Background: Inconsistent associations between socioeconomic position (SEP) and air pollution have been reported in Europe. We aimed to assess association between SEP and air pollution exposure at residential address across 20 European cities with homogenised SEP and air pollution indicators. Methods: Three SEP indicators, defined at individual- (education and occupation) and small area-level (unemployment rate) were assessed in three European multicenter cohorts (ECRHS, EGEA and SAPALDIA). NO2 exposure was estimated at participants' residential addresses with land use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE). Pooled and city-specific linear regressions were used to analyse associations between each SEP indicator and NO2. Heterogeneity across cities was assessed using a random-effects meta-analysis. Results: 8666 participants from 20 European cities were included. In a pooled analysis, participants with lower individual-SEP indicators tended to be less exposed to NO2. Conversely, participants living in neighbourhood with higher unemployment rate were more exposed. However, in both cases, city-specific results exhibited considerable heterogeneity across areas (I2>75%). In models with both individual- and area-SEP indicators, estimates were similar compared to the simple regression model, suggesting independent associations between individual-SEP and small area-level unemployment rate with NO2. Conclusions: At European level, associations between SEP and NO2 were heterogeneous and no geographical or urban pattern could be identified. Our results showed that individual- and area-SEP indicators capture different aspects of the SEP distribution regarding exposure to air pollution, stressing the importance of considering both in air pollution epidemiological studies.
Introduction: The association between air pollution and rhinitis is scarcely studied in adults. The objective is to assess the association between modeled PM10, PM2.5 and NO2 concentrations and rhinitis in two European studies. Methods: Cross-sectional analyses were performed in adults from two multicentre cohorts: the European Community Respiratory Health Survey (ECRHS) and the French longitudinal Epidemiological Study on the Genetics and Environment of Asthma (EGEA, case-control on asthma and family study), both involved in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Symptoms of rhinitis -ever sneezing, runny or blocked nose in absence of cold or flu- were self-reported by questionnaire. Annual averages of pollutants exposure were estimated at participants' residential addresses with land use regression models. Data were analysed using logistic regression analysis. Results were adjusted on age, sex, tobacco status and city. Results: Pooled analysis was performed on 6781 adults from 17 European cities: 5586 from ECRHS (mean age=42years, 53% women) and 1195 from EGEA (mean age=42 years, 49.5% women). Prevalence of asthma ever and symptoms of rhinitis were higher in EGEA than in ECRHS (40% vs 15% for asthma ever and 60.5% vs 45.5% for symptoms of rhinitis). A negative association between PM10 and symptoms of rhinitis was found in the crude analysis (cOR(95%CI)= 0.83(0.76-0.90) per 5 µg/m3) but no association remained after adjustment (aOR=1.01(0.82-1.24)). When stratifying on asthma, crude results were significant only in non-asthmatics (cOR=0.84(0.76-0.92) and 0.94(0.75-1.17) in asthmatics) but no association remained after adjustment. Similar results were found for PM2.5. No association between NO2 and rhinitis was found (cOR: 0.98(0.95-1.01) per 10 µg/m3, aOR: 1.02(0.96-1.07)). Conclusions: As it was previously found in children, these results do not support associations between either PM10, PM2.5 or NO2 and symptoms of rhinitis.
The effects of exposure to black carbon (BC) on various diseases remains unclear, one reason being potential exposure misclassification following modelling of ambient air pollution levels. Urinary BC particles may be a more precise measure to analyze the health effects of BC. We aimed to assess the risk of prediabetes and metabolic syndrome (MetS) in relation to urinary BC particles and ambient BC and to compare their associations in 5453 children from IDEFICS/I.Family cohort. We determined the amount of BC particles in urine using label-free white-light generation under femtosecond pulsed laser illumination. We assessed annual exposure to ambient air pollutants at the place of residence using land use regression models for Europe, and we calculated the residential distance to major roads (≤250m vs. more). We analyzed the cross-sectional relationships between urinary BC and air pollutants and distance to roads, and the associations of all these variables to the risk of prediabetes and MetS, using logistic and linear regression models. We observed higher urinary BC levels in children living ≤250m to a major road compared to those living >250m away from a major road. We observed a positive association between log-transformed urinary BC particles and MetS (OR per unit increase =1.72, 95% CI=1.21; 2.45) . An association between ambient BC and MetS was only observed in children living closer to a major road. Our findings suggest that exposure to BC (ambient and biomarker) may contribute to the risk of MetS in children. By measuring the internal dose, the BC particles in urine may have additionally captured non-residential sources and reduced exposure misclassification. Larger studies, with longitudinal design including measurement of urinary BC at multiple time-points are warranted to confirm our findings.
Background: Effects of air pollution exposure on IgE‐mediated response in asthmatics are poorly investigated. The aim was to examine the relationship between air pollution concentrations and total IgE levels in adult asthmatics. Methods: The present study relates to the 369 asthmatic adults from the French Epidemiological study on Genetics and Environment of Asthma (EGEA), with availability of data on both total serum IgE measurements and air pollution concentrations. Geo‐statistical models were performed on 4 × 4 km grids to assess individual outdoor air pollution exposure. Annual outdoor concentrations of ozone (O 3 ), nitrogen dioxide (NO 2 ), sulphur dioxide (SO 2 ), and particulate matter smaller than 10 μm size (PM 10 ), and concentrations of summer ozone were assigned to subject’s home address. Results: The geometric mean of total IgE was 161 IU/ml and the average of O 3 exposure was 44.9 ± 9.5 μg/m 3 . Ozone concentrations were positively related to total IgE levels and an increase of 10 μg/m 3 of O 3 resulted in an increase of 20.4% (95% CI = 3.0–40.7) in total IgE levels. Adjustment for age, gender, smoking habits and previous life in the countryside did not change the results, and an increase of 19.1% (2.4–38.6) in total IgE was observed with O 3 . Negative associations observed between NO 2 and total IgE levels disappeared after including O 3 in the models. Neither SO 2 nor PM 10 were correlated with total IgE levels. Conclusions: Results suggest that O 3 or related ambient pollutants may up‐regulate total IgE levels among asthmatic adults.
ISEE-249 Objective: INMA (Environment and Childhood) Study is a Spanish research network of several birth cohorts to study the impact of environmental pollutants and diet on children's development and health. Here we describe the associations between self-reported traffic intensity, air pollution annoyance, and GIS-modeled exposure to air pollution during pregnancy in the cohort of Sabadell (n = 504), a city in the metropolitan area of Barcelona. Material and Methods: NO2 and volatile organic compounds (benzene, toluene, ethylbenzene, and xylenes) were measured in 57 sites with passive samplers in 3 periods of 1-week between April 2005 and March 2006. Land-use regression modeling was used to predict outdoor annual mean levels of these pollutants at the participants' home addresses. Women reported traffic intensity and air pollution annoyance at their home addresses during the pregnancy. To compare the classification between reported (traffic intensity and air pollution annoyance) and predicted (GIS-modeled) variables, GIS-modeled exposure was categorized into 3 levels of exposure (low, medium, and high) with similar distribution as the categories of the reported variables. Linear regression models were developed using reported variables as ordinal predictors. Results: The agreement for the medium exposure classification (11%–42%) was lower than that in the other exposure groups (35%–72%). The highest agreement was found for the low-exposure group in reported traffic intensity of heavy vehicles (72%). We found a statistically significant increase in NO2-modeled concentrations with increased self-reported traffic intensity of heavy vehicles and increased annoyance. The association between VOCs modeled concentrations and annoyance was also statistically significant. Neither the reported variables nor the GIS-modeled levels of air pollution showed any trend with social class. Conclusions: Air pollution annoyance showed an association with modeled levels of NO2 and VOCs. The association between self-reported traffic intensity and NO2 was significant only for heavy vehicles.
Abstract The prevalence of rhinitis has increased in the past decades. We aim to study the effect of air pollution, as one of the environmental factors that may explain the increase of rhinitis prevalence. A total of 21507 (80%); of the 26737 participants included until December 2013 in Constances, a large French population-based cohort, answered standardized questions on rhinitis in 2014. Ever rhinitis was defined by a positive response to “Have you ever had a problem with sneezing or a runny or a blocked nose when you did not have a cold or the flu?”. Current rhinitis was defined among those reporting ever rhinitis and nasal symptoms in the past 12 months. Annual exposure to nitrogen dioxide (NO2), particulate matter ≤2.5 µm (PM2.5) and black carbon (BC) was estimated at the participants' residential address by extrapolating European land-use regression models for 2010 to year 2014. Associations between annual exposure to air pollution and rhinitis were estimated using a logistic model adjusted for age, gender, smoking and education level. After exclusions, 18506 participants were included (mean age: 52, 45% men, 13% ever asthma). Ever and current prevalence of rhinitis were 58% and 41% respectively. Significant and positive associations were found between each pollutant and current rhinitis. Adjusted ORs were 1.26 [1.16-1.36] per 15 µg.m-3 increase in NO2, 1.28 [1.17-1.41] per 5 µg.m-3 increase in PM2.5, and 1.36 [1.22-1.51] per 10-5.m-1 increase in BC. Results were similar for non-smoking participants and those whose address had not changed since inclusion. Exposure to air pollution is associated with current rhinitis in adults in the general population. In view of the high prevalence of rhinitis and its costs, these findings have an important public health impact and reinforce the need to reduce the population's exposure to air pollution. Key messages Exposure to air pollution is associated with current rhinitis in adults in general population. These results contribute to a better understanding of health effects of air pollution.
The effects of exposure to black carbon (BC) on various diseases remains unclear, one reason being potential exposure misclassification following modelling of ambient air pollution levels. Urinary BC particles may be a more precise measure to analyze the health effects of BC. We aimed to assess the risk of prediabetes and metabolic syndrome (MetS) in relation to urinary BC particles and ambient BC and to compare their associations in 5453 children from IDEFICS/I. Family cohort. We determined the amount of BC particles in urine using label-free white-light generation under femtosecond pulsed laser illumination. We assessed annual exposure to ambient air pollutants (BC, PM2.5 and NO2) at the place of residence using land use regression models for Europe, and we calculated the residential distance to major roads (≤250 m vs. more). We analyzed the cross-sectional relationships between urinary BC and air pollutants (BC, PM2.5 and NO2) and distance to roads, and the associations of all these variables to the risk of prediabetes and MetS, using logistic and linear regression models. Though we did not observe associations between urinary and ambient BC in overall analysis, we observed a positive association between urinary and ambient BC levels in boys and in children living ≤250 m to a major road compared to those living >250 m away from a major road. We observed a positive association between log-transformed urinary BC particles and MetS (ORper unit increase = 1.72, 95% CI = 1.21; 2.45). An association between ambient BC and MetS was only observed in children living closer to a major road. Our findings suggest that exposure to BC (ambient and biomarker) may contribute to the risk of MetS in children. By measuring the internal dose, the BC particles in urine may have additionally captured non-residential sources and reduced exposure misclassification. Larger studies, with longitudinal design including measurement of urinary BC at multiple time-points are warranted to confirm our findings.
Associations between SES and asthma are not always consistent, partly due to the complexity of the SES assessment at individual- or area-level. A first step to better understand this point is to examine consistency between SES measures.
The aim was to define the most appropriate area-level SES in the French context by 1) measuring agreement between area-level SES 2) testing the well-known hypothesis that French elderly women with low SES have lowest probability to smoke than those with high SES.
Analyses were performed in Asthma-E3N (nested case-control study on asthma; n=19,346; mean age=70 yrs; 72% never smokers, 12% low education level (number of school years (NSY) ≤12)). Two individual (education & occupation) and 3 area-level Deprivation Index (DI) (Townsend, French European Deprivation Index (FEDI), French Deprivation Index (Fdep) defined at the smallest French area-level and classified in quintiles) were used.
According to Townsend, FEDI, Fdep, 23%, 20% and 12% of the women lived in most deprived areas, respectively. Agreement between Townsend and the 2 French DIs was slight (weighted kappa: 0.21 and 0.06, respectively) and moderate between FEDI & Fdep ( k =0.54). As expected, using individual measures, elderly women with low SES were significantly less often smokers than those with high SES (NSY ≤12 vs. >17: OR adjusted for age [CI95%]=0.40[0.35-0.46]). At area-level, significant associations were only found for the Fdep (most vs. least deprived area: 0.81[0.72-0.91]).
Fdep seems to be adapted for E3N elderly women, mostly teachers living in urban areas. Analyses will be pursued by studying associations between body mass index, alcohol intake, asthma and SES.
Introduction: The comprehension of the relationship between asthma and immunoglobulin E (IgE) remains a challenge. Several occupational asthmogens have been identified to cause or aggravate asthma, but their associations with IgE have rarely been studied.
Aim: To study the relationship between occupational exposure to asthmogens and total serum IgE in non-asthmatics, childhood-onset and adult-onset asthmatics.
Methods: Analyses were conducted in 1212 adults (aged 17-79 years, 48% men) from the Epidemiological study on the Genetics and Environment of Asthma (EGEA2, 2003-07) without missing data for work history and IgE. Lifetime exposure to asthmogens was estimated using an asthma-specific job-exposure matrix.
Results: 32%, 28% and 36% of non-asthmatics, childhood-onset and adult-onset asthmatics had respectively ever been exposed to asthmogens. In non-asthmatics, exposed subjects had a significantly lower total IgE level. In asthmatics, no association was observed. Nevertheless, among women with childhood-onset asthma, exposure to asthmogens was associated with higher IgE level (adjusted OR (95%CI) for IgE>=100 IU/ml: 2.49 (1.07-5.83)).
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Conclusion: Our results suggest a healthy worker effect among non-asthmatics. Further analyses will be conducted by distinguishing the types of asthmogens.
Founded in part: AFSSET-EST-09-15
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.Annual average particulate matter (PM(10), PM(2.5), PM(absorbance), PM(coarse)), NO(2), nitrogen oxides (NO(x)) 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.15 279 and 10 537 participants respectively were included in the main NO(2) 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 NO(2) 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 PM(coarse) OR 1.31 (1.05 to 1.64) per 5 µg/m(3) increase and PM(10) with similar effect size. Sensitivity analyses of older cohorts showed increased risk of chronic cough with PM(2.5abs) (black carbon) exposures.Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations.
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