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Impact of long-term exposure to ambient ozone on lung function over a course of 20 years (The ECRHS study): a prospective cohort study in adults
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
Institute of Psychology, Jagiellonian University, Krakow, Poland; “Health and Quality of Life in a Green and Sustainable Environment”, SRIPD, Medical University of Plovdiv, Plovdiv, Bulgaria.
National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC Centre for Environment & Health, London, United Kingdom.
Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
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2023 (English)In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 34, article id 100729Article in journal (Refereed) Published
Abstract [en]

Background: While the adverse effects of short-term ambient ozone exposure on lung function are well-documented, the impact of long-term exposure remains poorly understood, especially in adults.

Methods: We aimed to investigate the association between long-term ozone exposure and lung function decline. The 3014 participants were drawn from 17 centers across eight countries, all of which were from the European Community Respiratory Health Survey (ECRHS). Spirometry was conducted to measure pre-bronchodilation forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) at approximately 35, 44, and 55 years of age. We assigned annual mean values of daily maximum running 8-h average ozone concentrations to individual residential addresses. Adjustments were made for PM2.5, NO2, and greenness. To capture the ozone-related change in spirometric parameters, our linear mixed effects regression models included an interaction term between long-term ozone exposure and age.

Findings: Mean ambient ozone concentrations were approximately 65 μg/m³. A one interquartile range increase of 7 μg/m³ in ozone was associated with a faster decline in FEV1 of −2.08 mL/year (95% confidence interval: −2.79, −1.36) and in FVC of −2.86 mL/year (−3.73, −1.99) mL/year over the study period. Associations were robust after adjusting for PM2.5, NO2, and greenness. The associations were more pronounced in residents of northern Europe and individuals who were older at baseline. No consistent associations were detected with the FEV1/FVC ratio.

Interpretation: Long-term exposure to elevated ambient ozone concentrations was associated with a faster decline of spirometric lung function among middle-aged European adults over a 20-year period. Funding: German Research Foundation.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 34, article id 100729
Keywords [en]
Air pollution, Forced expiratory volume, Middle aged, NDVI, Spirometry, Vital capacity
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-214280DOI: 10.1016/j.lanepe.2023.100729Scopus ID: 2-s2.0-85169614645OAI: oai:DiVA.org:umu-214280DiVA, id: diva2:1795904
Available from: 2023-09-11 Created: 2023-09-11 Last updated: 2023-09-11Bibliographically approved

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Forsberg, BertilModig, Lars

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