Chronic obstructive pulmonary disease and long-term exposure to traffic-related air pollution: a cohort study

TY - JOUR

T1 - Chronic obstructive pulmonary disease and long-term exposure to traffic-related air pollution: a cohort study

AU - Andersen, Zorana J

AU - Hvidberg, Martin

AU - Jensen, Steen S

AU - Ketzel, Matthias

AU - Loft, Steffen

AU - Sørensen, Mette

AU - Tjønneland, Anne

AU - Overvad, Kim

AU - Raaschou-Nielsen, Ole

PY - 2011/2/15

Y1 - 2011/2/15

N2 - Rationale: Short-term exposure to air pollution has been associated with exacerbation of chronic obstructivepulmonarydisease(COPD), whereas the role of long-term exposures on the development of COPD is not yet fully understood. Objectives: We assessed the effect of exposure to traffic-related air pollution over 35 years on the incidence of COPD in a prospective cohort study. Methods: We followed 57,053 participants in the Danish Diet, Cancer, and Health cohort in the Hospital Discharge Register for their first hospital admission for COPD between 1993 and 2006. We estimated the annual mean levels of nitrogen dioxide (NO2) and nitrogen oxides (NOx) at all residential addresses of the cohort participants since 1971 to an event or 2006 and used indicators of traffic near the residential address at recruitment. We assessed the association between exposure to air pollution and COPD incidence by Cox regression analyses for the full cohort, and for participants with and without comorbid conditions, including asthma, diabetes, or cardiovascular disease. Measurements and Main Results: A first hospital admission for COPD was recorded for 1,786 (3.4%) of 52,799 eligible subjects between recruitment (1993-1997) and 2006. COPD incidence was associated with the 35-year mean NO2 level (hazard ratio, 1.08;95%confidence interval, 1.02-1.14, per interquartile range of 5.8 mg/m3), with stronger associations in subjects with diabetes (1.29; 1.05-1.50) and asthma (1.19; 1.03-1.38). Conclusions: Long-term exposure to traffic-related air pollution may contribute to the development of COPD with possibly enhanced susceptibility in people with diabetes and asthma.

AB - Rationale: Short-term exposure to air pollution has been associated with exacerbation of chronic obstructivepulmonarydisease(COPD), whereas the role of long-term exposures on the development of COPD is not yet fully understood. Objectives: We assessed the effect of exposure to traffic-related air pollution over 35 years on the incidence of COPD in a prospective cohort study. Methods: We followed 57,053 participants in the Danish Diet, Cancer, and Health cohort in the Hospital Discharge Register for their first hospital admission for COPD between 1993 and 2006. We estimated the annual mean levels of nitrogen dioxide (NO2) and nitrogen oxides (NOx) at all residential addresses of the cohort participants since 1971 to an event or 2006 and used indicators of traffic near the residential address at recruitment. We assessed the association between exposure to air pollution and COPD incidence by Cox regression analyses for the full cohort, and for participants with and without comorbid conditions, including asthma, diabetes, or cardiovascular disease. Measurements and Main Results: A first hospital admission for COPD was recorded for 1,786 (3.4%) of 52,799 eligible subjects between recruitment (1993-1997) and 2006. COPD incidence was associated with the 35-year mean NO2 level (hazard ratio, 1.08;95%confidence interval, 1.02-1.14, per interquartile range of 5.8 mg/m3), with stronger associations in subjects with diabetes (1.29; 1.05-1.50) and asthma (1.19; 1.03-1.38). Conclusions: Long-term exposure to traffic-related air pollution may contribute to the development of COPD with possibly enhanced susceptibility in people with diabetes and asthma.

KW - Air Pollutants

KW - Air Pollution

KW - Asthma

KW - Causality

KW - Cohort Studies

KW - Comorbidity

KW - Denmark

KW - Diabetes Mellitus

KW - Environmental Exposure

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Nitrogen Dioxide

KW - Nitrogen Oxides

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive

KW - Risk Factors

KW - Vehicle Emissions

U2 - 10.1164/rccm.201006-0937OC

DO - 10.1164/rccm.201006-0937OC

M3 - Journal article

C2 - 20870755

SN - 1073-449X

VL - 183

SP - 455

EP - 461

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

IS - 4

ER -