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

Research output: Contribution to journalJournal articlepeer-review

  • Shuo Liu
  • Jeanette Therming Jorgensen
  • Petter Ljungman
  • Goran Pershagen
  • Tom Bellander
  • Karin Leander
  • Patrik K. E. Magnusson
  • Debora Rizzuto
  • Ulla A. Hvidtfeldt
  • Ole Raaschou Nielsen
  • Kathrin Wolf
  • Barbara Hoffmann
  • Bert Brnekree
  • Maciej Strak
  • Jie Chen
  • Amar Mehta
  • Richard W. Atkinson
  • Mariska Bauwelrick
  • Raphaelle Varraso
  • Marie-Christine Boutron-Ruault
  • Jorgen Brandt
  • Giulia Cesaroni
  • Francesco Forastiere
  • Daniela Fecht
  • John Gulliver
  • Ole Herte
  • Kees de Hoogh
  • Nicole A. H. Janssen
  • Klea Katsouyanni
  • Matthias Ketzel
  • Jochem O. Klompmaker
  • Gabriele Nagel
  • Bente Oftedal
  • Annette Peters
  • Sophia P. Rodopoulou
  • Evangelia Samoli
  • Doris Tove Kristoffersen
  • Torben Sigsgaard
  • Massimo Stafoggia
  • Danielle Vienneau
  • Gudrun Weinmayr
  • Gerard Hoek

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

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.

Original languageEnglish
Article number2003099
JournalEuropean Respiratory Journal
Volume57
Issue number6
Number of pages11
ISSN0903-1936
DOIs
Publication statusPublished - 2021

    Research areas

  • ADULT-ONSET ASTHMA, EUROPEAN COHORTS, GLOBAL BURDEN, FOLLOW-UP, DISEASE, MORTALITY, HEALTH, NO2, PM2.5, SCALE

ID: 272071965