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Donat-Vargas, C., Bergdahl, I. A., Tornevi, A., Wennberg, M., Sommar, J., Koponen, J., . . . Åkesson, A. (2019). Associations between repeated measure of plasma perfluoroalkyl substances and cardiometabolic risk factors. Environment International, 124, 58-65
Open this publication in new window or tab >>Associations between repeated measure of plasma perfluoroalkyl substances and cardiometabolic risk factors
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 124, p. 58-65Article in journal (Refereed) Published
Abstract [en]

Background: Perfluoroalkyl substances (PFAS) are persistent synthetic chemicals that may affect components of metabolic risk through the peroxisome proliferator-activated receptor but epidemiological data remain scarce and inconsistent.

Objective: To estimate associations between repeated measurements of the main PFAS in plasma and total cholesterol, triglycerides and hypertension among the control subjects from a population-based nested case-control study on diabetes type 2 in middle-aged women and men.

Methods: Participants (n = 187) were free of diabetes at both baseline and follow-up visits to the Västerbotten Intervention Programme, 10 years apart: during 1990 to 2003 (baseline) and 2001 to 2013 (follow-up). Participants left blood samples, completed questionnaires on diet and lifestyle factors, and underwent medical examinations, including measurement of blood pressure. PFAS and lipids were later determined in stored plasma samples. Associations for the repeated measurements were assessed using generalized estimating equations.

Results: Six PFAS exceeded the limit of quantitation. Repeated measures of PFAS in plasma, cardiometabolic risk factors and confounders, showed an average decrease of triglycerides from −0.16 mmol/l (95% confidence interval [CI]: −0.33, 0.02 for PFOA) to −0.26 mmol/l (95% CI: −0.50, −0.08 for PFOS), when comparing the highest tertile of PFAS plasma levels with the lowest. Associations based on average PFAS measurements and follow-up triglycerides revealed similar inverse associations, although attenuated. The estimates for cholesterol and hypertension were inconsistent and with few exception non-significant.

Conclusions: This study found inverse associations between PFAS and triglycerides, but did not support any clear link with either cholesterol or hypertension.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Cardiometabolic risk factors, Environmental epidemiology, Hypertension, Lipids, Plasma perfluoroalkyl substances, Prospective assessment, Repeated measurements
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-156228 (URN)10.1016/j.envint.2019.01.007 (DOI)000457122700007 ()30639908 (PubMedID)2-s2.0-85059696116 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0758Västerbotten County CouncilSwedish Research Council, 2017-00822
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-22Bibliographically approved
Donat-Vargas, C., Bergdahl, I., Tornevi, A., Wennberg, M., Sommar, J., Kiviranta, H., . . . Akesson, A. (2019). Perfluoroalkyl substances and risk of type II diabetes: A prospective nested case-control study. Environment International, 123, 390-398
Open this publication in new window or tab >>Perfluoroalkyl substances and risk of type II diabetes: A prospective nested case-control study
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 123, p. 390-398Article in journal (Refereed) Published
Abstract [en]

Background: Perfluoroalkyl substances (PFAS) have drawn much attention due to bioaccumulation potential and their current omnipresence in human blood. We assessed whether plasma PFAS, suspected to induce endocrine-disrupting effects, were prospectively associated with clinical type 2 diabetes (T2D) risk.

Methods: We established a nested case-control study within the Swedish prospective population-based Västerbotten Intervention Programme cohort. Several PFAS were measured in plasma from a subset of 124 case-control pairs at baseline (during 1990–2003) and at 10-year follow-up. T2D cases were matched (1:1) according to gender, age and sample date with participants without T2D (controls).

Conditional logistic regressions were used to prospectively assess risk of T2D by baseline PFAS plasma concentrations. Associations between long-term PFAS plasma levels (mean of baseline and follow-up) and insulin resistance (HOMA2-IR) and beta-cell function (HOMA2-B%) at follow-up were prospectively explored among 178 and 181 controls, respectively, by multivariable linear regressions.

Results: After adjusting for gender, age, sample year, diet and body mass index, the odds ratio of T2D for the sum of PFAS (Σ z-score PFAS) was 0.52 (95% confidence interval, CI: 0.20, 1.36), comparing third with first tertile; and 0.92 (95% CI: 0.84, 1.00) per one standard deviation increment of sum of log-transformed PFAS. Among the controls, the adjusted β of HOMA2-IR and HOMA-B% for the sum of PFAS were −0.26 (95% CI: −0.52, −0.01) and −9.61 (95% CI: −22.60, 3.39) respectively comparing third with first tertile.

Conclusions: This prospective nested case-control study yielded overall inverse associations between individual PFAS and risk of T2D, although mostly non-significant. Among participants without T2D, long-term PFAS exposure was prospectively associated with lower insulin resistance.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Environmental contaminants, Plasma perfluoroalkyl substances, Environmental risk factors, Diabetes, Insulin resistance, Endocrine disruption, Environmental epidemiology, Nested case-control study, Prospective assessment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-155947 (URN)10.1016/j.envint.2018.12.026 (DOI)000455532500044 ()30622063 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0758Västerbotten County Council, 2017-00822Swedish Research Council
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-08Bibliographically approved
Nagel, G., Stafoggia, M., Pedersen, M., Andersen, Z. J., Galassi, C., Munkenast, J., . . . Weinmayr, G. (2018). Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE). International Journal of Cancer, 143(7), 1632-1643
Open this publication in new window or tab >>Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)
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2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 143, no 7, p. 1632-1643Article in journal (Refereed) Published
Abstract [en]

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancersof the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient airpollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-useregression models for particulate matter (PM) below 10mm (PM10), below 2.5mm (PM2.5), between 2.5 and 10mm (PMcoarse),PM2.5absorbance and nitrogen oxides (NO2and NOX) as well as approximated by traffic indicators. Cox regression modelswith adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined withrandom effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastriccancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5mg/m3of PM2.5was 1.38 (95% CI 0.99; 1.92)for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures consid-ered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influencemarkedly the effect estimate for PM2.5and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5wasfound in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study showsan association between long-term exposure to PM2.5and gastric cancer, but not UADT cancers, suggesting that air pollutionmay contribute to gastric cancer risk.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
ESCAPE, air pollution, epidemiology, gastric cancer, upper aerodigestive tract cancer
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-147272 (URN)10.1002/ijc.31564 (DOI)000443392100009 ()29696642 (PubMedID)
Available from: 2018-05-02 Created: 2018-05-02 Last updated: 2018-11-05Bibliographically approved
Raza, W., Forsberg, B., Johansson, C. & Nilsson Sommar, J. (2018). Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling. Global Health Action, 11(1), Article ID 1429081.
Open this publication in new window or tab >>Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling
2018 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1429081Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision.

OBJECTIVE: To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments.

METHODS: A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines.

RESULTS: We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure.

CONCLUSION: A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different selection of dose-response functions. This kind of assessments would improve from more holistic approaches using more specific exposure-response functions.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Active commuting, mode shift, emission factors, population exposure, commuters’ exposure, exposure response function, comparative risk assessment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-144660 (URN)10.1080/16549716.2018.1429081 (DOI)000424246900001 ()29400262 (PubMedID)
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2018-06-09Bibliographically approved
Shirdel, M., Sommar, J. N., Andersson, B. M., Bergdahl, I. A., Wingfors, H. & Liljelind, I. E. (2018). Choosing the number of images and image position when analysing the UNC Passive Aerosol Sampler for occupational exposure assessment. Journal of Occupational and Environmental Hygiene, 15(11), 767-772
Open this publication in new window or tab >>Choosing the number of images and image position when analysing the UNC Passive Aerosol Sampler for occupational exposure assessment
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2018 (English)In: Journal of Occupational and Environmental Hygiene, ISSN 1545-9624, E-ISSN 1545-9632, Vol. 15, no 11, p. 767-772Article in journal (Refereed) Published
Abstract [en]

The University of North Carolina passive aerosol sampler (UNC sampler) could be an alternative when measuring occupational dust exposure, but the time required for microscopic imaging of the sampler needs to be reduced to make it more attractive. The aims of this study were to 1) characterise the effect on precision when reducing imaging, in order to shorten analysis time and 2) assess if the position of the images makes a difference. Eighty-eight samplers were deployed in different locations of an open pit mine. Sixty images were captured for each UNC sampler, covering 51% of its collection surface, using scanning electron microscopy. Bootstrapped samples were generated with different image combinations, to assess the within-sampler coefficient of variation (CVws) for different numbers of images. In addition, the particle concentration relative to the distance from the centre of the sampler was studied. Reducing the number of images collected from the UNC sampler led to up to 8.3% CVws for ten images when calculating respirable fraction. As the overall CV has previously been assessed to 36%, the additional contribution becomes minimal, increasing the overall CV to 37%. The mean concentrations of the images were modestly related to distance from the centre of the sampler. The CVws changed from 8.26% to 8.13% for ten images when applying rules for the image collection based on distance. Thus, the benefit of these rules on the precision is small and the images can therefore be chosen at random. In conclusion, reducing the number of images analysed from 60 to 10, corresponding to a reduction of the imaged sampling area from 51% to 8.5%, results in a negligible loss in precision for respirable fraction dust measurements in occupational environments.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Dust particles, PM10, PM2.5, occupational hygienist, passive sampling, respirable fraction
National Category
Public Health, Global Health, Social Medicine and Epidemiology Environmental Sciences
Identifiers
urn:nbn:se:umu:diva-152114 (URN)10.1080/15459624.2018.1508875 (DOI)000451621900002 ()30111275 (PubMedID)
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2018-12-19Bibliographically approved
Schantz, P., Wahlgren, L., Salier Eriksson, J., Nilsson Sommar, J. & Rosdahl, H. (2018). Estimating duration-distance relations in cycle commuting in the general population. PLoS ONE, 13(11), Article ID e0207573.
Open this publication in new window or tab >>Estimating duration-distance relations in cycle commuting in the general population
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207573Article in journal (Refereed) Published
Abstract [en]

It is important to estimate the duration-distance relation in cycle commuting in the general population since this enables analyses of the potential for various public health outcomes. Therefore, the aim is to estimate this relation in the Swedish adult population of 2015. For that purpose, the first step was to establishit for adult male and female cycle commuters in Greater Stockholm, Sweden. Whether or not the slopes of these relations needed to be altered in order to make them representative of the general population was evaluated by comparing the levels of maximal oxygen uptake in samples of commuter cyclists and the population. The measure used was the maximal oxygen uptake divided by both the body weight and a cycle weight of 18.5 kg. The body weights in the population samples were adjusted to mirror relevant levels in 2015. Age adjustments for the duration-distance relations were calculated on the basis of the maximal oxygen uptake in the population samples aged 20-65 years. The duration-distance relations of the cycle commuters were downscaled by about 24-28% to mirror levels in the general population. The empirical formula for the distance (D, km) was based on duration (T, minutes) · speed (km/min) · a correction factor from cycle commuter to the general population · age adjustment (A, years). For the males in the general population the formula was: D = T · 20.76 km/h · 0.719 · (1.676-0.0147 · A). For females, the formula was: D = T · 16.14 km/h · 0.763 · (1.604-0.0129 · A). These formulas, combined with distributions of route distances between home and work in the population, enable realistic evaluations of the potential for different public health outcomes through cycle commuting.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-153803 (URN)10.1371/journal.pone.0207573 (DOI)000450420900042 ()30444927 (PubMedID)2-s2.0-85056699840 (Scopus ID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2018-12-07Bibliographically approved
Andersson Kallin, S., Lindberg, E., Nilsson Sommar, J., Bossios, A., Ekerljung, L., Malinovschi, A., . . . Janson, C. (2018). Excessive daytime sleepiness in asthma: what are the risk factors?. Journal of Asthma, 55(18), 844-850
Open this publication in new window or tab >>Excessive daytime sleepiness in asthma: what are the risk factors?
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2018 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 55, no 18, p. 844-850Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Previous studies have found that excessive daytime sleepiness (EDS) is a more common problem in asthmatic subjects than in the general population. The aim of this study was to investigate whether the prevalence of EDS is increased in asthmatic subjects and, if so, to analyse the occurrence of potential risk factors for EDS in asthmatics.

METHODS: Cross-sectional epidemiological study. In 2008, a postal questionnaire was sent out to a random sample of 45,000 individuals aged 16-75 years in four Swedish cities.

RESULTS: Of the 25,160 persons who participated, 7.3% were defined as having asthma. The prevalence of EDS was significantly higher in asthmatic subjects (42.1% vs 28.5%, p<0.001) compared with non-asthmatic subjects. Asthma was an independent risk factor for EDS (adjusted OR 1.29) and the risk of having EDS increased with asthma severity. Risk factors for EDS in subjects with asthma included insomnia (OR, 3.87; 95% CI, 3.10-4.84), chronic rhinosinusitis (OR, 2.00; 95% CI, 1.53-2.62), current smoking (OR, 1.60; 95% CI, 1.15-2.22) and obesity (OR, 1.53; 95% CI, 1.09-2.13).

CONCLUSIONS: EDS is a common problem among subjects with asthma. Asthma is an independent risk factor for having EDS. Furthermore, subjects with asthma often have other risk factors for EDS, many of them potentially modifiable.

Place, publisher, year, edition, pages
Abingdon: Taylor & Francis, 2018
Keywords
asthma severity, chronic rhinosinusitis, insomnia, physical activity, rhinitis, smoking
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-132454 (URN)10.1080/02770903.2016.1263316 (DOI)000446112800004 ()27880055 (PubMedID)
Funder
Swedish Asthma and Allergy Association, 2008021Swedish Heart Lung Foundation, HLF20070500
Available from: 2017-03-14 Created: 2017-03-14 Last updated: 2018-10-30Bibliographically approved
Svedmark, Å., Björklund, M., Häger, C. K., Nilsson Sommar, J. & Wahlström, J. (2018). Impact of workplace exposure and stress on neck pain and disabilities in women: a longitudinal follow-up after a rehabilitation intervention. Annals of Work exposure and Health, 62(5), 591-603
Open this publication in new window or tab >>Impact of workplace exposure and stress on neck pain and disabilities in women: a longitudinal follow-up after a rehabilitation intervention
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2018 (English)In: Annals of Work exposure and Health, ISSN 2398-7308, Vol. 62, no 5, p. 591-603Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim was to evaluate if pain, disability, and work productivity are influenced by physical and psychosocial work exposures as well as by stress, up to 1 year after a randomized controlled trial treatment intervention, and to determine whether any such association differed between treatment and control groups.

Methods: Ninety-seven working women suffering non-specific neck pain (n = 67 treatment group, n = 30 control group) were followed from end of treatment intervention and at 9- and 15-month follow-ups, respectively. Physical and psychosocial exposures, as well as perceived stress, were assessed after the treatment intervention. Pain, neck disability, and work productivity were assessed at baseline, after intervention 3 months later and at 9- and 15-month follow-ups. Longitudinal assessment was conducted using the exposure level at 3 months as predictor of pain, disability, and work productivity at 3, 9, and 15 months, respectively. Mixed models were used to estimate longitudinal associations, accounting for within-individual correlation of repeated outcome measures by incorporation of a random intercept. Age and duration of neck pain were adjusted for in all models. To evaluate group differences, interactions between exposures and treatment groups were estimated.

Results: High perceived stress was associated with more neck pain, more neck disability, and decreased work productivity in both cross-sectional and longitudinal analyses. High ‘control of decision’ was associated with less neck pain, less neck disability, and higher work productivity in cross-sectional analyses but only to less disability and higher productivity in longitudinal analyses. Shoulder/arm load was the only physical exposure variable that was significantly associated with work productivity in the univariate analyses. Only small differences were observed between treatment and control groups.

Conclusion: High perceived stress and low ‘control of decision’ were associated with more neck pain, increased neck disability, and decreased work productivity. Treatment interventions for individuals with neck pain should take into account psychosocial workplace exposures and stress to improve intermediate and long-term results.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
non-specific neck pain, physiotherapy, shoulder pain, work productivity
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-139392 (URN)10.1093/annweh/wxy018 (DOI)000449420200007 ()29562318 (PubMedID)2-s2.0-85050676120 (Scopus ID)
Funder
AFA Insurance, 090288Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1403
Available from: 2017-09-11 Created: 2017-09-11 Last updated: 2018-11-26Bibliographically approved
Shirdel, M., Andersson, B. M., Bergdahl, I., Sommar, J. N., Wingfors, H. & Liljelind, I. E. (2018). Improving the UNC passive aerosol sampler model based on comparison with commonly used aerosol sampling methods. Annals of Work Exposures and Health, 62(3), 328-338
Open this publication in new window or tab >>Improving the UNC passive aerosol sampler model based on comparison with commonly used aerosol sampling methods
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2018 (English)In: Annals of Work Exposures and Health, ISSN 2398-7308, Vol. 62, no 3, p. 328-338Article in journal (Refereed) Published
Abstract [en]

Objectives: In an occupational environment, passive sampling could be an alternative to active sampling with pumps for sampling of dust. One passive sampler is the University of North Carolina passive aerosol sampler (UNC sampler). It is often analysed by microscopic imaging. Promising results have been shown for particles above 2.5 µm, but indicate large underestimations for PM2.5. The aim of this study was to evaluate, and possibly improve, the UNC sampler for stationary sampling in a working environment.

Methods: Sampling was carried out at 8-h intervals during 24 h in four locations in an open pit mine with UNC samplers, respirable cyclones, PM10 and PM2.5 impactors, and an aerodynamic particle sizer (APS). The wind was minimal. For quantification, two modifications of the UNC sampler analysis model, UNC sampler with hybrid model and UNC sampler with area factor, were compared with the original one, UNC sampler with mesh factor derived from wind tunnel experiments. The effect of increased resolution for the microscopic imaging was examined.

Results: Use of the area factor and a higher resolution eliminated the underestimation for PM10 and PM2.5. The model with area factor had the overall lowest deviation versus the impactor and the cyclone. The intraclass correlation (ICC) showed that the UNC sampler had a higher precision and better ability to distinguish between different exposure levels compared to the cyclone (ICC: 0.51 versus 0.24), but lower precision compared to the impactor (PM10: 0.79 versus 0.99; PM2.5: 0.30 versus 0.45). The particle size distributions as calculated from the different UNC sampler analysis models were visually compared with the distributions determined by APS. The distributions were obviously different when the UNC sampler with mesh factor was used but came to a reasonable agreement when the area factor was used.

Conclusions: High resolution combined with a factor based on area only, results in no underestimation of small particles compared to impactors and cyclones and a better agreement with the APS’s particle size distributions. The UNC sampler had lower precision than the impactors, but higher than the respirable cyclone. The UNC sampler with area factor could be used for PM2.5, PM10 and respirable fraction measurements in this working environment without wind.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
inorganic dust, mesh factor, PM10, PM2.5, respirable fraction, UNC passive aerosol sampler, working environment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-145698 (URN)10.1093/annweh/wxx110 (DOI)000432804600008 ()29300818 (PubMedID)
Available from: 2018-03-14 Created: 2018-03-14 Last updated: 2018-06-26Bibliographically approved
Pedersen, M., Stafoggia, M., Weinmayr, G., Andersen, Z. J., Galassi, C., Sommar, J., . . . Raaschou-Nielsen, O. (2018). Is there an association between ambient air pollution and bladder cancer incidence?: Analysis of 15 European cohorts. European Urology Focus, 4(1), 113-120
Open this publication in new window or tab >>Is there an association between ambient air pollution and bladder cancer incidence?: Analysis of 15 European cohorts
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2018 (English)In: European Urology Focus, ISSN 1540-0085, E-ISSN 1788-618X, Vol. 4, no 1, p. 113-120Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population.

OBJECTIVE: To evaluate the association between long-term exposure to ambient air pollution and BC incidence.

DESIGN, SETTING, AND PARTICIPANTS: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10μm (PM10), <2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10), PM2.5absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence.

RESULTS AND LIMITATIONS: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m(3) increase in NO2 and 5-μg/m(3) increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure.

CONCLUSIONS: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC.

PATIENT SUMMARY: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Air pollution, Bladder cancer, Environment, Prevention
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-137924 (URN)10.1016/j.euf.2016.11.008 (DOI)28753823 (PubMedID)2-s2.0-85007499735 (Scopus ID)
Available from: 2017-07-31 Created: 2017-07-31 Last updated: 2018-11-16Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8854-498x

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