title: Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis.
abstract: The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Residential exposure to nitrogen oxides (NO₂, NOx) and particulate matter (PM) was modelled and traffic indicators were assessed in a standardised manner. The spirometric parameters forced expiratory volume in 1 s (FEV₁) and forced vital capacity (FVC) from 7613 subjects were considered as outcomes. Cohort-specific results were combined using meta-analysis. We did not observe an association of air pollution with longitudinal change in lung function, but we observed that a 10 μg·m(-3) increase in NO₂ exposure was associated with lower levels of FEV₁ (-14.0 mL, 95% CI -25.8 to -2.1) and FVC (-14.9 mL, 95% CI -28.7 to -1.1). An increase of 10 μg·m(-3) in PM10, but not other PM metrics (PM2.5, coarse fraction of PM, PM absorbance), was associated with a lower level of FEV₁ (-44.6 mL, 95% CI -85.4 to -3.8) and FVC (-59.0 mL, 95% CI -112.3 to -5.6). The associations were particularly strong in obese persons. This study adds to the evidence for an adverse association of ambient air pollution with lung function in adults at very low levels in Europe.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel These authors contributed equally.
authors.forename: Martin
authors.initials: M
authors.lastname: Adam
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf These authors contributed equally.
authors.forename: Tamara
authors.initials: T
authors.lastname: Schikowski
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain These authors contributed equally.
authors.forename: Anne Elie
authors.initials: AE
authors.lastname: Carsin
authors.affiliation: MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London.
authors.forename: Yutong
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, Villejuif Univ. Paris-Sud, UMRS 1018, Villejuif.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Jacquemin
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, Villejuif Univ. Paris-Sud, UMRS 1018, Villejuif.
authors.forename: Margaux
authors.initials: M
authors.lastname: Sanchez
authors.affiliation: Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vierkötter
authors.affiliation: Unit of Epidemiology and Medical Statistics, Dept of Public Health and Community Medicine, University of Verona, Verona.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marcon
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel.
authors.forename: Dirk
authors.initials: D
authors.lastname: Keidel
authors.affiliation: Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Sugiri
authors.affiliation: MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London.
authors.forename: Zaina
authors.initials: Z
authors.lastname: Al Kanani
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, Villejuif Univ. Paris-Sud, UMRS 1018, Villejuif.
authors.forename: Rachel
authors.initials: R
authors.lastname: Nadif
authors.affiliation: Inserm U823, Environmental Epidemiology Applied to Reproduction and Respiratory Health Team, Grenoble Univ. Joseph Fourier, Grenoble.
authors.forename: Valérie
authors.initials: V
authors.lastname: Siroux
authors.affiliation: MRC University Unit for Lifelong Health and Ageing, University College London, London.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.affiliation: MRC University Unit for Lifelong Health and Ageing, University College London, London.
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.affiliation: Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Thierry
authors.initials: T
authors.lastname: Rochat
authors.affiliation: Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Bridevaux
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel Institute for Risk Assessment Sciences, Utrecht University, Utrecht.
authors.forename: Marloes
authors.initials: M
authors.lastname: Eeftens
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel.
authors.forename: Ming-Yi
authors.initials: MY
authors.lastname: Tsai
authors.affiliation: Unit of Biostatistics and Clinical Epidemiology Dept of Public Health, Experimental and Forensic Medicine University of Pavia, Pavia.
authors.forename: Simona
authors.initials: S
authors.lastname: Villani
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel.
authors.forename: Harish Chandra
authors.initials: HC
authors.lastname: Phuleria
authors.affiliation: Helmholtz Zentrum, München and German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg.
authors.forename: Matthias
authors.initials: M
authors.lastname: Birk
authors.affiliation: Helmholtz Zentrum, München and German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg Environmental Science Center, University Augsburg, Augsburg.
authors.forename: Josef
authors.initials: J
authors.lastname: Cyrys
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Cirach
authors.affiliation: Centre for Environmental Policy, Imperial College London, London.
authors.forename: Audrey
authors.initials: A
authors.lastname: de Nazelle
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.affiliation: Environmental and Occupational Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Forsberg
authors.affiliation: MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London.
authors.forename: Kees
authors.initials: K
authors.lastname: de Hoogh
authors.affiliation: French Institute for Public Health Surveillance, Saint-Maurice.
authors.forename: Christophe
authors.initials: C
authors.lastname: Declerq
authors.affiliation: Dept of Public Health and Pediatrics, University of Turin, Turin.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bono
authors.affiliation: SC Pneumologia CPA ASL 4 Turin, Turin, Italy.
authors.forename: Pavilio
authors.initials: P
authors.lastname: Piccioni
authors.affiliation: Air Quality and Sustainable Nanotechnology, IUTA Institut für Energie- und Umwelttechnik e.V., Duisburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Quass
authors.affiliation: Helmholtz Zentrum, München and German Research Centre for Environmental Health, Institute of Epidemiology I, Neuherberg.
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London Dept of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London.
authors.forename: Deborah
authors.initials: D
authors.lastname: Jarvis
authors.affiliation: Inserm U823, Environmental Epidemiology Applied to Reproduction and Respiratory Health Team, Grenoble Univ. Joseph Fourier, Grenoble Pédiatrie, CHU de Grenoble, La Tronche, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pin
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Utrecht.
authors.forename: Rob
authors.initials: R
authors.lastname: Beelen
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Utrecht.
authors.forename: Gerard
authors.initials: G
authors.lastname: Hoek
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Utrecht Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: Brunekreef
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel.
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Steering Committee of ESCAPE Work Package 4 on Respiratory Health in Adults.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.affiliation: Leibniz Research Institute for Environmental Medicine (IUF), Düsseldorf Steering Committee of ESCAPE Work Package 4 on Respiratory Health in Adults.
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Respiratory and Environmental Epidemiology Team, Villejuif Steering Committee of ESCAPE Work Package 4 on Respiratory Health in Adults.
authors.forename: Francine
authors.initials: F
authors.lastname: Kauffmann
authors.affiliation: MRC-PHE Centre for Environment and Health, Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London Public Health and Primary Care Directorate, Imperial College Healthcare NHS Trust, London, UK Steering Committee of ESCAPE Work Package 4 on Respiratory Health in Adults.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hansell
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel Steering Committee of ESCAPE Work Package 4 on Respiratory Health in Adults.
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
authors.affiliation: Swiss Tropical and Public Health Institute, Basel University of Basel, Basel Steering Committee of ESCAPE Work Package 4 on Respiratory Health in Adults Nicole.Probst@unibas.ch.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000009:adverse effects*; D004781:Environmental Exposure; D004784:Environmental Monitoring / Q000379:methods; D005060:Europe; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009589:Nitrogen Oxides / Q000737:chemistry; D052638:Particulate Matter; D012143:Respiratory Physiological Phenomena
chemical_list: D000393:Air Pollutants; D009589:Nitrogen Oxides; D052638:Particulate Matter