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
N1 - Funding Information:
This research was completed using data collected through the 45 and Up Study ( www.saxinstitute.org.au ). The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW; and partners: the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; NSW Government Family & Community Services – Ageing, Carers and the Disability Council NSW; and the Australian Red Cross Blood Service. We thank the many thousands of people participating in the 45 and Up Study.
Funding Information:
This project was funded by Centre for Air Pollution, Energy and Health (CAR) and the Clean Air and Urban Landscapes (CAUL) hub of the Australian Government's National and Environmental Science Programme (NESP). This study is part of the “Understanding the impact of the social, economic and environmental factors on the health of Australians in mid - later life; where are the opportunities for prevention?” study ( National Health & Medical Research Council (NHMRC) Grant 402810 ) and we wish to acknowledge Philayrath Phongsavan for her tireless and effective coordination of the project.
Publisher Copyright:
© 2018
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
C2 - 30261462
AN - SCOPUS:85053782930
SN - 0160-4120
VL - 121
SP - 415
EP - 420
JO - Environment International
JF - Environment International
ER -
