Cross-sectional associations between air pollution and chronic bronchitis: an ESCAPE meta-analysis across five cohorts

Yutong Cai, Tamara Schikowski, Martin Adam, Anna Buschka, Anne-Elie Carsin, Benedicte Jacquemin, Alessandro Marcon, Margaux Sanchez, Andrea Vierkoetter, Zaina Al-Kanaani, Rob Beelen, Matthias Birk, Bert Brunekreef, Marta Cirach, Franoise Clavel-Chapelon, Christophe Declercq, Kees de Hoogh, Audrey de Nazelle, Regina E. Ducret-Stich, Virginia Valeria FerrettiBertil Forsberg, Margaret W. Gerbase, Rebecca Hardy, Joachim Heinrich, Gerard Hoek, Debbie Jarvis, Dirk Keidel, Diana Kuh, Mark J. Nieuwenhuijsen, Martina S. Ragettli, Andrea Ranzi, Thierry Rochat, Christian Schindler, Dorothea Sugiri, Sofia Temam, Ming-Yi Tsai, Raphaelle Varraso, Francine Kauffmann, Ursula Kraemer, Jordi Sunyer, Nino Kuenzli, Nicole Probst-Hensch, Anna L. Hansell*

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    Background This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project.

    Methods Annual average particulate matter (PM10, PM2.5, PMabsorbance, PMcoarse), NO2, nitrogen oxides (NOx) and road traffic measures modelled from ESCAPE measurement campaigns 2008-2011 were assigned to home address at most recent assessments (1998-2011). Symptoms examined were chronic bronchitis (cough and phlegm for >= 3 months of the year for >= 2 years), chronic cough (with/without phlegm) and chronic phlegm (with/without cough). Cohort-specific cross-sectional multivariable logistic regression analyses were conducted using common confounder sets (age, sex, smoking, interview season, education), followed by meta-analysis.

    Results 15 279 and 10 537 participants respectively were included in the main NO2 and PM analyses at assessments in 1998-2011. Overall, there were no statistically significant associations with any air pollutant or traffic exposure. Sensitivity analyses including in asthmatics only, females only or using back-extrapolated NO2 and PM10 for assessments in 1985-2002 (ECRHS, NSHD, SALIA, SAPALDIA) did not alter conclusions. In never-smokers, all associations were positive, but reached statistical significance only for chronic phlegm with PMcoarse OR 1.31 (1.05 to 1.64) per 5 mu g/m(3) increase and PM10 with similar effect size. Sensitivity analyses of older cohorts showed increased risk of chronic cough with PM2.5abs (black carbon) exposures.

    Conclusions Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations.

    Original languageEnglish
    Pages (from-to)1005-1014
    Number of pages10
    JournalThorax
    Volume69
    Issue number11
    DOIs
    Publication statusPublished - Nov 2014

    Keywords

    • OBSTRUCTIVE PULMONARY-DISEASE
    • TERM AMBIENT CONCENTRATIONS
    • USE REGRESSION-MODELS
    • RESPIRATORY SYMPTOMS
    • NONSMOKING POPULATION
    • PARTICULATE MATTER
    • AUTOMOBILE EXHAUST
    • ADULTS SAPALDIA
    • EXPOSURE
    • HEALTH

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