title: Long-term air pollution exposure and lung function in 15 year-old adolescents living in an urban and rural area in Germany: The GINIplus and LISAplus cohorts.
abstract: BACKGROUND
  The impact of outdoor air pollution exposure on long-term lung development and potential periods of increased lung susceptibility remain unknown. This study assessed associations between early-life and current residential exposure to air pollution and lung function at 15-years of age in two German birth cohorts.
  
  
  METHODS
  Fifteen year-old participants living in an urban and rural area in Germany underwent spirometry before and after bronchodilation (N=2266). Annual average (long-term) exposure to nitrogen dioxide (NO(2)), particles with aerodynamic diameters less than 2.5 μg/m(3) (PM2.5) mass and less than 10 μg/m(3) (PM(10)) mass, PM(2.5) absorbance and ozone were estimated to each participant's birth-, 10- and 15-year home address using land-use regression and kriging (ozone only) modelling. Associations between lung function variables and long-term pollutant concentrations were assessed using linear regression models adjusted for host and environmental covariates and recent short-term air pollution exposures.
  
  
  RESULTS
  Long-term air pollution concentrations assessed to the birth-, 10- and 15-year home addresses were not associated with lung function variables, before and after bronchodilation, in the complete or study area specific populations. However, several lung function variables were negatively associated with long-term NO2 concentrations among asthmatics. For example, NO(2) estimated to the 15-year home address was associated with the ratio of forced expiratory volume in one second to forced vital capacity (FEV(1)/FVC) and the mean flow rate between 25% and 75% of FVC (-3.5%, 95% confidence interval [-6.0, -1.0] and -297.4 ml/s [-592.6, -2.1] per 5.9 μg/m(3) increase in NO(2), respectively). Nearly all effect estimates for the associations between the short-term PM(2.5) mass, PM(10) mass and ozone concentrations and the lung function variables were negative in the complete population.
  
  
  CONCLUSIONS
  Early-life and current long-term air pollution exposures and lung function at the age of 15 years were not associated in the complete study population. Asthmatics may represent a vulnerable group.
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany. Electronic address: elaine.fuertes@helmholtz-muenchen.de.
authors.forename: Elaine
authors.initials: E
authors.lastname: Fuertes
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany. Electronic address: johannes.bracher@helmholtz-muenchen.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Bracher
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany. Electronic address: claudia.flexeder@helmholtz-muenchen.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Flexeder
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Lindwurmstraße 4, 80337 Munich, Germany. Electronic address: iana.markevych@helmholtz-muenchen.de.
authors.forename: Iana
authors.initials: I
authors.lastname: Markevych
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Auf'm Hennekamp 50, 40225 Düsseldorf, Germany. Electronic address: Claudia.Kluemper@IUF-Duesseldorf.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Klümper
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Auf'm Hennekamp 50, 40225 Düsseldorf, Germany; Heinrich-Heine University of Düsseldorf, Medical Faculty, Deanery of Medicine, 40204 Düsseldorf, Germany. Electronic address: B.Hoffmann@uni-duesseldorf.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: IUF-Leibniz Research Institute for Environmental Medicine, Auf'm Hennekamp 50, 40225 Düsseldorf, Germany. Electronic address: Ursula.Kraemer@IUF-Duesseldorf.de.
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.affiliation: Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Pastor-Janßen-Str. 8-38, 46483 Wesel, Germany. Electronic address: avb.rodehorst@gmx.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
authors.affiliation: Department of Pediatrics, Technical University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany. Electronic address: cpbauer@t-online.de.
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Bauer
authors.affiliation: Division of Paediatric Gastroenterology and Hepatology, Ludwig Maximilians University of Munich, Dr. von Hauner Children's Hospital, Lindwurmstraße 4, 80337 Munich, Germany. Electronic address: Sibylle.Koletzko@med.uni-muenchen.de.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.affiliation: Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Pastor-Janßen-Str. 8-38, 46483 Wesel, Germany. Electronic address: berdel.vonberg@t-online.de.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Berdel
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research, Max-Lebsche-Platz 31, 81377 Munich, Germany. Electronic address: heinrich@helmholtz-muenchen.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research, Max-Lebsche-Platz 31, 81377 Munich, Germany. Electronic address: schulz@helmholtz-muenchen.de.
authors.forename: Holger
authors.initials: H
authors.lastname: Schulz
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis / Q000494:pharmacology*; D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis*; D001249:Asthma / Q000503:physiopathology; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D005260:Female; D005541:Forced Expiratory Volume; D005858:Germany; D006801:Humans; D016014:Linear Models; D008168:Lung / Q000187:drug effects* / Q000502:physiology; D008297:Male; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis / Q000494:pharmacology*; D010126:Ozone / Q000009:adverse effects / Q000032:analysis / Q000494:pharmacology*; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis / Q000494:pharmacology*; D012424:Rural Population; D013147:Spirometry; D014505:Urban Population; D014797:Vital Capacity
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D010126:Ozone; D009585:Nitrogen Dioxide
keywords: Air pollution; Asthma; Birth cohort; FEV(1); FVC; Lung function