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Arthur Hvidtfeldt, U., Chen, J., Jovanovic Andersen, Z., Atkinson, R., Bauwelinck, M., Bellander, T., . . . Raaschou-Nielsen, O. (2021). Long-term exposure to fine particle elemental components and lung cancer incidence in the ELAPSE pooled cohort. Environmental Research, 193, Article ID 110568.
Open this publication in new window or tab >>Long-term exposure to fine particle elemental components and lung cancer incidence in the ELAPSE pooled cohort
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2021 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 193, article id 110568Article in journal (Refereed) Published
Abstract [en]

Background: An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study builds on recent findings from the Effects of Low-level Air Pollution: A Study in Europe (ELAPSE) collaboration and addresses the potential association between specific elemental components of PM2.5 and lung cancer incidence.

Methods: We pooled seven cohorts from across Europe and assigned exposure estimates for eight components of PM2.5 representing non-tail pipe emissions (copper (Cu), iron (Fe), and zinc (Zn)), long-range transport (sulfur (S)), oil burning/industry emissions (nickel (Ni), vanadium (V)), crustal material (silicon (Si)), and biomass burning (potassium (K)) to cohort participants' baseline residential address based on 100 m by 100 m grids from newly developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status).

Results: The pooled study population comprised 306,550 individuals with 3916 incident lung cancer events during 5,541,672 person-years of follow-up. We observed a positive association between exposure to all eight components and lung cancer incidence, with adjusted HRs of 1.10 (95% CI 1.05, 1.16) per 50 ng/m(3) PM2.5 K, 1.09 (95% CI 1.02, 1.15) per 1 ng/m3 PM2.5 Ni, 1.22 (95% CI 1.11, 1.35) per 200 ng/m(3) PM2.5 S, and 1.07 (95% CI 1.02, 1.12) per 200 ng/m(3) PM2.5 V. Effect estimates were largely unaffected by adjustment for nitrogen dioxide (NO2). After adjustment for PM2.5 mass, effect estimates of K, Ni, S, and V were slightly attenuated, whereas effect estimates of Cu, Si, Fe, and Zn became null or negative.

Conclusions: Our results point towards an increased risk of lung cancer in connection with sources of combustion particles from oil and biomass burning and secondary inorganic aerosols rather than non-exhaust traffic emissions. Specific limit values or guidelines targeting these specific PM2.5 components may prove helpful in future lung cancer prevention strategies.

Keywords
Air pollution, Fine particulate matter, Elemental components, Lung cancer incidence, Pooled cohort
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:su:diva-191158 (URN)10.1016/j.envres.2020.110568 (DOI)000613939500009 ()33278469 (PubMedID)
Available from: 2021-03-10 Created: 2021-03-10 Last updated: 2022-03-01Bibliographically approved
Liu, S., Therming Jorgensen, J., Ljungman, P., Pershagen, G., Bellander, T., Leander, K., . . . Jovanovic Andersen, Z. (2021). Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project. European Respiratory Journal, 57(6), Article ID 2003099.
Open this publication in new window or tab >>Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project
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2021 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 57, no 6, article id 2003099Article in journal (Refereed) Published
Abstract [en]

Background: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 mu m (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in adults.

Methods: We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land-use regression models at participants' baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders.

Results: Of 98326 participants, 1965 developed asthma during a mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 mu g.m(-3) for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 mu g.m(-3) for NO2 and 1.15 (95% CI 1.08-1.23) per 0.5 x 10(-5) m(-1) for BC. Hazard ratios were larger in cohort subsets with exposure levels below the European Union and US limit values and possibly World Health Organization guidelines for PM2.5 and NO2. NO 2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration-response curves showed no evidence of a threshold.

Conclusions: Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.

National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:su:diva-194978 (URN)10.1183/13993003.030992020 (DOI)000658388200006 ()33303534 (PubMedID)
Available from: 2021-07-29 Created: 2021-07-29 Last updated: 2022-03-07Bibliographically approved
Liu, S., Jørgensen, J. T., Ljungman, P., Pershagen, G., Bellander, T., Leander, K., . . . Andersen, Z. J. (2021). Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project. Environment International, 146, Article ID 106267.
Open this publication in new window or tab >>Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease: The ELAPSE project
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2021 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 146, article id 106267Article in journal (Refereed) Published
Abstract [en]

Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent.

Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence.

Methods: Within the 'Effects of Low-Level Air Pollution: A Study in Europe' (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 mu m (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants' baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models.

Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 mu g/m(3) for PM2.5, 1.11 (1.06, 1.16) per 10 mu g/m(3) for NO2, and 1.11 (1.06, 1.15) per 0.5 10(-5) m(-1) for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC.

Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant.

Keywords
Air pollution, COPD incidence, Low-level exposure
National Category
Earth and Related Environmental Sciences
Identifiers
urn:nbn:se:su:diva-190064 (URN)10.1016/j.envint.2020.106267 (DOI)000604625600001 ()33276316 (PubMedID)
Available from: 2021-02-17 Created: 2021-02-17 Last updated: 2025-02-07Bibliographically approved
Roswall, N., Pyko, A., Ögren, M., Oudin, A., Rosengren, A., Lager, A., . . . Sørensen, M. (2021). Long-Term Exposure to Transportation Noise and Risk of Incident Stroke: A Pooled Study of Nine Scandinavian Cohorts. Journal of Environmental Health Perspectives, 129(10), Article ID 107002.
Open this publication in new window or tab >>Long-Term Exposure to Transportation Noise and Risk of Incident Stroke: A Pooled Study of Nine Scandinavian Cohorts
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2021 (English)In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 129, no 10, article id 107002Article in journal (Refereed) Published
Abstract [en]

Background: Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse.

Objective: We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population.

Methods: We harmonized and pooled data from nine Scandinavian cohorts (seven Swedish, two Danish), totaling 135,951 participants. We identified residential address history and estimated road, railway, and aircraft noise for all addresses. Information on stroke incidence was acquired through linkage to national patient and mortality registries. We analyzed data using Cox proportional hazards models, including socioeconomic and lifestyle confounders, and air pollution.

Results: During follow-up (median=19.5y), 11,056 stroke cases were identified. Road traffic noise (Lden) was associated with risk of stroke, with a hazard ratio (HR) of 1.06 [95% confidence interval (CI): 1.03, 1.08] per 10-dB higher 5-y mean time-weighted exposure in analyses adjusted for individual- and area-level socioeconomic covariates. The association was approximately linear and persisted after adjustment for air pollution [particulate matter (PM) with an aerodynamic diameter of ≤2.5μm (PM2.5) and NO2]. Stroke was associated with moderate levels of 5-y aircraft noise exposure (40–50 vs. ≤40 dB) (HR=1.12; 95% CI: 0.99, 1.27), but not with higher exposure (≥50 dB, HR=0.94HR; 95% CI: 0.79, 1.11). Railway noise was not associated with stroke.

Discussion: In this pooled study, road traffic noise was associated with a higher risk of stroke. This finding supports road traffic noise as an important cardiovascular risk factor that should be included when estimating the burden of disease due to traffic noise.

National Category
Public Health, Global Health and Social Medicine Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:su:diva-198558 (URN)10.1289/EHP8949 (DOI)000705561000001 ()34605674 (PubMedID)
Available from: 2021-11-12 Created: 2021-11-12 Last updated: 2025-02-20Bibliographically approved
Hvidtfeldt, U. A., Severi, G., Jovanovic Andersen, Z., Atkinson, R., Bauwelinck, M., Bellander, T., . . . Fecht, D. (2021). Long-term low-level ambient air pollution exposure and risk of lung cancer - A pooled analysis of 7 European cohorts. Environment International, 146, Article ID 106249.
Open this publication in new window or tab >>Long-term low-level ambient air pollution exposure and risk of lung cancer - A pooled analysis of 7 European cohorts
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2021 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 146, article id 106249Article in journal (Refereed) Published
Abstract [en]

Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence.

Methods: The Effects of Low-level Air Pollution: a Study in Europe (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O-3) to assign exposure to cohort participants' residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socioeconomic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines.

Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O-3 (warm season) were 24.2 mu g/m(3) (19.5, 29.7), 15.4 mu g/m(3) (12.8, 17.3), 1.6 10(-5)m(-1) (1.3, 1.8), and 86.6 mu g/m(3) (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 mu g/m(3)). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset of subjects with exposure below the EU limit value of 25 mu g/m(3). We did not observe associations between NO2, BC or O-3 and lung cancer incidence.

Conclusions: Long-term ambient PM2.5 exposure is associated with lung cancer incidence even at concentrations below current EU limit values and possibly WHO Air Quality Guidelines.

Keywords
Air pollution, Lung cancer incidence, Particulate matter, Dose response relationship
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:su:diva-190078 (URN)10.1016/j.envint.2020.106249 (DOI)000604626300010 ()33197787 (PubMedID)
Available from: 2021-02-16 Created: 2021-02-16 Last updated: 2022-03-01Bibliographically approved
Pedersen, M., Stafoggia, M., Weinmayr, G., Andersen, Z. J., Galassi, C., Sommar, J., . . . Raaschou-Nielsen, O. (2018). Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts. European Urology Focus, 4(1), 113-120
Open this publication in new window or tab >>Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts
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2018 (English)In: European Urology Focus, E-ISSN 2405-4569, Vol. 4, no 1, p. 113-120Article in journal (Refereed) Published
Abstract [en]

Background: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population. Objective: To evaluate the association between long-term exposure to ambient air pollution and BC incidence. Design, setting and participants: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N = 303 431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10 mu m (PM10), <2.5 mu m (PM2.5). between 2.5 and 10 mu m (PM2.5-10). PM2.5 absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project. Outcome measurements and statistical analysis: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRS) for BC incidence. Results and limitations: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-mu g/m(3) increase in NO2 and 51-mu g/m(3) increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure. Conclusions: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC. Patient summary: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk.

Keywords
Air pollution, Bladder cancer, Environment, Prevention
National Category
Clinical Medicine Cancer and Oncology
Identifiers
urn:nbn:se:su:diva-175001 (URN)10.1016/j.euf.2016.11.008 (DOI)000486142900029 ()28753823 (PubMedID)
Available from: 2019-10-15 Created: 2019-10-15 Last updated: 2025-02-18Bibliographically approved
Raaschou-Nielsen, O., Beelen, R., Wang, M., Hoek, G., Andersen, Z. J., Hoffmann, B., . . . Vineis, P. (2016). Particulate matter air pollution components and risk for lung cancer. Environment International, 87, 66-73
Open this publication in new window or tab >>Particulate matter air pollution components and risk for lung cancer
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2016 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 87, p. 66-73Article in journal (Refereed) Published
Abstract [en]

Background: Particulate matter (PM) air pollution is a human lung carcinogen; however, the components responsible have not been identified. We assessed the associations between PM components and lung cancer incidence. Methods: We used data from 14 cohort studies in eight European countries. We geocoded baseline addresses and assessed air pollution with land-use regression models for eight elements (Cu, Fe, K, Ni, S, Si, V and Zn) in size fractions of PM2.5 and PM10. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effect models for meta-analysis. Results: The 245,782 cohort members contributed 3,229,220 person-years at risk. During follow-up (mean, 13.1 years), 1878 incident cases of lung cancer were diagnosed. In the meta-analyses, elevated hazard ratios (HRs) for lung cancer were associated with all elements except V; none was statistically significant In analyses restricted to participants who did not change residence during follow-up, statistically significant associations were found for PM2.5 Cu (HR, 125; 95% Cl, 1.01-1.53 per 5 ng/m(3)), PM10 Zn (1.28; 1.02-1.59 per 20 ng/m3), PMio S (1.58; 1.03-2.44 per 200 ng/m(3)), PM10 Ni (1.59; 1.12-2.26 per 2 ng/m(3)) and PM10K (1.17; 1.02-1.33 per 100 ng/m(3)). In two-pollutant models, associations between PMio and PM2.5 and lung cancer were largely explained by PM2.5 S. Conclusions: This study indicates that the association between PM in air pollution and lung cancer can be attributed to various PM components and sources. PM containing S and Ni might be particularly important.

Keywords
Air pollution, Particulate matter, Sulfur, Nickel, Cohort study, Lung cancer
National Category
Earth and Related Environmental Sciences Occupational Health and Environmental Health
Identifiers
urn:nbn:se:su:diva-159615 (URN)10.1016/j.envint.2015.11.007 (DOI)000368951700008 ()26641521 (PubMedID)
Available from: 2018-09-06 Created: 2018-09-06 Last updated: 2025-01-31Bibliographically approved
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4138-9828

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