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Peralta, G. P., Marcon, A., Carsin, A.-E., Abramson, M. J., Accordini, S., Amaral, A. F. .., . . . Garcia-Aymerich, J. (2020). Body mass index and weight change are associated with adult lung function trajectories: the prospective ECRHS study. Thorax
Open this publication in new window or tab >>Body mass index and weight change are associated with adult lung function trajectories: the prospective ECRHS study
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2020 (English)In: Thorax, ISSN 0040-6376, E-ISSN 1468-3296Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood from 20-year weight change profiles using data from the population-based European Community Respiratory Health Survey (ECRHS).

METHODS: We included 3673 participants recruited at age 20-44 years with repeated measurements of weight and lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)) in three study waves (1991-93, 1999-2003, 2010-14) until they were 39-67 years of age. We classified subjects into weight change profiles according to baseline body mass index (BMI) categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations.

RESULTS: In individuals with normal BMI, overweight and obesity at baseline, moderate (0.25-1 kg/year) and high weight gain (>1 kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared with participants with baseline normal BMI and stable weight (±0.25 kg/year), obese individuals with high weight gain during follow-up had -1011 mL (95% CI -1.259 to -763) lower estimated FVC at 65 years despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<-0.25 kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline.

CONCLUSION: Moderate and high weight gain over 20 years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.

Keywords
BMI, adults, epidemiology, lung function, obesity, weight change
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-168520 (URN)10.1136/thoraxjnl-2019-213880 (DOI)32098862 (PubMedID)
Available from: 2020-03-02 Created: 2020-03-02 Last updated: 2020-03-10
Burte, E., Leynaert, B., Marcon, A., Bousquet, J., Benmerad, M., Bono, R., . . . Jacquemin, B. (2020). Long-term air pollution exposure is associated with increased severity of rhinitis in 2 European cohorts. Journal of Allergy and Clinical Immunology, 145(3), 834-842.e6
Open this publication in new window or tab >>Long-term air pollution exposure is associated with increased severity of rhinitis in 2 European cohorts
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2020 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 145, no 3, p. 834-842.e6Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Very few studies have examined the association between long-term outdoor air pollution and rhinitis severity in adults.

OBJECTIVE: We sought to assess the cross-sectional association between individual long-term exposure to air pollution and severity of rhinitis.

METHODS: Participants with rhinitis from 2 multicenter European cohorts (Epidemiological Study on the Genetics and Environment on Asthma and the European Community Respiratory Health Survey) were included. Annual exposure to NO2, PM10, PM2.5, and PMcoarse (calculated by subtracting PM2.5 from PM10) was estimated using land-use regression models derived from the European Study of Cohorts for Air Pollution Effects project, at the participants' residential address. The score of rhinitis severity (range, 0-12), based on intensity of disturbance due to symptoms reported by questionnaire, was categorized into low (reference), mild, moderate, and high severity. Polytomous logistic regression models with a random intercept for city were used.

RESULTS: A total of 1408 adults with rhinitis (mean age, 52 years; 46% men, 81% from the European Community Respiratory Health Survey) were included. The median (1st quartile-3rd quartile) score of rhinitis severity was 4 (2-6). Higher exposure to PM10 was associated with higher rhinitis severity (adjusted odds ratio [95% CI] for a 10 μg/m3 increase in PM10: for mild: 1.20 [0.88-1.64], moderate: 1.53 [1.07-2.19], and high severity: 1.72 [1.23-2.41]). Similar results were found for PM2.5. Higher exposure to NO2 was associated with an increased severity of rhinitis, with similar adjusted odds ratios whatever the level of severity. Adjusted odds ratios were higher among participants without allergic sensitization than among those with, but interaction was found only for NO2. CONCLUSIONS: People with rhinitis who live in areas with higher levels of pollution are more likely to report more severe nasal symptoms. Further work is required to elucidate the mechanisms of this association.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Rhinitis, air pollution, allergic sensitization, environment, respiratory disease, severity
National Category
Occupational Health and Environmental Health Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-167764 (URN)10.1016/j.jaci.2019.11.040 (DOI)000518756700021 ()31983528 (PubMedID)
Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2020-04-27Bibliographically approved
Strömgren, M., Schantz, P., Sommar, J., Raza, W., Markstedt, A. & Forsberg, B. (2020). Modeling commuter modal shift from car trips to cycling: Scenario construction and outcomes for Stockholm, Sweden. Journal of Transport Geography (86), Article ID 102740.
Open this publication in new window or tab >>Modeling commuter modal shift from car trips to cycling: Scenario construction and outcomes for Stockholm, Sweden
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2020 (English)In: Journal of Transport Geography, ISSN 0966-6923, E-ISSN 1873-1236, no 86, article id 102740Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-171297 (URN)10.1016/j.jtrangeo.2020.102740 (DOI)
Available from: 2020-06-01 Created: 2020-06-01 Last updated: 2020-06-02Bibliographically approved
Vicedo-Cabrera, A. M., Sera, F., Liu, C., Armstrong, B., Milojevic, A., Guo, Y., . . . Gasparrini, A. (2020). Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries. BMJ. British Medical Journal, 368, Article ID m108.
Open this publication in new window or tab >>Short term association between ozone and mortality: global two stage time series study in 406 locations in 20 countries
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2020 (English)In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 368, article id m108Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To assess short term mortality risks and excess mortality associated with exposure to ozone in several cities worldwide.

DESIGN: Two stage time series analysis.

SETTING: 406 cities in 20 countries, with overlapping periods between 1985 and 2015, collected from the database of Multi-City Multi-Country Collaborative Research Network.

POPULATION: Deaths for all causes or for external causes only registered in each city within the study period.

MAIN OUTCOME MEASURES: Daily total mortality (all or non-external causes only).

RESULTS: A total of 45 165 171 deaths were analysed in the 406 cities. On average, a 10 µg/m3 increase in ozone during the current and previous day was associated with an overall relative risk of mortality of 1.0018 (95% confidence interval 1.0012 to 1.0024). Some heterogeneity was found across countries, with estimates ranging from greater than 1.0020 in the United Kingdom, South Africa, Estonia, and Canada to less than 1.0008 in Mexico and Spain. Short term excess mortality in association with exposure to ozone higher than maximum background levels (70 µg/m3) was 0.26% (95% confidence interval 0.24% to 0.28%), corresponding to 8203 annual excess deaths (95% confidence interval 3525 to 12 840) across the 406 cities studied. The excess remained at 0.20% (0.18% to 0.22%) when restricting to days above the WHO guideline (100 µg/m3), corresponding to 6262 annual excess deaths (1413 to 11 065). Above more lenient thresholds for air quality standards in Europe, America, and China, excess mortality was 0.14%, 0.09%, and 0.05%, respectively.

CONCLUSIONS: Results suggest that ozone related mortality could be potentially reduced under stricter air quality standards. These findings have relevance for the implementation of efficient clean air interventions and mitigation strategies designed within national and international climate policies.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-168151 (URN)10.1136/bmj.m108 (DOI)000514097800001 ()32041707 (PubMedID)
Available from: 2020-02-18 Created: 2020-02-18 Last updated: 2020-03-10Bibliographically approved
Kukkonen, J., López-Aparicio, S., Segersson, D., Geels, C., Kangas, L., Kauhaniemi, M., . . . Brandt, J. (2020). The influence of residential wood combustion on the concentrations of PM2.5 in four Nordic cities. Atmospheric Chemistry And Physics, 20(7), 4333-4365
Open this publication in new window or tab >>The influence of residential wood combustion on the concentrations of PM2.5 in four Nordic cities
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2020 (English)In: Atmospheric Chemistry And Physics, ISSN 1680-7316, E-ISSN 1680-7324, Vol. 20, no 7, p. 4333-4365Article in journal (Refereed) Published
Abstract [en]

Residential wood combustion (RWC) is an important contributor to air quality in numerous regions worldwide. This study is the first extensive evaluation of the influence of RWC on ambient air quality in several Nordic cities. We have analysed the emissions and concentrations of PM2.5 in cities within four Nordic countries: in the metropolitan areas of Copenhagen, Oslo, and Helsinki and in the city of Umeå. We have evaluated the emissions for the relevant urban source categories and modelled atmospheric dispersion on regional and urban scales. The emission inventories for RWC were based on local surveys, the amount of wood combusted, combustion technologies and other relevant factors. The accuracy of the predicted concentrations was evaluated based on urban concentration measurements. The predicted annual average concentrations ranged spatially from 4 to 7 µg m−3 (2011), from 6 to 10 µg m−3 (2013), from 4 to more than 13 µg m−3 (2013) and from 9 to more than 13 µg m−3 (2014), in Umeå, Helsinki, Oslo and Copenhagen, respectively. The higher concentrations in Copenhagen were mainly caused by the relatively high regionally and continentally transported background contributions. The annual average fractions of PM2.5 concentrations attributed to RWC within the considered urban regions ranged spatially from 0 % to 15 %, from 0 % to 20 %, from 8 % to 22 % and from 0 % to 60 % in Helsinki, Copenhagen, Umeå and Oslo, respectively. In particular, the contributions of RWC in central Oslo were larger than 40 % as annual averages. In Oslo, wood combustion was used mainly for the heating of larger blocks of flats. In contrast, in Helsinki, RWC was solely used in smaller detached houses. In Copenhagen and Helsinki, the highest fractions occurred outside the city centre in the suburban areas. In Umeå, the highest fractions occurred both in the city centre and its surroundings.

Place, publisher, year, edition, pages
European Geosciences Union (EGU), 2020
National Category
Meteorology and Atmospheric Sciences
Identifiers
urn:nbn:se:umu:diva-170499 (URN)10.5194/acp-20-4333-2020 (DOI)000526058600001 ()2-s2.0-85083510725 (Scopus ID)
Funder
NordForsk, 75007Swedish Armed Forces
Available from: 2020-05-07 Created: 2020-05-07 Last updated: 2020-05-28Bibliographically approved
Olstrup, H., Johansson, C., Forsberg, B., Tornevi, A., Ekebom, A. & Meister, K. (2019). A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden. International Journal of Environmental Research and Public Health, 16(1), Article ID 105.
Open this publication in new window or tab >>A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden
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2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 1, article id 105Article in journal (Refereed) Published
Abstract [en]

In this study, an Air Quality Health Index (AQHI) for Stockholm is introduced as a tool to capture the combined effects associated with multi-pollutant exposure. Public information regarding the expected health risks associated with current or forecasted concentrations of pollutants and pollen can be very useful for sensitive persons when planning their outdoor activities. For interventions, it can also be important to know the contribution from pollen and the specific air pollutants, judged to cause the risk. The AQHI is based on an epidemiological analysis of asthma emergency department visits (AEDV) and urban background concentrations of NOx, O₃, PM10 and birch pollen in Stockholm during 2001⁻2005. This analysis showed per 10 µg·m⁻3 increase in the mean of same day and yesterday an increase in AEDV of 0.5% (95% CI: -1.2⁻2.2), 0.3% (95% CI: -1.4⁻2.0) and 2.5% (95% CI: 0.3⁻4.8) for NOx, O₃ and PM10, respectively. For birch pollen, the AEDV increased with 0.26% (95% CI: 0.18⁻0.34) for 10 pollen grains·m⁻3. In comparison with the coefficients in a meta-analysis, the mean values of the coefficients obtained in Stockholm are smaller. The mean value of the risk increase associated with PM10 is somewhat smaller than the mean value of the meta-coefficient, while for O₃, it is less than one fifth of the meta-coefficient. We have not found any meta-coefficient using NOx as an indicator of AEDV, but compared to the mean value associated with NO₂, our value of NOx is less than half as large. The AQHI is expressed as the predicted percentage increase in AEDV without any threshold level. When comparing the relative contribution of each pollutant to the total AQHI, based on monthly averages concentrations during the period 2015⁻2017, there is a tangible pattern. The AQHI increase associated with NOx exhibits a relatively even distribution throughout the year, but with a clear decrease during the summer months due to less traffic. O₃ contributes to an increase in AQHI during the spring. For PM10, there is a significant increase during early spring associated with increased suspension of road dust. For birch pollen, there is a remarkable peak during the late spring and early summer during the flowering period. Based on monthly averages, the total AQHI during 2015⁻2017 varies between 4 and 9%, but with a peak value of almost 16% during the birch pollen season in the spring 2016. Based on daily mean values, the most important risk contribution during the study period is from PM10 with 3.1%, followed by O₃ with 2.0%.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
AQHI, NOx, PM10, asthma, birch pollen, ozone, risk coefficients
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-154982 (URN)10.3390/ijerph16010105 (DOI)000459111400105 ()30609753 (PubMedID)
Funder
EU, Horizon 2020
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-04-15Bibliographically approved
Liu, C., Chen, R., Sera, F., Vicedo-Cabrera, A. M., Guo, Y., Tong, S., . . . Kan, H. (2019). Ambient Particulate Air Pollution and Daily Mortality in 652 Cities. New England Journal of Medicine, 381(8), 705-715
Open this publication in new window or tab >>Ambient Particulate Air Pollution and Daily Mortality in 652 Cities
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2019 (English)In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 381, no 8, p. 705-715Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The systematic evaluation of the results of time-series studies of air pollution is challenged by differences in model specification and publication bias.

METHODS: We evaluated the associations of inhalable particulate matter (PM) with an aerodynamic diameter of 10 μm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) with daily all-cause, cardiovascular, and respiratory mortality across multiple countries or regions. Daily data on mortality and air pollution were collected from 652 cities in 24 countries or regions. We used overdispersed generalized additive models with random-effects meta-analysis to investigate the associations. Two-pollutant models were fitted to test the robustness of the associations. Concentration-response curves from each city were pooled to allow global estimates to be derived.

RESULTS: On average, an increase of 10 μg per cubic meter in the 2-day moving average of PM10 concentration, which represents the average over the current and previous day, was associated with increases of 0.44% (95% confidence interval [CI], 0.39 to 0.50) in daily all-cause mortality, 0.36% (95% CI, 0.30 to 0.43) in daily cardiovascular mortality, and 0.47% (95% CI, 0.35 to 0.58) in daily respiratory mortality. The corresponding increases in daily mortality for the same change in PM2.5 concentration were 0.68% (95% CI, 0.59 to 0.77), 0.55% (95% CI, 0.45 to 0.66), and 0.74% (95% CI, 0.53 to 0.95). These associations remained significant after adjustment for gaseous pollutants. Associations were stronger in locations with lower annual mean PM concentrations and higher annual mean temperatures. The pooled concentration-response curves showed a consistent increase in daily mortality with increasing PM concentration, with steeper slopes at lower PM concentrations.

CONCLUSIONS: Our data show independent associations between short-term exposure to PM10 and PM2.5 and daily all-cause, cardiovascular, and respiratory mortality in more than 600 cities across the globe. These data reinforce the evidence of a link between mortality and PM concentration established in regional and local studies. (Funded by the National Natural Science Foundation of China and others.).

Place, publisher, year, edition, pages
Waltham: Massachusetts Medical Society, 2019
National Category
Occupational Health and Environmental Health Environmental Sciences
Identifiers
urn:nbn:se:umu:diva-162609 (URN)10.1056/NEJMoa1817364 (DOI)000483203400006 ()31433918 (PubMedID)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-10-31Bibliographically approved
Olstrup, H., Johansson, C., Forsberg, B. & Åström, C. (2019). Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden. International Journal of Environmental Research and Public Health, 16(6), Article ID E1028.
Open this publication in new window or tab >>Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 6, article id E1028Article in journal (Refereed) Published
Abstract [en]

In this study, the effects on daily mortality in Stockholm associated with short-term exposure to ultrafine particles (measured as number of particles with a diameter larger than 4 nm, PNC₄), black carbon (BC) and coarse particles (PM2.5⁻10) have been compared with the effects from more common traffic-pollution indicators (PM10, PM2.5 and NO₂) and O₃ during the period 2000⁻2016. Air pollution exposure was estimated from measurements at a 20 m high building in central Stockholm. The associations between daily mortality lagged up to two days (lag 02) and the different air pollutants were modelled by using Poisson regression. The pollutants with the strongest indications of an independent effect on daily mortality were O₃, PM2.5⁻10 and PM10. In the single-pollutant model, an interquartile range (IQR) increase in O₃ was associated with an increase in daily mortality of 2.0% (95% CI: 1.1⁻3.0) for lag 01 and 1.9% (95% CI: 1.0⁻2.9) for lag 02. An IQR increase in PM2.5⁻10 was associated with an increase in daily mortality of 0.8% (95% CI: 0.1⁻1.5) for lag 01 and 1.1% (95% CI: 0.4⁻1.8) for lag 02. PM10 was associated with a significant increase only at lag 02, with 0.8% (95% CI: 0.08⁻1.4) increase in daily mortality associated with an IQR increase in the concentration. NO₂ exhibits negative associations with mortality. The significant excess risk associated with O₃ remained significant in two-pollutant models after adjustments for PM2.5⁻10, BC and NO₂. The significant excess risk associated with PM2.5⁻10 remained significant in a two-pollutant model after adjustment for NO₂. The significantly negative associations for NO₂ remained significant in two-pollutant models after adjustments for PM2.5⁻10, O₃ and BC. A potential reason for these findings, where statistically significant excess risks were found for O₃, PM2.5⁻10 and PM10, but not for NO₂, PM2.5, PNC₄ and BC, is behavioral factors that lead to misclassification in the exposure. The concentrations of O₃ and PM2.5⁻10 are in general highest during sunny and dry days during the spring, when exposure to outdoor air tend to increase, while the opposite applies to NO₂, PNC₄ and BC, with the highest concentrations during the short winter days with cold weather, when people are less exposed to outdoor air.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
PM2.5–10, excess risk, exposure, linear regression, mortality, ozone, particle number count (PNC)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-157554 (URN)10.3390/ijerph16061028 (DOI)000465159500128 ()30901873 (PubMedID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-05-28Bibliographically approved
Nerpin, E., Olivieri, M., Gislason, T., Olin, A. C., Nielsen, R., Johannessen, A., . . . Malinovschi, A. (2019). Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III. Clinical and Experimental Allergy, 49(7), 969-979
Open this publication in new window or tab >>Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III
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2019 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 7, p. 969-979Article in journal (Refereed) Published
Abstract [en]

Introduction: The fractional exhaled nitric oxide (FENO) is a marker for type 2 inflammation used in diagnostics and management of asthma. In order to use FENO as a reliable biomarker, it is important to investigate factors that influence FENO in healthy individuals. Men have higher levels of FENO than women, but it is unclear whether determinants of FENO differ by sex.

Objective: To identify determinants of FENO in men and women without lung diseases.

Method: FENO was validly measured in 3,881 healthy subjects that had answered the main questionnaire of the European Community Respiratory Health Survey III without airways or lung disease

Results: Exhaled NO levels were 21.3% higher in men compared with women p<0.001. Being in the upper age quartile (60.3–67.6 years) men had 19.2 ppb (95% CI: 18.3, 20.2) higher FENO than subjects in the lowest age quartile (39.7–48.3 years) p=0.02. Women in the two highest age quartiles (54.6–60.2 and 60.3–67.6 years) had 15.4 ppb (14.7, 16.2), p=0.03 and 16.4 ppb (15.6, 17.1), p=<0.001 higher FENO, compared with the lowest age quartile.

Height was related to 8% higher FENO level in men (p<0.001) and 5% higher FENO levels in women (p=0.008). Men who smoked had 37% lower FENO levels and women had 30% lower levels compared with never‐smokers (p<0.001 for both). Men and women sensitized to both grass and perennial allergens had higher FENO levels compared with non‐sensitized subjects 26% and 29%, p<0.001 for both.

Conclusion & Clinical Relevance: FENO levels were higher in men than women. Similar effects of current smoking, height, and IgE sensitization were found in both sexes. FENO started increasing at lower age in women than in men, suggesting that interpretation of FENO levels in adults aged over 50 years should take into account age and sex.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
FENO, IgE sensitization, healthy population, smoking
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-157857 (URN)10.1111/cea.13394 (DOI)000474610200004 ()30934155 (PubMedID)2-s2.0-85064513946 (Scopus ID)
Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-09-06Bibliographically approved
Olivieri, M., Murgia, N., Carsin, A.-E., Heinrich, J., Benke, G., Bono, R., . . . Verlato, G. (2019). Effects of Smoking Bans on Passive Smoking Exposure at Work and at Home. The European Community Respiratory Health Survey. Indoor Air, 29(4), 670-679
Open this publication in new window or tab >>Effects of Smoking Bans on Passive Smoking Exposure at Work and at Home. The European Community Respiratory Health Survey
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2019 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, no 4, p. 670-679Article in journal (Refereed) Published
Abstract [en]

This longitudinal study investigated whether smoking bans influence passive smoking at work and/or at home in the same subjects. Passive smoking at work and/or at home was investigated in random population samples (European Community Respiratory Health Survey) in 1990-95, with follow-up interviews in 1998-2003 and 2010-2014. National smoking bans were classified as partial (restricted to public workplaces) or global (extended to private workplaces). Multivariable analysis was accomplished by three-level logistic regression models, where level-1, level-2 and level-3 units were respectively questionnaire responses, subjects and centres. Passive smoking at work was reported by 31.9% in 1990-95, 17.5% in 1998-2003 and 2.5% in 2010-14. Concurrently passive smoking at home decreased from 28.9% to 18.2% and 8.8%. When controlling for sex, age, education, smoking status and ECHRS wave, the odds of passive smoking at work was markedly reduced after global smoking bans (OR=0.45, 95%CI 0.25-0.81), particularly among non-smokers, while the protective effect of global smoking bans on passive smoking at home was only detected in non-smokers. Smoking bans both in public and private workplaces were effective in reducing passive smoking at work in Europe. However, given the inefficacy of smoking bans in current smokers' dwellings, better strategies are needed to avoid smoking indoors. 

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
follow-up study, home environment, secondhand smoke, smoking restriction, social settings, workplace
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-158174 (URN)10.1111/ina.12556 (DOI)000471273100013 ()30963644 (PubMedID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-07-10Bibliographically approved
Projects
The potential for prevention of heat related deaths when heat waves become more extreme [2009-00454_Forte]; Umeå UniversityClimate change, source water quality, treatment and distribution ? assessment of microbial risks from health studies [2010-134_Formas]; Umeå UniversityDoes traffic related air pollution accelerate brain aging and dementia? A prospective cohort study with individual exposure data [2011-01218_Forte]; Umeå UniversityShifting from car to active transport ? an integrated environment and health impact assessment [2012-01296_Forte]; Umeå UniversityTrichloramine (NCl3) in air of indoor swimming pools and its relationship to health effects in exposed children. [2013-431_Formas]; Umeå UniversityIs exercise in an air polluted place good or bad for health [2014-01908_Forte]; Umeå UniversityThe effects of noise, socioeconomic status and genetics in the relationship between air pollution and dementia [2015-1099_Formas]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0159-6657

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