umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Forsberg, Bertil
Alternative names
Publications (10 of 270) Show all publications
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
Show others...
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
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)30901873 (PubMedID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-04-01Bibliographically approved
Nerpin, E., Olivieri, M., Gislason, T., Olin, A., 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
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.
Show others...
2019 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222Article in journal (Refereed) Accepted
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)30934155 (PubMedID)
Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-04-08
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
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.
Show others...
2019 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668Article in journal (Refereed) Epub ahead of print
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. This article is protected by copyright. All rights reserved.

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)30963644 (PubMedID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-04-16
Mogensen, I., Alving, K., Dahlen, S.-E., James, A., Forsberg, B., Ono, J., . . . Malinovschi, A. (2019). Fixed airflow obstruction relates to eosinophil activation in asthmatics.. Clinical and Experimental Allergy, 49(2), 155-162
Open this publication in new window or tab >>Fixed airflow obstruction relates to eosinophil activation in asthmatics.
Show others...
2019 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 49, no 2, p. 155-162Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Some asthmatics develop irreversible chronic airflow obstruction, e.g., fixed airflow obstruction (fixed-AO). This is probably a consequence of airway remodeling, but neither its relation to inflammation, nor which asthma biomarkers can be clinically useful are elucidated. We hypothesized that the presence of type-2 inflammation relates to fixed-AO.

OBJECTIVES: Evaluate the presence of four markers for type-2 inflammation in fixed airflow obstruction among asthmatics.

METHODS: This was a cross-sectional study of 403 participants with asthma, aged 17-75 years, from three Swedish centers. Fixed airflow obstruction was defined as forced expiratory volume during the first second (FEV1 ) over forced vital capacity (FVC) being below the lower limit of normal (LLN). The following type-2 inflammation markers were assessed: exhaled nitric oxide (FeNO), serum periostin, serum eosinophil cationic protein (S-ECP) and urinary eosinophil-derived neurotoxin (U-EDN).

RESULTS: Elevated U-EDN (values in the highest tertile, ≥ 65.95 mg/mol creatinine) was more common in subjects with fixed-AO vs. subjects without fixed-AO: 55% vs. 29%, p<0.001. Elevated U-EDN related to increased likelihood of having fixed-AO in both all subjects and never-smoking subjects, with adjusted (adjusted for sex, age group, use of inhaled corticosteroids last week, atopy, early onset asthma, smoking history and packyears) odds ratios (aOR) of 2.38 (1.28-4.41) and 2.51 (1.04-6.07), respectively. In a separate analysis, having both elevated S-ECP (>20 μg/L) and U-EDN was related to having the highest likelihood of fixed-AO (aOR (95% CI) 6.06 (2.32-15.75)). Elevated serum periostin or FeNO did not relate to fixed-AO.

CONCLUSIONS AND CLINICAL RELEVANCE: These findings support that type-2 inflammation, and in particular eosinophil inflammation, is found in asthma with fixed-AO. This could indicate a benefit from eosinophil-directed therapies. Further longitudinal studies are warranted to investigate causality and relation to lung function decline. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-152938 (URN)10.1111/cea.13302 (DOI)000457469600003 ()30365193 (PubMedID)
Funder
Swedish Heart Lung FoundationSwedish Research CouncilStockholm County CouncilSwedish Asthma and Allergy AssociationSwedish Foundation for Strategic Research
Available from: 2018-10-30 Created: 2018-10-30 Last updated: 2019-02-22Bibliographically approved
Sera, F., Armstrong, B., Tobias, A., Vicedo-Cabrera, A. M., Åström, C., Bell, M. L., . . . Gasparrini, A. (2019). How urban characteristics affect vulnerability to heat and cold: a multi-country analysis. International Journal of Epidemiology, Article ID dyz008.
Open this publication in new window or tab >>How urban characteristics affect vulnerability to heat and cold: a multi-country analysis
Show others...
2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, article id dyz008Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The health burden associated with temperature is expected to increase due to a warming climate. Populations living in cities are likely to be particularly at risk, but the role of urban characteristics in modifying the direct effects of temperature on health is still unclear. In this contribution, we used a multi-country dataset to study effect modification of temperature-mortality relationships by a range of city-specific indicators.

METHODS: We collected ambient temperature and mortality daily time-series data for 340 cities in 22 countries, in periods between 1985 and 2014. Standardized measures of demographic, socio-economic, infrastructural and environmental indicators were derived from the Organisation for Economic Co-operation and Development (OECD) Regional and Metropolitan Database. We used distributed lag non-linear and multivariate meta-regression models to estimate fractions of mortality attributable to heat and cold (AF%) in each city, and to evaluate the effect modification of each indicator across cities.

RESULTS: Heat- and cold-related deaths amounted to 0.54% (95% confidence interval: 0.49 to 0.58%) and 6.05% (5.59 to 6.36%) of total deaths, respectively. Several city indicators modify the effect of heat, with a higher mortality impact associated with increases in population density, fine particles (PM2.5), gross domestic product (GDP) and Gini index (a measure of income inequality), whereas higher levels of green spaces were linked with a decreased effect of heat.

CONCLUSIONS: This represents the largest study to date assessing the effect modification of temperature-mortality relationships. Evidence from this study can inform public-health interventions and urban planning under various climate-change and urban-development scenarios.

Keywords
Temperature, cities, climate, epidemiology, heat, mortality
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-157116 (URN)10.1093/ije/dyz008 (DOI)30815699 (PubMedID)
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-03-15
Lytras, T., Kogevinas, M., Kromhout, H., Carsin, A.-E., Antó, J. M., Bentouhami, H., . . . Zock, J.-P. (2019). Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: the European Community Respiratory Health Survey. Occupational and Environmental Medicine, 76, 222-229
Open this publication in new window or tab >>Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: the European Community Respiratory Health Survey
Show others...
2019 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 76, p. 222-229Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey.

METHODS: Population samples aged 20-44 were randomly selected in 1991-1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations.

RESULTS: 8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides.

CONCLUSIONS: Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
epidemiology, longitudinal studies, respiratory, retrospective exposure assessment
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-156108 (URN)10.1136/oemed-2018-105274 (DOI)30700596 (PubMedID)
Available from: 2019-02-05 Created: 2019-02-05 Last updated: 2019-04-03Bibliographically approved
Carsin, A.-E., Fuertes, E., Schaffner, E., Jarvis, D., Antó, J. M., Heinrich, J., . . . Garcia-Aymerich, J. (2019). Restrictive spirometry pattern is associated with low physical activity levels: A population based international study. Respiratory Medicine, 146, 116-123
Open this publication in new window or tab >>Restrictive spirometry pattern is associated with low physical activity levels: A population based international study
Show others...
2019 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 146, p. 116-123Article in journal (Refereed) Published
Abstract [en]

Introduction: Restrictive spirometry pattern is an under-recognised disorder with a poor morbidity and mortality prognosis. We compared physical activity levels between adults with a restrictive spirometry pattern and with normal spirometry.

Methods: Restrictive spirometry pattern was defined as a having post-bronchodilator FEV1/FVC ≥ Lower Limit of Normal and a FVC<80% predicted in two population-based studies (ECRHS-III and SAPALDIA3). Physical activity was measured using the International Physical Activity Questionnaire. The odds of having low physical activity (<1st study-specific tertile) was evaluated using adjusted logistic regression models.

Results: Subjects with a restrictive spirometry pattern (n = 280/4721 in ECRHS, n = 143/3570 in SAPALDIA) reported lower levels of physical activity than those with normal spirometry (median of 1770 vs 2253 MET·min/week in ECRHS, and 3519 vs 3945 MET·min/week in SAPALDIA). Subjects with a restrictive spirometry pattern were more likely to report low physical activity (meta-analysis odds ratio: 1.41 [95%CI 1.07–1.86]) than those with a normal spirometry. Obesity, respiratory symptoms, co-morbidities and previous physical activity levels did not fully explain this finding.

Conclusion: Adults with a restrictive spirometry pattern were more likely to report low levels of physical activity than those with normal spirometry. These results highlight the need to identify and act on this understudied but prevalent condition.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Restrictive spirometry pattern, Body mass index, Epidemiology, Lung function, Physical activity
National Category
Occupational Health and Environmental Health Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-154766 (URN)10.1016/j.rmed.2018.11.017 (DOI)000456074000018 ()2-s2.0-85058942184 (Scopus ID)
Available from: 2019-01-02 Created: 2019-01-02 Last updated: 2019-02-26Bibliographically approved
Accordini, S., Calciano, L., Johannessen, A., Portas, L., Benediktsdóttir, B., Bertelsen, R. J., . . . Svanes, C. (2018). A three-generation study on the association of tobacco smoking with asthma. International Journal of Epidemiology, 47(4), 1106-1117
Open this publication in new window or tab >>A three-generation study on the association of tobacco smoking with asthma
Show others...
2018 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 47, no 4, p. 1106-1117Article in journal (Refereed) Published
Abstract [en]

Background: Mothers' smoking during pregnancy increases asthma risk in their offspring. There is some evidence that grandmothers' smoking may have a similar effect, and biological plausibility that fathers' smoking during adolescence may influence offspring's health through transmittable epigenetic changes in sperm precursor cells. We evaluated the three-generation associations of tobacco smoking with asthma.

Methods: Between 2010 and 2013, at the European Community Respiratory Health Survey III clinical interview, 2233 mothers and 1964 fathers from 26 centres reported whether their offspring (aged ≤51 years) had ever had asthma and whether it had coexisted with nasal allergies or not. Mothers and fathers also provided information on their parents' (grandparents) and their own asthma, education and smoking history. Multilevel mediation models within a multicentre three-generation framework were fitted separately within the maternal (4666 offspring) and paternal (4192 offspring) lines.

Results: Fathers' smoking before they were 15 [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI): 1.01-2.01] and mothers' smoking during pregnancy (RRR = 1.27, 95% CI: 1.01-1.59) were associated with asthma without nasal allergies in their offspring. Grandmothers' smoking during pregnancy was associated with asthma in their daughters [odds ratio (OR) = 1.55, 95% CI: 1.17-2.06] and with asthma with nasal allergies in their grandchildren within the maternal line (RRR = 1.25, 95% CI: 1.02-1.55).

Conclusions: Fathers' smoking during early adolescence and grandmothers' and mothers' smoking during pregnancy may independently increase asthma risk in offspring. Thus, risk factors for asthma should be sought in both parents and before conception.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keywords
asthma, mothers’ smoking during pregnancy, grandmothers’ smoking during pregnancy, fathers’ smoking during puberty, multilevel mediation model, Ageing Lungs in European Cohorts (ALEC) Study
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-145740 (URN)10.1093/ije/dyy031 (DOI)000444559900020 ()29534228 (PubMedID)
Funder
EU, Horizon 2020, GA-633212
Available from: 2018-03-16 Created: 2018-03-16 Last updated: 2018-10-05Bibliographically 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)
Show others...
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
Organisations

Search in DiVA

Show all publications