark and Sweden with
information on asthma hospital diagnoses. The average concentrations of
air pollutants in 2010 were modelled by hybrid land-use regression
models at participants’ baseline residential addresses. Associations of
air pollution exposures with asthma incidence were explored with Cox
proportional hazard models, adjusting for potential confounders.
Results: Of 98326 participants, 1965 developed asthma during a mean
follow-up of 16.6 years. We observed associations in fully adjusted
models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 mu g.m(-3)
for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 mu g.m(-3) for NO2 and 1.15
(95% CI 1.08-1.23) per 0.5 x 10(-5) m(-1) for BC. Hazard ratios were
larger in cohort subsets with exposure levels below the European Union
and US limit values and possibly World Health Organization guidelines
for PM2.5 and NO2. NO 2 and BC estimates remained unchanged in
two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated
to unity. The concentration-response curves showed no evidence of a
threshold.
Conclusions: Long-term exposure to air pollution, especially from fossil
fuel combustion sources such as motorised traffic, was associated with
adult-onset asthma, even at levels below the current limit values."
}