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Asthma, rhinitis, and asthma-related symptoms in relation to vehicle exhaust using different exposure metrics
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
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 [en]
Asthma, rhinitis, asthmatic symptoms, annoyance, vehicle exhaust
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:umu:diva-22315ISBN: 978-91-7264-793-0 (print)OAI: oai:DiVA.org:umu-22315DiVA: diva2:214570
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
List of papers
1. Perceived annoyance and asthmatic symptoms in relation to vehicle exhaust levels outside home: a cross-sectional study
Open this publication in new window or tab >>Perceived annoyance and asthmatic symptoms in relation to vehicle exhaust levels outside home: a cross-sectional study
2007 (English)In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 6, 29- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Exhaust emissions from vehicles is a well known problem with both epidemiological and experimental studies showing increasing adverse health effects with elevating levels. Many of the studies concerning vehicle exhausts and health are focused on health outcomes where the proportion attributed to exhaust is low, while there is less information on early and more frequent subjective indicators of adverse effects.

METHODS: The primary aim of this study was to study perceived annoyance in relation to vehicle exhaust concentrations using modelled levels of nitrogen dioxide outside the home as an indicator with high spatial resolution. Almost 2800 persons in a random sample from three Swedish cities (Umea, Uppsala and Gothenburg) responded to our questionnaire. Questions were asked to determine the degree of annoyance related to vehicle exhausts and also the prevalence of irritating and asthmatic symptoms. Exposure was described for each participants home address by meteorological dispersion models with a 50 meter resolution.

RESULTS: We found a significant increase of peoples' self-assessed annoyance with rising levels of NO2. The odds of being very annoyed by vehicle exhausts increased by 14% per 1 microg/m3 increase of the NO2 level (odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.11-1.18), and the odds of reporting the air as daily or almost daily irritating increased by 9% (OR = 1.09, 95% CI = 1.05-1.13). Also the odds of reporting asthmatic symptoms increased significantly with elevated NO2 levels (OR = 1.04, 95% CI = 1.01-1.07).

CONCLUSION: This study found the degree of annoyance related to vehicle exhaust and irritating and asthmatic symptoms to be significantly dependent on the levels of traffic related pollutants outside the home. The detailed exposure assessment lowers the degree of misclassification as compared to between-city analyses, which makes the results more accurate and applicable on the local scale.

Identifiers
urn:nbn:se:umu:diva-18825 (URN)10.1186/1476-069X-6-29 (DOI)17903240 (PubMedID)
Available from: 2009-02-25 Created: 2009-02-25 Last updated: 2017-12-13Bibliographically approved
2. Vehicle exhaust exposure in an incident case-control study of adult asthma
Open this publication in new window or tab >>Vehicle exhaust exposure in an incident case-control study of adult asthma
Show others...
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
Keyword
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:nbn:se:umu:diva-5907 (URN)10.1183/09031936.06.00071505 (DOI)16540504 (PubMedID)
Available from: 2007-12-03 Created: 2007-12-03 Last updated: 2017-12-14Bibliographically approved
3. Vehicle exhaust outside the home and onset of asthma among adults
Open this publication in new window or tab >>Vehicle exhaust outside the home and onset of asthma among adults
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2009 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 33, no 6, 1261-7 p.Article in journal (Refereed) Published
Abstract [en]

Few studies have investigated the relationship between vehicle exhaust and new onset of asthma among adults. The aim of this prospective cohort study was to investigate the relationship between the cumulative incidence of asthma and onset asthma among adults and vehicle exhaust concentrations at home.Participants from three Swedish cities included in the RHINE (Respiratory Health in Northern Europe) Cohort constituted the study population. Exposure at each participant's home was calculated using dispersion models. We also used less than 50 meter distance to nearest major road as a more simple indicator of exposure. The adjusted model included 3609 participants of which 107 were classified as onset cases and 55 as true incident cases of asthma.There was a positive association between asthma onset (Odds Ratio, OR per 10 microg.m(-3) = 1.46, 95% Confidence Interval (CI) 1.07-1.99) and incident asthma (OR per 10 microg.m(-3) = 1.54, 95% CI 1.00-2.36) and the levels of NO2 which remained statistically significant after adjusting for potential confounders. The relationship between asthma and NO2 was not significantly modified by sex, hay fever or wheeze.This study suggests that elevated levels of vehicle exhaust outside the home increase the risk of onset and incident asthma among adults.

National Category
Environmental Health and Occupational Health
Identifiers
urn:nbn:se:umu:diva-22310 (URN)10.1183/09031936.00101108 (DOI)19251785 (PubMedID)
Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2017-12-13Bibliographically approved
4. Levels of vehicle exhaust particles outside the home and the development of rhinitis and asthma among adults
Open this publication in new window or tab >>Levels of vehicle exhaust particles outside the home and the development of rhinitis and asthma among adults
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(English)Manuscript (Other academic)
Identifiers
urn:nbn:se:umu:diva-22311 (URN)
Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2010-01-14Bibliographically approved

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