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Vehicle exhaust exposure in an incident case-control study of adult asthma
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
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2006 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 28, no 1, 75-81 p.Article in journal (Refereed) Published
Abstract [en]

The objective of this case–control study was to evaluate whether traffic-related air pollution exposure at home increases the risk of asthma in adults and to compare two commonly used exposure variables and differences between urban and rural living. Incident cases of asthma and matched controls of subjects aged 20–60 yrs were recruited in Luleå, Sweden. In total 203 cases and 203 controls were enrolled in the study. Exposure was estimated by traffic flow and measured levels of outdoor nitrogen dioxide (NO2) in the surrounding environment of each home, respectively. The relationship between measured levels of NO2 and traffic flow was studied using linear regression. The results indicated a nonsignificant tendency between living in a home close to a high traffic flow and an increased risk of asthma. The association between asthma and measured NO2 was weak and not significant, but the skin-prick test result acted as an effect modifier with a borderline significant association among positives. The correlation between traffic flow and outdoor NO2 was low. The results suggest that living close to high traffic flows might increase the asthma incidence in adults, while the tendency for nitrogen dioxide was only seen among atopics. Traffic flow and nitrogen dioxide had a lower than expected correlation.

Place, publisher, year, edition, pages
Copenhagen: Munksgaard , 2006. Vol. 28, no 1, 75-81 p.
Keyword [en]
Adult, Air Pollution, Asthma/epidemiology/*etiology/*pathology, Case-Control Studies, Environmental Exposure, Female, Humans, Incidence, Male, Middle Aged, Motor Vehicles, Nitrogen Dioxide/*analysis, Regression Analysis, Risk Factors, Rural Population, Sweden, Urban Population, Vehicle Emissions/*toxicity
National Category
Environmental Health and Occupational Health
Identifiers
URN: urn:nbn:se:umu:diva-5907DOI: 10.1183/09031936.06.00071505PubMedID: 16540504OAI: oai:DiVA.org:umu-5907DiVA: diva2:145575
Available from: 2007-12-03 Created: 2007-12-03 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Asthma, rhinitis, and asthma-related symptoms in relation to vehicle exhaust using different exposure metrics
Open this publication in new window or tab >>Asthma, rhinitis, and asthma-related symptoms in relation to vehicle exhaust using different exposure metrics
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Air pollution is a well known public health problem that involves both long-term and acute effects. An outcome associated with traffic-related air pollution is respiratory illness. Many studies have described the relationship between asthmatic symptoms and traffic-related air pollution; however, few have investigated the potential of air pollution to cause asthma itself, especially among adults.

The overall aim of this thesis was to study the relationship between vehicle exhaust levels at home and the prevalence of self-reported annoyance and asthmatic symptoms, and the incidence of asthma and rhinitis. These relationships were evaluated using different indicators of exposure with a high spatial resolution.

Three different data sets were used for the four papers included in this thesis. The first paper (paper I) is based on a questionnaire that was sent to a random selection of the adult population within three Swedish cities (Gothenburg, Uppsala, and Umeå) as part of the Swedish Environmental Protection Agency’s health-related environmental monitoring. The aim was to study the degree of self-reported annoyance and the prevalence of asthmatic symptoms in relation to the levels of vehicle exhaust outside the home. The level of exposure was described using modeled levels of nitrogen dioxide (NO2) as the exposure indicator.

The second paper (paper II) is based on new asthma cases identified within the Obstructive Lung disease In Northern Sweden (OLIN) study, each with a matched referent. The aim of this study was to analyze if new cases of asthma had higher levels of vehicle exhaust outside the home compared to the population controls. Exposure was assessed using both measured levels of NO2 outside each home, and by summarizing the amount of traffic within a 200 metre buffer surrounding each participant’s home.

Papers III and IV were based on the Respiratory Health in Northern Europe (RHINE) Cohort, a prospective cohort of adults included in 1990 and followed up with in 1999. The proportion of new cases of asthma (papers III and IV) and rhinitis (paper IV) were identified based on the answers from the initial and follow-up questionnaires. In paper III, exposure was assessed by using meteorological dispersion models to calculate the levels of NO2 outside each home as an indicator of the levels of vehicle exhaust. As an alternative indicator, the distance from each participant’s home to the nearest major road was calculated using geographical information system (GIS) tools. The exposure assessment in paper IV was also based on meteorological dispersion models, but expressed the levels of vehicle exhaust as particle mass concentration.

The results show that the levels of vehicle exhaust outside the home are significantly correlated with the degree of self-reported annoyance and the prevalence of asthmatic symptoms, and also with the risk of developing asthma, but not rhinitis, among adults. The odds ratio (OR) for high annoyance to vehicle exhaust and reporting asthmatic symptoms was 1.14 (95% Confidence Interval, CI 1.11-1.18) and 1.04 (95% CI 1.01-1.07) per 1 µg/m3 increase in the NO2 level outside the home, respectively. Paper II showed there was a non-significant tendency for increased risk of developing asthma among those living with high levels of vehicle exhaust outside their home. This finding was then supported by papers III and IV, showing a significant relationship between the onset of asthma and the mean (winter) levels of NO2 outside the home (OR=1.46, 95% CI 1.07-1.99 per 10 µg/m3) and the levels of vehicle exhaust particles outside the home. In paper III, living close to a major road was significantly related to the risk of developing asthma. No significant results were shown between vehicle exhaust and rhinitis.

In conclusion, vehicle exhaust outside the home is associated with the prevalence of annoyance and asthmatic symptoms, and with the risk of developing asthma, but not rhinitis, among adults.

Place, publisher, year, edition, pages
Umeå: Folkhälsa och klinisk medicin, 2009. 60 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1269
Keyword
Asthma, rhinitis, asthmatic symptoms, annoyance, vehicle exhaust
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-22315 (URN)978-91-7264-793-0 (ISBN)
Distributor:
Yrkes- och miljömedicin, 901 87, Umeå
Public defence
2009-05-29, Major Groove, by 6L, Umeå Universitet (NUS), 901 87, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-05-11 Created: 2009-05-05 Last updated: 2010-01-18Bibliographically approved

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