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

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.