Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases

A prospective cohort study in Australia

Farhad Salimi, Geoffrey Morgan, Margaret Rolfe, Evangelia Samoli, Christine T. Cowie, Ivan Hanigan, Luke Knibbs, Martin Cope, Fay H. Johnston, Yuming Guo, Guy B. Marks, Jane Heyworth, Bin Jalaludin

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Abstract

Background: Short- and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure. Objectives: We assessed the association between spatial variation in long-term exposure to PM 2.5 and NO 2 and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations. Methods: We recorded data on hospitalisations for 100,084 participants, who were aged >45 years at entry in 2006–2009 until June 2014. Annual NO 2 and PM 2.5 concentrations were estimated for the participants’ residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI. Results: NO 2 and PM 2.5 annual mean exposure estimates were 17.5 μg·m −3 and 4.5 μg·m −3 respectively. NO 2 and PM 2.5 was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 μg·m −3 increase in PM 2.5 was 1.08, 95% confidence interval 0.89–1.30. The adjusted hazard ratio for a 5 μg·m −3 increase in NO 2 was 1.03, 95% confidence interval 0.88–1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD. Conclusions: We found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases.

Original languageEnglish
Pages (from-to)415-420
Number of pages6
JournalEnvironment International
Volume121
DOIs
Publication statusPublished - 1 Dec 2018

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respiratory disease
asthma
pneumonia
atmospheric pollution
hazard
confidence interval
morbidity
air pollutant
exposure
smoking
spatial variation
education

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Salimi, Farhad ; Morgan, Geoffrey ; Rolfe, Margaret ; Samoli, Evangelia ; Cowie, Christine T. ; Hanigan, Ivan ; Knibbs, Luke ; Cope, Martin ; Johnston, Fay H. ; Guo, Yuming ; Marks, Guy B. ; Heyworth, Jane ; Jalaludin, Bin. / Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases : A prospective cohort study in Australia. In: Environment International. 2018 ; Vol. 121. pp. 415-420.
@article{af5a8a50ed6b4f6587bcd755ce27c4cb,
title = "Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases: A prospective cohort study in Australia",
abstract = "Background: Short- and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure. Objectives: We assessed the association between spatial variation in long-term exposure to PM 2.5 and NO 2 and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations. Methods: We recorded data on hospitalisations for 100,084 participants, who were aged >45 years at entry in 2006–2009 until June 2014. Annual NO 2 and PM 2.5 concentrations were estimated for the participants’ residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI. Results: NO 2 and PM 2.5 annual mean exposure estimates were 17.5 μg·m −3 and 4.5 μg·m −3 respectively. NO 2 and PM 2.5 was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 μg·m −3 increase in PM 2.5 was 1.08, 95{\%} confidence interval 0.89–1.30. The adjusted hazard ratio for a 5 μg·m −3 increase in NO 2 was 1.03, 95{\%} confidence interval 0.88–1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD. Conclusions: We found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases.",
keywords = "Air pollution, Cohort study, Hospitalisation, Low concentration, Particulate matter, Respiratory",
author = "Farhad Salimi and Geoffrey Morgan and Margaret Rolfe and Evangelia Samoli and Cowie, {Christine T.} and Ivan Hanigan and Luke Knibbs and Martin Cope and Johnston, {Fay H.} and Yuming Guo and Marks, {Guy B.} and Jane Heyworth and Bin Jalaludin",
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Salimi, F, Morgan, G, Rolfe, M, Samoli, E, Cowie, CT, Hanigan, I, Knibbs, L, Cope, M, Johnston, FH, Guo, Y, Marks, GB, Heyworth, J & Jalaludin, B 2018, 'Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases: A prospective cohort study in Australia', Environment International, vol. 121, pp. 415-420. https://doi.org/10.1016/j.envint.2018.08.050

Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases : A prospective cohort study in Australia. / Salimi, Farhad; Morgan, Geoffrey; Rolfe, Margaret; Samoli, Evangelia; Cowie, Christine T.; Hanigan, Ivan; Knibbs, Luke; Cope, Martin; Johnston, Fay H.; Guo, Yuming; Marks, Guy B.; Heyworth, Jane; Jalaludin, Bin.

In: Environment International, Vol. 121, 01.12.2018, p. 415-420.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term exposure to low concentrations of air pollutants and hospitalisation for respiratory diseases

T2 - A prospective cohort study in Australia

AU - Salimi, Farhad

AU - Morgan, Geoffrey

AU - Rolfe, Margaret

AU - Samoli, Evangelia

AU - Cowie, Christine T.

AU - Hanigan, Ivan

AU - Knibbs, Luke

AU - Cope, Martin

AU - Johnston, Fay H.

AU - Guo, Yuming

AU - Marks, Guy B.

AU - Heyworth, Jane

AU - Jalaludin, Bin

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Short- and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure. Objectives: We assessed the association between spatial variation in long-term exposure to PM 2.5 and NO 2 and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations. Methods: We recorded data on hospitalisations for 100,084 participants, who were aged >45 years at entry in 2006–2009 until June 2014. Annual NO 2 and PM 2.5 concentrations were estimated for the participants’ residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI. Results: NO 2 and PM 2.5 annual mean exposure estimates were 17.5 μg·m −3 and 4.5 μg·m −3 respectively. NO 2 and PM 2.5 was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 μg·m −3 increase in PM 2.5 was 1.08, 95% confidence interval 0.89–1.30. The adjusted hazard ratio for a 5 μg·m −3 increase in NO 2 was 1.03, 95% confidence interval 0.88–1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD. Conclusions: We found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases.

AB - Background: Short- and long-term spatiotemporal variation in exposure to air pollution is associated with respiratory morbidity in areas with moderate-to-high level of air pollution, but very few studies have examined whether these associations also exist in areas with low level exposure. Objectives: We assessed the association between spatial variation in long-term exposure to PM 2.5 and NO 2 and hospitalisation for all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), and pneumonia, in older adults residing in Sydney, Australia, a city with low-level concentrations. Methods: We recorded data on hospitalisations for 100,084 participants, who were aged >45 years at entry in 2006–2009 until June 2014. Annual NO 2 and PM 2.5 concentrations were estimated for the participants’ residential addresses and Cox proportional hazards regression was used to model the association between exposure to air pollutants and first episode of hospitalisation, controlling for personal and area level covariates. We further investigated the shape of the exposure-response association and potential effect modification by age, sex, education level, smoking status, and BMI. Results: NO 2 and PM 2.5 annual mean exposure estimates were 17.5 μg·m −3 and 4.5 μg·m −3 respectively. NO 2 and PM 2.5 was positively, although not significantly, associated with asthma. The adjusted hazard ratio for a 1 μg·m −3 increase in PM 2.5 was 1.08, 95% confidence interval 0.89–1.30. The adjusted hazard ratio for a 5 μg·m −3 increase in NO 2 was 1.03, 95% confidence interval 0.88–1.19. We found no positive statistically significant associations with hospitalisation for all respiratory diseases, and pneumonia while negative associations were observed with COPD. Conclusions: We found weak positive associations of exposure to air pollution with hospitalisation for asthma while there was no evidence of an association for all respiratory diseases.

KW - Air pollution

KW - Cohort study

KW - Hospitalisation

KW - Low concentration

KW - Particulate matter

KW - Respiratory

UR - http://www.scopus.com/inward/record.url?scp=85053782930&partnerID=8YFLogxK

U2 - 10.1016/j.envint.2018.08.050

DO - 10.1016/j.envint.2018.08.050

M3 - Article

VL - 121

SP - 415

EP - 420

JO - Environmental International

JF - Environmental International

SN - 0160-4120

ER -