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Published online before print May 14, 2009, 10.1183/09031936.00138208
Eur Respir J 2009; 34:834-842
Copyright ©ERS Journals Ltd 2009
doi: 10.1183/09031936.00138208

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Association between modelled traffic-related air pollution and asthma score in the ECRHS

B. Jacquemin1,2, J. Sunyer1,3,4,5, B. Forsberg6, I. Aguilera1,3,4, L. Bouso1,3,4, D. Briggs7, R. de Marco8, R. García-Esteban1,3,4, J. Heinrich9, D. Jarvis10, J. A. Maldonado11, F. Payo12, E. Rage2, D. Vienneau7 and N. Künzli1,3,4,13

1 Centre for Research in Environmental Epidemiology (CREAL), 3 Municipal Institute of Medical Research (IMIM)-Hospital del Mar, 4 CIBER in Epidemiology and Public Health (CIBERESP), 5 Dept of Health and Experimental Sciences, University Pompeu Fabra, 13 Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, 11 Hospital Juan Ramon Jimenez, Huelva, and 12 Hospital Central de Asturias, Oviedo, Spain. 2 INSERM U780, Epidemiology and Biostatistics, University Paris-Sud, Villejuif, France. 6 Occupational and Environmental Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 7 Dept of Respiratory Epidemiology and Public Health, Imperial College, 10 National Heart and Lung Institute, Imperial College London, London, UK. 8 Dept of Medicine and Public Health, University of Verona, Verona, Italy. 9 Institute of Epidemiology, Helmholtz Zentrum München, Munich, Germany.

CORRESPONDENCE: B. Jacquemin, Inserm U780, Epidémiologie et Biostatistique, 16, avenue Paul Vaillant Couturier. E-mail: benedicte.jacquemin{at}inserm.fr

Keywords: Air pollution, asthma, asthma score

Received: September 9, 2008
Accepted April 23, 2009

The aim of our analysis was to study the association between air pollution and asthma among adults. For this goal, a previously developed "asthma score" was used.

Persons aged 25–44 yrs were randomly selected (1991–1993) and followed up (2000–2002) within the European Community Respiratory Health Survey (ECRHS I and II, respectively). The asthma score was defined from 0 to 5, based on the positive answers to the following symptoms reported for the last 12 months: wheeze/breathlessness, chest tightness, dyspnoea at rest, dyspnoea after exercise and woken by dyspnoea. Participants' home addresses were linked to outdoor modelled NO2 estimates for 2001. Negative binomial regression was used to model the asthma score.

The score from ECRHS II was positively associated with NO2 (ratio of the mean asthma score (RMS) 1.23, 95% CI 1.09–1.38, for an increase of 10 µg·m–3). After excluding participants with asthma and symptoms at baseline, the association remained (RMS 1.25, 95% CI 1.05–1.51), and was particularly high among those reporting a high score in ECRHS II. The latter probably reflects incident cases of asthma.

Our results suggest that traffic-related pollution causes asthma symptoms and possibly asthma incidence in adults. The asthma score offers an alternative with which to investigate the course and aetiology of asthma in adults.






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