Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study

Zorana Jovanovic Andersen; Klaus Bønnelykke; Martin Hvidberg; Steen S Jensen; Matthias Ketzel; Steffen Loft; Mette Sørensen; Anne Tjønneland; Kim Overvad; Ole Raaschou-Nielsen

doi:10.1136/thoraxjnl-2011-200711

Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study

Zorana Jovanovic Andersen, Klaus Bønnelykke, Martin Hvidberg, Steen S Jensen, Matthias Ketzel, Steffen Loft, Mette Sørensen, Anne Tjønneland, Kim Overvad, Ole Raaschou-Nielsen

78 Citations (Scopus)

Abstract

Background: Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood. Objectives: The authors studied the effect of exposure to traffic-related air pollution over 35 years on the risk for asthma hospitalisation in older people. Methods: 57 053 participants in the Danish Diet, Cancer and Health cohort, aged 50-65 years at baseline (1993-1997), were followed up for first hospital admission for asthma until 2006, and the annual nitrogen dioxide (NO₂) levels were estimated as a proxy of the exposure to traffic-related air pollution at the residential addresses of the participants since 1971. The association between NO₂ and hospitalisation for asthma was modelled using Cox regression, for the full cohort and in people with and without previous hospitalisations for asthma, and the effect modification by comorbid conditions was assessed. Results: During 10.2 years' median follow-up, 977 (1.9%) of 53 695 eligible people were admitted to hospital for asthma: 821 were first-ever admissions and 176 were readmissions. NO₂ levels were associated with risk for asthma hospitalisation in the full cohort (HR and 95% CI per IQR, 5.8 μg/m³: 1.12; 1.04-1.22), and for first-ever admissions (1.10; 1.01-1.20), with the highest risk in people with a history of asthma (1.41; 1.15-2.07) or chronic obstructive pulmonary disease (COPD) (1.30; 1.07-1.52) hospitalisation. Conclusions: Long-term exposure to traffic-related air pollution increases the risk for asthma hospitalisation in older people. People with previous asthma or COPD hospitalisations are most susceptible.

Original language	English
Journal	Thorax
Volume	67
Issue number	1
Pages (from-to)	6-11
Number of pages	6
ISSN	0040-6376
DOIs	https://doi.org/10.1136/thoraxjnl-2011-200711
Publication status	Published - Jan 2012

Keywords

Aged
Air Pollutants
Asthma
Denmark
Disease Progression
Female
Follow-Up Studies
Hospitalization
Humans
Incidence
Male
Middle Aged
Prevalence
Proportional Hazards Models
Retrospective Studies
Risk Factors
Time Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/thoraxjnl-2011-200711

Cite this

@article{fa70bc97bb824759a22a16afa16ec1ad,

title = "Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study",

abstract = "Background: Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood. Objectives: The authors studied the effect of exposure to traffic-related air pollution over 35 years on the risk for asthma hospitalisation in older people. Methods: 57 053 participants in the Danish Diet, Cancer and Health cohort, aged 50-65 years at baseline (1993-1997), were followed up for first hospital admission for asthma until 2006, and the annual nitrogen dioxide (NO2) levels were estimated as a proxy of the exposure to traffic-related air pollution at the residential addresses of the participants since 1971. The association between NO2 and hospitalisation for asthma was modelled using Cox regression, for the full cohort and in people with and without previous hospitalisations for asthma, and the effect modification by comorbid conditions was assessed. Results: During 10.2 years' median follow-up, 977 (1.9%) of 53 695 eligible people were admitted to hospital for asthma: 821 were first-ever admissions and 176 were readmissions. NO2 levels were associated with risk for asthma hospitalisation in the full cohort (HR and 95% CI per IQR, 5.8 μg/m3: 1.12; 1.04-1.22), and for first-ever admissions (1.10; 1.01-1.20), with the highest risk in people with a history of asthma (1.41; 1.15-2.07) or chronic obstructive pulmonary disease (COPD) (1.30; 1.07-1.52) hospitalisation. Conclusions: Long-term exposure to traffic-related air pollution increases the risk for asthma hospitalisation in older people. People with previous asthma or COPD hospitalisations are most susceptible.",

keywords = "Aged, Air Pollutants, Asthma, Denmark, Disease Progression, Female, Follow-Up Studies, Hospitalization, Humans, Incidence, Male, Middle Aged, Prevalence, Proportional Hazards Models, Retrospective Studies, Risk Factors, Time Factors",

author = "Andersen, {Zorana Jovanovic} and Klaus B{\o}nnelykke and Martin Hvidberg and Jensen, {Steen S} and Matthias Ketzel and Steffen Loft and Mette S{\o}rensen and Anne Tj{\o}nneland and Kim Overvad and Ole Raaschou-Nielsen",

year = "2012",

month = jan,

doi = "10.1136/thoraxjnl-2011-200711",

language = "English",

volume = "67",

pages = "6--11",

journal = "Thorax",

issn = "0040-6376",

publisher = "B M J Group",

number = "1",

}

TY - JOUR

T1 - Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study

AU - Andersen, Zorana Jovanovic

AU - Bønnelykke, Klaus

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 - 2012/1

Y1 - 2012/1

N2 - Background: Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood. Objectives: The authors studied the effect of exposure to traffic-related air pollution over 35 years on the risk for asthma hospitalisation in older people. Methods: 57 053 participants in the Danish Diet, Cancer and Health cohort, aged 50-65 years at baseline (1993-1997), were followed up for first hospital admission for asthma until 2006, and the annual nitrogen dioxide (NO2) levels were estimated as a proxy of the exposure to traffic-related air pollution at the residential addresses of the participants since 1971. The association between NO2 and hospitalisation for asthma was modelled using Cox regression, for the full cohort and in people with and without previous hospitalisations for asthma, and the effect modification by comorbid conditions was assessed. Results: During 10.2 years' median follow-up, 977 (1.9%) of 53 695 eligible people were admitted to hospital for asthma: 821 were first-ever admissions and 176 were readmissions. NO2 levels were associated with risk for asthma hospitalisation in the full cohort (HR and 95% CI per IQR, 5.8 μg/m3: 1.12; 1.04-1.22), and for first-ever admissions (1.10; 1.01-1.20), with the highest risk in people with a history of asthma (1.41; 1.15-2.07) or chronic obstructive pulmonary disease (COPD) (1.30; 1.07-1.52) hospitalisation. Conclusions: Long-term exposure to traffic-related air pollution increases the risk for asthma hospitalisation in older people. People with previous asthma or COPD hospitalisations are most susceptible.

AB - Background: Exposure to air pollution in early life contributes to the burden of childhood asthma, but it is not clear whether long-term exposure to air pollution can lead to asthma onset or progression in adulthood. Objectives: The authors studied the effect of exposure to traffic-related air pollution over 35 years on the risk for asthma hospitalisation in older people. Methods: 57 053 participants in the Danish Diet, Cancer and Health cohort, aged 50-65 years at baseline (1993-1997), were followed up for first hospital admission for asthma until 2006, and the annual nitrogen dioxide (NO2) levels were estimated as a proxy of the exposure to traffic-related air pollution at the residential addresses of the participants since 1971. The association between NO2 and hospitalisation for asthma was modelled using Cox regression, for the full cohort and in people with and without previous hospitalisations for asthma, and the effect modification by comorbid conditions was assessed. Results: During 10.2 years' median follow-up, 977 (1.9%) of 53 695 eligible people were admitted to hospital for asthma: 821 were first-ever admissions and 176 were readmissions. NO2 levels were associated with risk for asthma hospitalisation in the full cohort (HR and 95% CI per IQR, 5.8 μg/m3: 1.12; 1.04-1.22), and for first-ever admissions (1.10; 1.01-1.20), with the highest risk in people with a history of asthma (1.41; 1.15-2.07) or chronic obstructive pulmonary disease (COPD) (1.30; 1.07-1.52) hospitalisation. Conclusions: Long-term exposure to traffic-related air pollution increases the risk for asthma hospitalisation in older people. People with previous asthma or COPD hospitalisations are most susceptible.

KW - Aged

KW - Air Pollutants

KW - Asthma

KW - Denmark

KW - Disease Progression

KW - Female

KW - Follow-Up Studies

KW - Hospitalization

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Proportional Hazards Models

KW - Retrospective Studies

KW - Risk Factors

KW - Time Factors

U2 - 10.1136/thoraxjnl-2011-200711

DO - 10.1136/thoraxjnl-2011-200711

M3 - Journal article

C2 - 21890573

SN - 0040-6376

VL - 67

SP - 6

EP - 11

JO - Thorax

JF - Thorax

IS - 1

ER -

Long-term exposure to air pollution and asthma hospitalisations in older adults: a cohort study

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this