Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project

Shuo Liu; Jeanette T. Jørgensen; Petter Ljungman; Göran Pershagen; Tom Bellander; Karin Leander; Patrik K.E. Magnusson; Debora Rizzuto; Ulla A. Hvidtfeldt; Ole Raaschou-Nielsen; Kathrin Wolf; Barbara Hoffmann; Bert Brunekreef; Maciej Strak; Jie Chen; Amar Mehta; Richard W. 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 A.H. Janssen; Klea Katsouyanni; Matthias Ketzel; Jochem O. Klompmaker; Gabriele Nagel; Bente Oftedal; Annette Peters; Anne Tjønneland; Sophia P. Rodopoulou; Evangelia Samoli; Terese Bekkevold; Torben Sigsgaard; Massimo Stafoggia; Danielle Vienneau; Gudrun Weinmayr; Gerard Hoek; Zorana J. Andersen

doi:10.1016/j.envint.2020.106267

Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project

Shuo Liu, Jeanette T. Jørgensen, Petter Ljungman, Göran Pershagen, Tom Bellander, Karin Leander, Patrik K.E. Magnusson, Debora Rizzuto, Ulla A. Hvidtfeldt, Ole Raaschou-Nielsen, Kathrin Wolf, Barbara Hoffmann, Bert Brunekreef, Maciej Strak, Jie Chen, Amar Mehta, Richard W. Atkinson, Mariska Bauwelinck, Raphaëlle Varraso, Marie Christine Boutron-RuaultJørgen Brandt, Giulia Cesaroni, Francesco Forastiere, Daniela Fecht, John Gulliver, Ole Hertel, Kees de Hoogh, Nicole A.H. Janssen, Klea Katsouyanni, Matthias Ketzel, Jochem O. Klompmaker, Gabriele Nagel, Bente Oftedal, Annette Peters, Anne Tjønneland, Sophia P. Rodopoulou, Evangelia Samoli, Terese Bekkevold, Torben Sigsgaard, Massimo Stafoggia, Danielle Vienneau, Gudrun Weinmayr, Gerard Hoek, Zorana J. Andersen

Research output: Contribution to journal › Article › peer-review

86 Citations (Scopus)

216 Downloads (Pure)

Abstract

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 (PM_2.5), 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 PM_2.5, 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 PM_2.5 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 PM_2.5, whereas the HR for PM_2.5 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.

Original language	English
Article number	106267
Pages (from-to)	106267
Number of pages	8
Journal	Environment International
Volume	146
DOIs	https://doi.org/10.1016/j.envint.2020.106267
Publication status	Published - Jan 2021

Bibliographical note

Funding Information:
This work was supported by the Health Effects Institute Research Agreement #4954-RFA14-3/16-5-3 and the China Scholarship Council No. 201806010406. SALT and TwinGene are sub-studies of The Swedish Twin Registry (STR) which is managed by Karolinska Institutet and receives additional funding through the Swedish Research Council under the grant no 2017-00641.

Funding Information:
Research described in this article was conducted under contract to the Health Effects Institute (HEI), an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers.

Publisher Copyright:
© 2020

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

Air pollution
COPD incidence
Low-level exposure

Access to Document

10.1016/j.envint.2020.106267Licence: CC BY-NC-ND

Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary diseaseFinal published version, 1.37 MBLicence: CC BY-NC-ND

Handle.net

Persistent link

Cite this

Liu, S., Jørgensen, J. T., Ljungman, P., Pershagen, G., Bellander, T., Leander, K., Magnusson, P. K. E., Rizzuto, D., Hvidtfeldt, U. A., Raaschou-Nielsen, O., Wolf, K., Hoffmann, B., Brunekreef, B., Strak, M., Chen, J., Mehta, A., Atkinson, R. W., Bauwelinck, M., Varraso, R., ... Andersen, Z. J. (2021). Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project. Environment International, 146, 106267. Article 106267. https://doi.org/10.1016/j.envint.2020.106267

@article{84b9ecc5f9f44d2ba60b826198fa1476,

title = "Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project",

abstract = "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 {\textquoteleft}Effects of Low-Level Air Pollution: A Study in Europe{\textquoteright} (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{\textquoteright} 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.",

keywords = "Air pollution, COPD incidence, Low-level exposure",

author = "Shuo Liu and J{\o}rgensen, {Jeanette T.} and Petter Ljungman and G{\"o}ran Pershagen and Tom Bellander and Karin Leander and Magnusson, {Patrik K.E.} and Debora Rizzuto and Hvidtfeldt, {Ulla A.} and Ole Raaschou-Nielsen and Kathrin Wolf and Barbara Hoffmann and Bert Brunekreef and Maciej Strak and Jie Chen and Amar Mehta and Atkinson, {Richard W.} and Mariska Bauwelinck and Rapha{\"e}lle Varraso and Boutron-Ruault, {Marie Christine} and J{\o}rgen Brandt and Giulia Cesaroni and Francesco Forastiere and Daniela Fecht and John Gulliver and Ole Hertel and {de Hoogh}, Kees and Janssen, {Nicole A.H.} and Klea Katsouyanni and Matthias Ketzel and Klompmaker, {Jochem O.} and Gabriele Nagel and Bente Oftedal and Annette Peters and Anne Tj{\o}nneland and Rodopoulou, {Sophia P.} and Evangelia Samoli and Terese Bekkevold and Torben Sigsgaard and Massimo Stafoggia and Danielle Vienneau and Gudrun Weinmayr and Gerard Hoek and Andersen, {Zorana J.}",

note = "Funding Information: This work was supported by the Health Effects Institute Research Agreement #4954-RFA14-3/16-5-3 and the China Scholarship Council No. 201806010406. SALT and TwinGene are sub-studies of The Swedish Twin Registry (STR) which is managed by Karolinska Institutet and receives additional funding through the Swedish Research Council under the grant no 2017-00641. Funding Information: Research described in this article was conducted under contract to the Health Effects Institute (HEI), an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. Publisher Copyright: {\textcopyright} 2020 Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2021",

month = jan,

doi = "10.1016/j.envint.2020.106267",

language = "English",

volume = "146",

pages = "106267",

journal = "Environment International",

issn = "0160-4120",

publisher = "Elsevier Limited",

}

Liu, S, Jørgensen, JT, Ljungman, P, Pershagen, G, Bellander, T, Leander, K, Magnusson, PKE, Rizzuto, D, Hvidtfeldt, UA, Raaschou-Nielsen, O, Wolf, K, Hoffmann, B, Brunekreef, B, Strak, M, Chen, J, Mehta, A, Atkinson, RW, Bauwelinck, M, Varraso, R, Boutron-Ruault, MC, Brandt, J, Cesaroni, G, Forastiere, F, Fecht, D, Gulliver, J, Hertel, O, de Hoogh, K, Janssen, NAH, Katsouyanni, K, Ketzel, M, Klompmaker, JO, Nagel, G, Oftedal, B, Peters, A, Tjønneland, A, Rodopoulou, SP, Samoli, E, Bekkevold, T, Sigsgaard, T, Stafoggia, M, Vienneau, D, Weinmayr, G, Hoek, G & Andersen, ZJ 2021, 'Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project', Environment International, vol. 146, 106267, pp. 106267. https://doi.org/10.1016/j.envint.2020.106267

TY - JOUR

T1 - Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease

T2 - The ELAPSE project

AU - Liu, Shuo

AU - Jørgensen, Jeanette T.

AU - Ljungman, Petter

AU - Pershagen, Göran

AU - Bellander, Tom

AU - Leander, Karin

AU - Magnusson, Patrik K.E.

AU - Rizzuto, Debora

AU - Hvidtfeldt, Ulla A.

AU - Raaschou-Nielsen, Ole

AU - Wolf, Kathrin

AU - Hoffmann, Barbara

AU - Brunekreef, Bert

AU - Strak, Maciej

AU - Chen, Jie

AU - Mehta, Amar

AU - Atkinson, Richard W.

AU - Bauwelinck, Mariska

AU - Varraso, Raphaëlle

AU - Boutron-Ruault, Marie Christine

AU - Brandt, Jørgen

AU - Cesaroni, Giulia

AU - Forastiere, Francesco

AU - Fecht, Daniela

AU - Gulliver, John

AU - Hertel, Ole

AU - de Hoogh, Kees

AU - Janssen, Nicole A.H.

AU - Katsouyanni, Klea

AU - Ketzel, Matthias

AU - Klompmaker, Jochem O.

AU - Nagel, Gabriele

AU - Oftedal, Bente

AU - Peters, Annette

AU - Tjønneland, Anne

AU - Rodopoulou, Sophia P.

AU - Samoli, Evangelia

AU - Bekkevold, Terese

AU - Sigsgaard, Torben

AU - Stafoggia, Massimo

AU - Vienneau, Danielle

AU - Weinmayr, Gudrun

AU - Hoek, Gerard

AU - Andersen, Zorana J.

N1 - Funding Information: This work was supported by the Health Effects Institute Research Agreement #4954-RFA14-3/16-5-3 and the China Scholarship Council No. 201806010406. SALT and TwinGene are sub-studies of The Swedish Twin Registry (STR) which is managed by Karolinska Institutet and receives additional funding through the Swedish Research Council under the grant no 2017-00641. Funding Information: Research described in this article was conducted under contract to the Health Effects Institute (HEI), an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. Publisher Copyright: © 2020 Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2021/1

Y1 - 2021/1

N2 - 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.

AB - 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.

KW - Air pollution

KW - COPD incidence

KW - Low-level exposure

UR - http://www.scopus.com/inward/record.url?scp=85097128896&partnerID=8YFLogxK

U2 - 10.1016/j.envint.2020.106267

DO - 10.1016/j.envint.2020.106267

M3 - Article

C2 - 33276316

AN - SCOPUS:85097128896

SN - 0160-4120

VL - 146

SP - 106267

JO - Environment International

JF - Environment International

M1 - 106267

ER -

Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project

Abstract

Bibliographical note

Keywords

Access to Document

Handle.net

Other files and links

Fingerprint

Cite this