Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project

作者：Shuo Liu, Jeanette T. Jørgensen, Petter Ljungman, Göran Pershagen, Tom Bellander, Karin Leander, Patrik K. E. Magnusson, Debora Rizzuto, Ulla Arthur Hvidtfeldt, Ole Raaschou‐Nielsen, Kathrin Wolf, Barbara Hoffmann, Bert Brunekreef, Maciej Strak, Jie Chen, Amar Mehta, Richard Atkinson, Mariska Bauwelinck, Raphaëlle Varraso, Marie‐Christine Boutron‐Ruault, Jørgen Brandt, Giulia Cesaroni, Francesco Forastiere, Daniela Fecht, John Gulliver, Ole Hertel, Kees de Hoogh, Nicole Janssen, Klea Katsouyanni, Matthias Ketzel, Jochem O. Klompmaker, Gabriele Nagel, Bente Oftedal, Annette Peters, Anne Tjønneland, Sophia Rodopoulou, Evangelia Samoli, Doris Tove Kristoffersen, Torben Sigsgaard, Massimo Stafoggia, Danielle Vienneau, Gudrun Weinmayr, Gerard Hoek, Zorana Jovanovic Andersen · 发表于：European Respiratory Journal · 年份：2021 · DOI：10.1183/13993003.03099-2020 · 被引用次数：94 · 研究领域：Air Quality and Health Impacts、Noise Effects and Management、Climate Change and Health Impacts

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 µm (PM 2.5 ), nitrogen dioxide (NO 2 ) 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 98 326 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 μg·m −3 for PM 2.5 , 1.17 (95% CI 1.10–1.25) per 10 µg·m −3 for NO 2 and 1.15 (95% CI 1.08–1.23) per 0.5×10 −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 PM 2.5 and NO 2 . NO 2 and BC estimates remained unchanged in two-pollutant models with PM 2.5 , whereas PM 2.5 estimates were attenuated to unity. The concentration–response cu...