[Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA)].
Long-term health effects of moderate ambient air pollution are rarely investigated. In Switzerland, no large-scale study has addressed this issue so far. Important results of the Swiss Study on Air Pollution and Lung Disease in Adults (SAPALDIA) are presented. During the period 1991-1993, SAPALDIA investigated a random population sample (18-60 years) in eight Swiss areas with different environmental characteristics (Aarau, Basel, Davos, Geneva, Lugano, Montana, Payerne, Wald). In total, 9651 adults (60%) participated in the cross-sectional investigation (part 1, 1991), consisting of the following standardized procedures: questionnaire (interview), forced expiratory lung function test, bronchial challenge with methacholine, atopy assessment (Phadiatop, unspecific total IgE), allergy skin tests, and endexpiratory CO-measurements. Subjects with a history of respiratory symptoms, increased bronchial reactivity, reduced lung function (FEV1/FVC < 80% predicted) and 150 healthy never-smokers were included in the subsequent diary study (part 2; n = 3281, 1992/93). Peak flow (morning and evening), symptoms, medication, personal activity and visits to the doctor were monitored. Across regions, annual mean values ranged from 9 to 52 mg/m3 (NO2) and 10 to 33 mg/m3 (PM10) respectively. Air pollution had effects on prevalence of dyspnea (+41% per 10 mg/m3 increment of the annual mean PM10, 95% CI 20-65%), on symptoms of chronic bronchitis (+31%, 10-55%), on FVC (-3.1%; -3.7 to -2.6%), and FEV1 (-1.1%; -1.7% to -0.5%), on the incidence of respiratory symptoms and the length of symptomfree intervals (11% change per 10 mg/m3 PM10), but not on the prevalence of asthma. Environmental tobacco smoke (ETS) showed impact on wheezing (OR 1.94; 1.39-2.70), asthma (1.39; 1.04-1.86), bronchitis (1.60; 1.24-2.08) and chronic bronchitis (1.50; 1.11-2.02). Health effects of moderate air pollution were confirmed in Switzerland. Although for the individual the relative risks are small, the public health impact may be considerable. An ongoing follow-up will investigate the mortality profile of the SAPALDIA cohort.
Leuenberger
P
P
Division de pneumologie, CHUV, Lausanne.
Künzli
N
N
Ackermann-Liebrich
U
U
Schindler
C
C
Bolognini
G
G
Bongard
J P
JP
Brändli
O
O
Defila
C
C
Domenighetti
G
G
Karrer
W
W
Keller
R
R
Medici
T
T
Monn
C
C
Perruchoud
A P
AP
Schöni
M
M
Tschopp
J M
JM
Villiger
B
B
Wüthrich
B
B
Zellweger
J P
JP
D000293:Adolescent; D000328:Adult; D000397:Air Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D001985:Bronchial Provocation Tests; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology*; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012306:Risk; D013557:Switzerland / Q000453:epidemiology
Etude suisse sur la pollution de l'air et les maladies respiratoires chez l'adulte (SAPALDIA). Swiss Study on Air Pollution and Lung Diseases in Adults.