Ambient air pollution and adult asthma incidence in six european cohorts (Escape)

Bénédicte Jacquemin, Valérie Siroux, Margaux Sanchez, Anne Elie Carsin, Tamara Schikowski, Martin Adam, Valeria Bellisario, Anna Buschka, Roberto Bono, Bert Brunekreef, Yutong Cai, Marta Cirach, Françoise Clavel-Chapelon, Christophe Declercq, Roberto de Marco, Audrey De Nazelle, Regina E. Ducret-Stich, Virginia Valeria Ferretti, Margaret W. Gerbase, Rebecca HardyJoachim Heinrich, Christer Janson, Deborah Jarvis, Zeinab Al Kanaani, Dirk Keidel, Diana Kuh, Nicole Le Moual, Mark J. Nieuwenhuijsen, Alessandro Marcon, Lars Modig, Isabelle Pin, Thierry Rochat, Christian Schindler, Dorothea Sugiri, Morgane Stempfelet, Sofia Temam, Ming Yi Tsai, Raphaëlle Varraso, Danielle Vienneau, Andrea Vierkötter, Anna L. Hansell, Ursula Krämer, Nicole M. Probst-Hensch, Jordi Sunyer, Nino Künzli, Francine Kauffmann

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Background: Short-term exposure to air pollution has adverse effects among patients with asthma, but whether long-term exposure to air pollution is a cause of adult-onset asthma is unclear. Objective: We aimed to investigate the association between air pollution and adult onset asthma. Methods: Asthma incidence was prospectively assessed in six European cohorts. Exposures studied were annual average concentrations at home addresses for nitrogen oxides assessed for 23,704 participants (including 1,257 incident cases) and particulate matter (PM) assessed for 17,909 participants through ESCAPE land-use regression models and traffic exposure indicators. Meta-analyses of cohort-specific logistic regression on asthma incidence were performed. Models were adjusted for age, sex, overweight, education, and smoking and included city/area within each cohort as a random effect. Results: In this longitudinal analysis, asthma incidence was positively, but not significantly, associated with all exposure metrics, except for PM<inf>coarse</inf>. Positive associations of borderline significance were observed for nitrogen dioxide [adjusted odds ratio (OR) = 1.10; 95% CI: 0.99, 1.21 per 10 μg/m<sup>3</sup>; p = 0.10] and nitrogen oxides (adjusted OR = 1.04; 95% CI: 0.99, 1.08 per 20 μg/m<sup>3</sup>; p = 0.08). Nonsignificant positive associations were estimated for PM<inf>10</inf> (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 10 μg/m<sup>3</sup>), PM<inf>2.5</inf> (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 5 μg/m<sup>3</sup>), PM<inf>2.5absorbance</inf> (adjusted OR = 1.06; 95% CI: 0.95, 1.19 per 10<sup>−5</sup>/m), traffic load (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 4 million vehicles × meters/day on major roads in a 100-m buffer), and traffic intensity (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 5,000 vehicles/day on the nearest road). A nonsignificant negative associa-tion was estimated for PM<inf>coarse</inf> (adjusted OR = 0.98; 95% CI: 0.87, 1.14 per 5 μg/m<sup>3</sup>). Conclusions: Results suggest a deleterious effect of ambient air pollution on asthma incidence in adults. Further research with improved personal-level exposure assessment (vs. residential exposure assessment only) and phenotypic characterization is needed.

Original languageEnglish
Pages (from-to)613-621
Number of pages9
JournalEnvironmental Health Perspectives
Issue number6
Publication statusPublished - 2015
Externally publishedYes


ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Public Health, Environmental and Occupational Health

Cite this

Jacquemin, B., Siroux, V., Sanchez, M., Carsin, A. E., Schikowski, T., Adam, M., Bellisario, V., Buschka, A., Bono, R., Brunekreef, B., Cai, Y., Cirach, M., Clavel-Chapelon, F., Declercq, C., de Marco, R., De Nazelle, A., Ducret-Stich, R. E., Ferretti, V. V., Gerbase, M. W., ... Kauffmann, F. (2015). Ambient air pollution and adult asthma incidence in six european cohorts (Escape). Environmental Health Perspectives, 123(6), 613-621.