TY - JOUR
TI - Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project
AU - Liu, S.
AU - Jørgensen, J.T.
AU - Ljungman, P.
AU - Pershagen, G.
AU - Bellander, T.
AU - Leander, K.
AU - Magnusson, P.K.E.
AU - Rizzuto, D.
AU - Hvidtfeldt, U.A.
AU - Raaschou-Nielsen, O.
AU - Wolf, K.
AU - Hoffmann, B.
AU - Brunekreef, B.
AU - Strak, M.
AU - Chen, J.
AU - Mehta, A.
AU - Atkinson, R.W.
AU - Bauwelinck, M.
AU - Varraso, R.
AU - Boutron-Ruault, M.-C.
AU - Brandt, J.
AU - Cesaroni, G.
AU - Forastiere, F.
AU - Fecht, D.
AU - Gulliver, J.
AU - Hertel, O.
AU - de Hoogh, K.
AU - Janssen, N.A.H.
AU - Katsouyanni, K.
AU - Ketzel, M.
AU - Klompmaker, J.O.
AU - Nagel, G.
AU - Oftedal, B.
AU - Peters, A.
AU - Tjønneland, A.
AU - Rodopoulou, S.P.
AU - Samoli, E.
AU - Bekkevold, T.
AU - Sigsgaard, T.
AU - Stafoggia, M.
AU - Vienneau, D.
AU - Weinmayr, G.
AU - Hoek, G.
AU - Andersen, Z.J.
JO - Environment International
PY - 2021
VL - 146
TODO - null
SP - null
PB - Elsevier Ireland Ltd
SN - 0160-4120
TODO - 10.1016/j.envint.2020.106267
TODO - Air pollution;  Diagnosis;  Hazards;  Land use;  Nitrogen oxides;  Regression analysis, Chronic obstructive pulmonary disease;  Confidence interval;  Cox proportional hazards models;  Hospital discharge;  Land-use regression models;  Long term exposure;  Particulate Matter;  Traffic-related pollutants, Pulmonary diseases, black carbon;  nitrogen dioxide;  ozone, atmospheric pollution;  black carbon;  chronic obstructive pulmonary disease;  cohort analysis;  disease incidence;  health risk;  nitrogen dioxide;  particulate matter;  pollution exposure;  risk factor, adult;  air pollution;  Article;  chronic obstructive lung disease;  concentration (parameter);  Denmark;  environmental exposure;  female;  follow up;  hospital discharge;  human;  incidence;  long term exposure;  major clinical study;  male;  middle aged;  particulate matter 2.5;  priority journal;  Sweden;  World Health Organization;  adverse event;  air pollutant;  analysis;  chronic obstructive lung disease;  cohort analysis;  environmental exposure;  Europe;  particulate matter;  toxicity, Denmark;  Sweden, Air Pollutants;  Air Pollution;  Cohort Studies;  Environmental Exposure;  Europe;  Humans;  Incidence;  Particulate Matter;  Pulmonary Disease, Chronic Obstructive;  Sweden
TODO - Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods: Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants’ baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models. Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 µg/m3 for PM2.5, 1.11 (1.06, 1.16) per 10 µg/m3 for NO2, and 1.11 (1.06, 1.15) per 0.5 10−5m−1 for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC. Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant. © 2020
ER -