Ambient Air Pollution and Adult Asthma Incidence in Six European Cohorts (ESCAPE)

Abstract

BackgroundShort-term exposure to air pollution has adverse effects among patients with asthma, but whether long-term exposure to air pollution is a cause of adult-onset asthma is unclear.ObjectiveWe aimed to investigate the association between air pollution and adult onset asthma.MethodsAsthma incidence was prospectively assessed in six European cohorts. Exposures studied were annual average concentrations at home addresses for nitrogen oxides assessed for 23,704 participants (including 1,257 incident cases) and particulate matter (PM) assessed for 17,909 participants through ESCAPE land-use regression models and traffic exposure indicators. Meta-analyses of cohort-specific logistic regression on asthma incidence were performed. Models were adjusted for age, sex, overweight, education, and smoking and included city/area within each cohort as a random effect.ResultsIn this longitudinal analysis, asthma incidence was positively, but not significantly, associated with all exposure metrics, except for PMcoarse. Positive associations of borderline significance were observed for nitrogen dioxide [adjusted odds ratio (OR) = 1.10; 95% CI: 0.99, 1.21 per 10 μg/m3; p = 0.10] and nitrogen oxides (adjusted OR = 1.04; 95% CI: 0.99, 1.08 per 20 μg/m3; p = 0.08). Nonsignificant positive associations were estimated for PM10 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 10 μg/m3), PM2.5 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 5 μg/m3), PM2.5absorbance (adjusted OR = 1.06; 95% CI: 0.95, 1.19 per 10–5/m), traffic load (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 4 million vehicles × meters/day on major roads in a 100-m buffer), and traffic intensity (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 5,000 vehicles/day on the nearest road). A nonsignificant negative association was estimated for PMcoarse (adjusted OR = 0.98; 95% CI: 0.87, 1.14 per 5 μg/m3).ConclusionsResults suggest a deleterious effect of ambient air pollution on asthma incidence in adults. Further research with improved personal-level exposure assessment (vs. residential exposure assessment only) and phenotypic characterization is needed.CitationJacquemin B, Siroux V, Sanchez M, Carsin AE, Schikowski T, Adam M, Bellisario V, Buschka A, Bono R, Brunekreef B, Cai Y, Cirach M, Clavel-Chapelon F, Declercq C, de Marco R, de Nazelle A, Ducret-Stich RE, Ferretti VV, Gerbase MW, Hardy R, Heinrich J, Janson C, Jarvis D, Al Kanaani Z, Keidel D, Kuh D, Le Moual N, Nieuwenhuijsen MJ, Marcon A, Modig L, Pin I, Rochat T, Schindler C, Sugiri D, Stempfelet M, Temam S, Tsai MY, Varraso R, Vienneau D, Vierkötter A, Hansell AL, Krämer U, Probst-Hensch NM, Sunyer J, Künzli N, Kauffmann F. 2015. Ambient air pollution and adult asthma incidence in six European cohorts (ESCAPE). Environ Health Perspect 123:613–621; http://dx.doi.org/10.1289/ehp.1408206

Gender differences in adult-onset asthma: results from the Swiss SAPALDIA cohort study

“…Using asthma incidence definition from JACQUEMIN et al [30] (which corresponds to definition 3b except the outcome is based on self-report and may reflect undiagnosed asthma) Definition 3b except the outcome is based on self-report [29,32,33]. Allergically sensitised subjects with doctor-diagnosed asthma were considered as having allergic asthma.…”

Asthma and Air Pollution. Where Are We?

“…It is interesting to note that in a prospective European meta-analysis including six cohorts, sex did not modify the associations between NO 2 and asthma incidence 59 . Furthermore, all cohorts showed positive associations between air pollution and asthma incidence in adults, except the Etude Epidémiologique auprès de femmes de la MGEN (Mutuelle Générale de l'Education Nationale) (E3N) cohort that only includes older women, mostly teachers 59 .…”

“…Young et al 58 US cohort including 50,884 women followed up for 5 years PM 2.5 and NO 2 Kriging models PM 2.5 and NO 2 were associated with asthma incidence Jacquemin et al 59 6 European cohorts of adults followed up for around 10 years. NO 2 , NOx, PM 10 , PM 2.5 , black smoke derived from land-use regression models NO 2 was borderline significant associated with asthma incidence Health Survey 56 also reported a positive association between NO 2 and asthma incidence.…”

“…A recent US study suggested an association of particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM 2.5 ) with incident asthma in women 58 . Within the context of the European Study of Cohorts for Air Pollution Effects (ESCAPE) including six cohorts, the authors also found that asthma incidence was positively associated with NO 2 but lacked the power to find an association with PM 59 . Even if, compared to the child literature, evidence is less extensive, it strongly suggests that air pollution could also be associated with asthma incidence in adults.…”

“…Furthermore, all cohorts showed positive associations between air pollution and asthma incidence in adults, except the Etude Epidémiologique auprès de femmes de la MGEN (Mutuelle Générale de l'Education Nationale) (E3N) cohort that only includes older women, mostly teachers 59 . However, conversely, results from a nationwide US cohort suggest that air pollution exposure increases the risk of developing asthma in adult women 58 .…”