Short-term air pollution exposure decreases lung function: a repeated measures study in healthy adults

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Abstract

Background

Daily changes in ambient concentrations of particulate matter, nitrogen oxides and ozone are associated with increased cardiopulmonary morbidity and mortality, with the lungs and their function being a vulnerable target.

Methods

To evaluate the association between daily changes in air pollution and lung function in healthy adults we obtained annual lung function measurements from a routine worker health surveillance program not designed for research purposes. Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), FEV1/FVC and Peak Expiratory flow (PEF) from a cohort of 2449 employees were associated with daily measurements of PM ₁₀, NO ₂ and ozone at a nearby monitoring station in the North of Belgium. Repeated measures were available for the period 2011–2015.

Results

The mean (SD) PM ₁₀ concentration on the day of the lung function test was 24.9 (15.5) μg/m ³. A 10 μg PM ₁₀/m ³ increase on the day of the clinical examination was associated with a 18.9 ml lower FVC (95% CI: -27.5 to −10.3, p < 0.0001), 12.8 ml lower FEV1 (−19.1 to −6.5; p < 0.0001), and a 51.4 ml/s lower PEF (−75.0 to −27.0; p < 0.0001). The FEV1/FVC-ratio showed no associations. An increase of 10 μgNO ₂/m ³ was associated with a reduction in PEF (−66.1 ml/s (−106.6 to −25.6; p < 0.001)) on the day of the examination.

Conclusions

We found negative associations between daily variations in ambient air pollution and FVC, FEV1 and PEF in healthy adults.

Electronic supplementary material

The online version of this article (doi:10.1186/s12940-017-0271-z) contains supplementary material, which is available to authorized users.

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Most cited references 20

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Short term exposure to air pollution and stroke: systematic review and meta-analysis

Anoop Shah, Kuan Lee, David McAllister … (2015)

Objective To review the evidence for the short term association between air pollution and stroke. Design Systematic review and meta-analysis of observational studies Data sources Medline, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science searched to January 2014 with no language restrictions. Eligibility criteria Studies investigating the short term associations (up to lag of seven days) between daily increases in gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate matter (<2.5 µm or <10 µm diameter (PM2.5 and PM10)), and admission to hospital for stroke or mortality. Main outcome measures Admission to hospital and mortality from stroke. Results From 2748 articles, 238 were reviewed in depth with 103 satisfying our inclusion criteria and 94 contributing to our meta-estimates. This provided a total of 6.2 million events across 28 countries. Admission to hospital for stroke or mortality from stroke was associated with an increase in concentrations of carbon monoxide (relative risk 1.015 per 1 ppm, 95% confidence interval 1.004 to 1.026), sulphur dioxide (1.019 per 10 ppb, 1.011 to 1.027), and nitrogen dioxide (1.014 per 10 ppb, 1.009 to 1.019). Increases in PM2.5 and PM10 concentration were also associated with admission and mortality (1.011 per 10 μg/m3 (1.011 to 1.012) and 1.003 per 10 µg/m3 (1.002 to 1.004), respectively). The weakest association was seen with ozone (1.001 per 10 ppb, 1.000 to 1.002). Strongest associations were observed on the day of exposure with more persistent effects observed for PM2·5. Conclusion Gaseous and particulate air pollutants have a marked and close temporal association with admissions to hospital for stroke or mortality from stroke. Public and environmental health policies to reduce air pollution could reduce the burden of stroke. Systematic review registration PROSPERO-CRD42014009225.

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Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis

Pablo Orellano, Nancy Quaranta, Julieta Reynoso … (2017)

Background Several observational studies have suggested that outdoor air pollution may induce or aggravate asthma. However, epidemiological results are inconclusive due to the presence of numerous moderators which influence this association. The goal of this study was to assess the relationship between outdoor air pollutants and moderate or severe asthma exacerbations in children and adults through a systematic review and multilevel meta-analysis. Material and methods We searched studies published in English on PubMed, Scopus, and Google Scholar between January 2000 and October 2016. Studies following a case-crossover design with records of emergency departments and/or hospital admissions as a surrogate of moderate or severe asthma exacerbations were selected. A multilevel meta-analysis was employed, taking into account the potential clustering effects within studies examining more than one lag. Odds ratios (ORs) and 95% confidence intervals were estimated. A subgroup analysis in children aged 0 to 18 years and a sensitivity analysis based on the quality of the included studies as defined in the Newcastle-Ottawa Scale were performed. Publication bias was evaluated through visual inspection of funnel plots and by a complementary search of grey literature. (Prospero Registration number CRD42015032323). Results Database searches retrieved 208 records, and finally 22 studies were selected for quantitative analysis. All pollutants except SO2 and PM10 showed a significant association with asthma exacerbations (NO2: 1.024; 95% CI: 1.005,1.043, SO2: 1.039; 95% CI: 0.988,1.094), PM10: 1.024; 95% CI: 0.995,1.053, PM2.5: 1.028; 95% CI: 1.009,1.047, CO: 1.045; 95% CI: 1.005,1.086, O3: 1.032; 95% CI: 1.005,1.060. In children, the association was significant for NO2, SO2 and PM2.5. Conclusion This meta-analysis provides evidence of the association between selected air pollutants and asthma exacerbations for different lags.

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Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis

Xue-Yan Zheng, Hong Ding, Li-na Jiang … (2015)

Background Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined. Objective We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations. Methods Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed. Results After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater. Conclusion Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.

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Author and article information

Contributors

Luc Int Panis:

ORCID: http://orcid.org/0000-0002-2558-4351

+32 14 33 51 45 , luc.intpanis@vito.be

Eline B Provost: eline.provost@vito.be

Bianca Cox: bianca.cox@uhasselt.be

Tijs Louwies: tijs.louwies@gmail.com

Michelle Laeremans: michelle.laeremans@vito.be

Arnout Standaert: arnout.standaert@vito.be

Evi Dons: evi.dons@vito.be

Luc Holmstock: lholmsto@sckcen.be

Tim Nawrot: tim.nawrot@uhasselt.be

Patrick De Boever: patrick.deboever@vito.be

Journal

Journal ID (nlm-ta): Environ Health

Journal ID (iso-abbrev): Environ Health

Title: Environmental Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1476-069X

Publication date (Electronic): 14 June 2017

Publication date PMC-release: 14 June 2017

Publication date Collection: 2017

Volume: 16

Electronic Location Identifier: 60

Affiliations

[1 ]ISNI 0000000120341548, GRID grid.6717.7, , Flemish Institute for Technological Research (VITO), ; Boeretang 200, 2400 Mol, Belgium

[2 ]ISNI 0000 0001 0604 5662, GRID grid.12155.32, , Transportation Research Institute, Hasselt University, ; Diepenbeek, Belgium

[3 ]ISNI 0000 0001 0604 5662, GRID grid.12155.32, , Centre for Environmental Sciences, Hasselt University, ; Diepenbeek, Belgium

[4 ]ISNI 0000 0000 9332 3503, GRID grid.8953.7, , The Belgian Nuclear Research Centre (SCK●CEN), ; Mol, Belgium

[5 ]ISNI 0000 0001 0668 7884, GRID grid.5596.f, Department of Public Health, , Leuven University (KU Leuven), ; Leuven, Belgium

Author information

Luc Int Panis http://orcid.org/0000-0002-2558-4351

Article

Publisher ID: 271

DOI: 10.1186/s12940-017-0271-z

PMC ID: 5471732

PubMed ID: 28615020

SO-VID: 40805ea0-e007-4854-afbc-b5d7d91cf582

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 16 January 2017

Date accepted : 6 June 2017

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000781, European Research Council;

Award ID: ERC-2012-StG 310898

Award Recipient : Tim Nawrot

Funded by: FundRef http://dx.doi.org/10.13039/501100004963, Seventh Framework Programme;

Award ID: 602624-2

Award Recipient : Michelle Laeremans

Funded by: FundRef http://dx.doi.org/10.13039/501100003130, Fonds Wetenschappelijk Onderzoek;

Award ID: nvt

Award Recipient : Evi Dons

Custom metadata

ScienceOpen disciplines: Public health

Keywords: air pollution,spirometry,fev1,fvc,pef,particulate matter,pm10,ozone,respiratory health

Data availability:

ScienceOpen disciplines: Public health

Keywords: air pollution, spirometry, fev1, fvc, pef, particulate matter, pm10, ozone, respiratory health

Short-term air pollution exposure decreases lung function: a repeated measures study in healthy adults

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Abstract

Background

Methods

Results

Conclusions

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Pneumonia, sex, and the environment

Most cited references 20

Short term exposure to air pollution and stroke: systematic review and meta-analysis

Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis

Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis

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