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

Cai, Yutong
; 
Schikowski, Tamara
; 
Adam, Martin
; 
Buschka, Anna
; 
Carsin, Anne-Elie
; 
Jacquemin, Benedicte
; 
Marcon, Alessandro
; 
Sanchez, Margaux
; 
Vierkötter, Andrea
; 
Al Kanani, Zaina
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Cai, Yutong
Schikowski, Tamara
Adam, Martin
Buschka, Anna
Carsin, Anne-Elie
Jacquemin, Benedicte
Marcon, Alessandro
Sanchez, Margaux
Vierkötter, Andrea
Al Kanani, Zaina
Beelen, Rob
Birk, Matthias
Brunekreef, Bert
Cirach, Marta
Clavel-Chapelon, Françoise
Declercq, Christophe
de Hoogh, Kees
de Nazelle, Audrey
Ducret-Stich, Regina E.
Ferretti, Virginia Valeria
Forsberg, Bertil
Gerbase, Margaret W.
Hardy, Rebecca
Heinrich, Joachim
Hoek, Gerard
Jarvis, Debbie
Keidel, Dirk
Kuh, Diana
Nieuwenhuijsen, Mark J.
Ragettli, Martina S.
Ranzi, Andrea
Rochat, Thierry
Schindler, Christian
Sugiri, Dorothea
Temam, Sofia
Tsai, Ming-Yi
Varraso, Raphaëlle
Kauffmann, Francine
Krämer, Ursula
Sunyer, Jordi
Künzli, Nino
Probst-Hensch, Nicole
Hansell, Anna L.
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 µg/m3 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.
Keywords
Date
2014
Type
Journal article
Journal
Thorax
Book
Volume
69
Issue
11
Page Range
1005-1014
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Collections
Mary MacKillop Institute for Health Research
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URI
https://hdl.handle.net/20.500.14802/22142
Relation URI
DOI
10.1136/thoraxjnl-2013-204352
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