Residential Air Pollution and Associations with Wheeze and Shortness of Breath in Adults: A Combined Analysis of Cross-Sectional Data from Two Large European Cohorts.pdf (1.14 MB)
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Residential Air Pollution and Associations with Wheeze and Shortness of Breath in Adults: A Combined Analysis of Cross-Sectional Data from Two Large European Cohorts.

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posted on 28.02.2019, 11:42 by D Doiron, K de Hoogh, N Probst-Hensch, S Mbatchou, M Eeftens, Y Cai, C Schindler, I Fortier, S Hodgson, A Gaye, R Stolk, A Hansell
BACKGROUND: Research examining associations between air pollution exposure and respiratory symptoms in adults has generally been inconclusive. This may be related in part to sample size issues, which also preclude analysis in potentially vulnerable subgroups. OBJECTIVES: We estimated associations between air pollution exposures and the prevalence of wheeze and shortness of breath using harmonized baseline data from two very large European cohorts, Lifelines (2006-2013) and UK Biobank (2006-2010). Our aim was also to determine whether the relationship between air pollution and respiratory symptom prevalence differed between individuals with different characteristics. METHODS: Cross-sectional analyses explored associations between prevalence of self-reported wheeze and shortness of breath and annual mean particulate matter with aerodynamic diameter <2.5μm, 2.5-10μm, and <10μm (PM2.5, PMcoarse, and PM10, respectively) and nitrogen dioxide (NO2) concentrations at place of residence using logistic regression. Subgroup analyses and tests for interaction were performed for age, sex, smoking status, household income, obesity status, and asthma status. RESULTS: All PM exposures were associated with respiratory symptoms based on single-pollutant models, with the largest associations seen for PM2.5 with prevalence of wheezing {odds ratio (OR)=1.16 per 5μg/m³ [95% confidence interval (CI): 1.11, 1.21]} and shortness of breath [OR=1.61 per 5μg/m³ (95% CI: 1.45, 1.78)]. The association between shortness of breath and a 5-μg/m³ increment in PM2.5 was significantly higher for individuals from lower-[OR=1.73 (95% CI: 1.52, 1.97)] versus higher-income households [OR=1.31 (95% CI: 1.11, 1.55); p-interaction=0.005), whereas the association between PM2.5 and wheeze was limited to lower-income participants [OR=1.30 (95% CI: 1.22, 1.38) vs. OR=1.02; (95% CI: 0.96, 1.08); p-interaction<0.001]. Exposure to NO2 also showed positive associations with wheeze and shortness of breath. CONCLUSION: Exposure to PM and NO2 air pollution was associated with the prevalence of wheeze and shortness of breath in this large study, with stronger associations between PM2.5 and both outcomes among lower- versus higher-income participants.


The authors wish to acknowledge the services of the staff at UK Biobank and the Lifelines Cohort Study, the contributing research centers delivering data on these two cohorts, and all the study participants. We also acknowledge the ESCAPE project for their work in developing the air pollution exposure assessments used in our study. Lastly, we would like to thank Y. Marcon (Research Institute of the McGill University Health Centre, Montreal, Canada), P. Burton and D. Avraam (School of Social and Community Medicine, Bristol, UK), and C. Pang (University Medical Center Groningen, Groningen, Netherlands) for their support in implementing DataSHIELD federated analyses. Open-source software and the methodology used to harmonize and analyze data across cohorts were developed by Maelstrom Research ( The research leading to these results received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement No. 261433 [Biobank Standardisation and Harmonisation for Research Excellence in the European Union (BioSHaRE-EU)]. Y.C. acknowledges support from the Early-Career Research Fellowship awarded by the UK Medical Research Council – Public Health England Centre for Environment and Health (Grant number MR/M501669/1).



Environmental Health Perspectives, 2017, 125 (9), CID: 097025

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