title: Air pollution and subclinical airway inflammation in the SALIA cohort study.
abstract: BACKGROUND
  The association between long-term exposure to air pollution and local inflammation in the lung has rarely been investigated in the general population of elderly subjects before. We investigated this association in a population-based cohort of elderly women from Germany.
  
  
  METHODS
  In a follow-up examination of the SALIA cohort study in 2008/2009, 402 women aged 68 to 79 years from the Ruhr Area and Borken (Germany) were clinically examined. Inflammatory markers were determined in exhaled breath condensate (EBC) and in induced sputum (IS). We used traffic indicators and measured air pollutants at single monitoring stations in the study area to assess individual traffic exposure and long-term air pollution background exposure. Additionally long-term residential exposure to air pollution was estimated using land-use regression (LUR) models. We applied multiple logistic and linear regression analyses adjusted for age, indoor mould, smoking, passive smoking and socio-economic status and additionally conducted sensitivity analyses.
  
  
  RESULTS
  Inflammatory markers showed a high variability between the individuals and were higher with higher exposure to air pollution. NO derivatives, leukotriene (LT) B4 and tumour necrosis factor-α (TNF-α) showed the strongest associations. An increase of 9.42 μg/m3 (interquartile range) in LUR modelled NO2 was associated with measureable LTB4 level (level with values above the detection limit) in EBC (odds ratio: 1.38, 95% CI: 1.02 -1.86) as well as with LTB4 in IS (%-change: 19%, 95% CI: 7% - 32%). The results remained consistent after exclusion of subpopulations with risk factors for inflammation (smoking, respiratory diseases, mould infestation) and after extension of models with additional adjustment for season of examination, mass of IS and urban/rural living as sensitivity analyses.
  
  
  CONCLUSIONS
  In this analysis of the SALIA study we found that long-term exposure to air pollutants from traffic and industrial sources was associated with an increase of several inflammatory markers in EBC and in IS. We conclude that long-term exposure to air pollution might lead to changes in the inflammatory marker profile in the lower airways in an elderly female population.
authors.affiliation: IUF - Leibniz Research Institute for Environmental Medicine, Auf'm Hennekamp 50, Düsseldorf 40225, Germany. Mohammad.Vossoughi@IUF-Duesseldorf.de.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Vossoughi
authors.forename: Tamara
authors.initials: T
authors.lastname: Schikowski
authors.forename: Andrea
authors.initials: A
authors.lastname: Vierkötter
authors.forename: Dorothea
authors.initials: D
authors.lastname: Sugiri
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.forename: Tom
authors.initials: T
authors.lastname: Teichert
authors.forename: Christian
authors.initials: C
authors.lastname: Herder
authors.forename: Thomas
authors.initials: T
authors.lastname: Schulte
authors.forename: Christian
authors.initials: C
authors.lastname: Luckhaus
authors.forename: Monika
authors.initials: M
authors.lastname: Raulf-Heimsoth
authors.forename: Swaantje
authors.initials: S
authors.lastname: Casjens
authors.forename: Thomas
authors.initials: T
authors.lastname: Brüning
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer