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IJE Advance Access published online on July 1, 2008
International Journal of Epidemiology, doi:10.1093/ije/dyn136
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

Air pollution and lung function in the European Community Respiratory Health Survey

Thomas Götschi1, Jordi Sunyer2,3,4, Susan Chinn5, Roberto de Marco6, Bertil Forsberg7, James W Gauderman1, Raquel Garcia-Esteban2,4, Joachim Heinrich8, Bénédicte Jacquemin2,4, Deborah Jarvis5, Michela Ponzio9, Simona Villani9 and Nino Künzli1,2,4,10,*

1Department of Preventive Medicine, University of Southern California, Los Angeles, USA.
2Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain.
3Universitat Pompeu Fabra, Barcelona, Spain.
4CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
5National Heart and Lung Institute, Imperial College, London, UK.
6Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy.
7Department of Public Health and Clinical Medicine, Umeå University, Sweden.
8GSF—National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
9Department of Health Sciences, Section of Epidemiology and Medical Statistic, University of Pavia, Italy.
10Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.

*Corresponding author. Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain. E-mail: kuenzli{at}creal.cat


  Abstract

Background The association of long-term air pollution and lung function has not been studied across adult European multi-national populations before. The aim of this study was to determine the association between long-term urban background air pollution and lung function levels, as well as change in lung function among European adults.

Methods Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and the ratio thereof (FEV1/FVC) were assessed at baseline and after 9 years of follow-up in adults from 21 European centres (followed-up sample 5610). Fine particles (PM2.5) were measured in 2000/2001 using central monitors.

Results Despite sufficient statistical power no significant associations were found between city-specific annual mean PM2.5 and average lung function levels. The findings also do not support an effect on change in lung function, albeit statistical power was insufficient to significantly detect such an association.

Conclusions The inability to refuse the null hypothesis may reflect (i) no effect of urban air pollution on lung function or (ii) inherent biases due to the study design. Examples of the latter are lack of individual-level air quality assignment, not quantified within-city contrasts in traffic-related pollution, or the heterogeneity of the studied populations and their urban environments. Future studies on long-term effects of air pollution on lung function could increase statistical power and reduce potential misclassification and confounding by characterizing exposure on the level of individuals, capturing contrasts due to local sources, in particular traffic.

Keywords PM2.5, FEV1, FVC, adults, longitudinal, multilevel

Accepted 2 June 2008


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