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Long-term air pollution exposure is associated with sick leave 20 years later

Ane Johannessen, Ingrid Nordeide Kuiper, Simone Accordini, Randi Jacobsen Bertelsen, Bertil Forsberg, Thorarinn Gislason, Joachim Heinrich, Mathias Holm, Rain Jögi, Jorunn Kirkeleit, Andrei Malinovschi, Alessandro Marcon, Iana Markevych, Anna Oudin, Vivi Schlünssen, Torben Sigsgaard, Cecilie Svanes, Kjell Torén, Christer Janson
European Respiratory Journal 2018 52: OA5182; DOI: 10.1183/13993003.congress-2018.OA5182
Ane Johannessen
1Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Ingrid Nordeide Kuiper
2Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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Simone Accordini
3Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Randi Jacobsen Bertelsen
4Department of Clinical Science, University of Bergen, Bergen, Norway
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Bertil Forsberg
5Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Thorarinn Gislason
6Department of Respiratory Medicine and Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
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Joachim Heinrich
7Institute and Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
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Mathias Holm
8Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Rain Jögi
9Lung Clinic, Tartu University Hospital, Tartu, Estonia
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Jorunn Kirkeleit
2Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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Andrei Malinovschi
10Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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Alessandro Marcon
3Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Iana Markevych
11Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
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Anna Oudin
5Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Vivi Schlünssen
12Department of Public Health, Section for Environment Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
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Torben Sigsgaard
13Department of Public Health, Aarhus University, Aarhus, Denmark
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Cecilie Svanes
2Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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Kjell Torén
8Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Christer Janson
14Department of Medical Sciences: Respiratory Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Abstract

Background: Little is known on outdoor air pollution in a long-term perspective and societal costs such as sick leave. In the Nordic countries, recent pollution health impact assessments have had to rely on outdated studies.

Aims: To investigate if air pollution exposure is associated with sick leave 20 years later.

Methods: We analysed self-reported sick leave (all-cause and respiratory) in 7 466 subjects from Bergen, Gothenburg, Umea, Uppsala in the RHINE3 study in 2010-12. Home addresses were geocoded and linked to annual average concentrations of PM2.5, PM10 and NO2 at RHINE3, 10 years earlier and 20 years earlier, using existing land-use regression (LUR) models. We performed multilevel logistic regression clustered by centre, and adjusted for sex, smoking, education and previous health-related workplace change.

Results: Age range in RHINE3 was 40-66 yrs, 34% and 4% reported all-cause and respiratory sick leave during the last year. In the adjusted analyses all-cause sick leave was associated with PM2.5 20 years earlier (OR per interquartile range (IQR) difference (2.6 µg/m³) 1.12 (95%CI 1.01, 1.24)), and borderline with NO2 (OR per IQR diff (8.1 µg/m³) 1.09 (95%CI 0.99, 1.19)). Respiratory sick leave was associated with PM10 20 years earlier (OR per IQR diff (3.92 µg/m³) 1.54 (95%CI 1.06, 2.25)), and borderline with PM2.5 (OR per IQR diff 1.31 (95%CI 0.97, 1.76)). Pollution exposures at present as well as 10 years earlier were not significantly associated with sick leave.

Conclusions: Air pollution exposure in a general population is associated with sick leave in a 20-year perspective. Our findings suggest that even low air pollution levels such as in Northern Europe have societal costs over time.

Footnotes

Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA5182.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2018
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Long-term air pollution exposure is associated with sick leave 20 years later
Ane Johannessen, Ingrid Nordeide Kuiper, Simone Accordini, Randi Jacobsen Bertelsen, Bertil Forsberg, Thorarinn Gislason, Joachim Heinrich, Mathias Holm, Rain Jögi, Jorunn Kirkeleit, Andrei Malinovschi, Alessandro Marcon, Iana Markevych, Anna Oudin, Vivi Schlünssen, Torben Sigsgaard, Cecilie Svanes, Kjell Torén, Christer Janson
European Respiratory Journal Sep 2018, 52 (suppl 62) OA5182; DOI: 10.1183/13993003.congress-2018.OA5182

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Long-term air pollution exposure is associated with sick leave 20 years later
Ane Johannessen, Ingrid Nordeide Kuiper, Simone Accordini, Randi Jacobsen Bertelsen, Bertil Forsberg, Thorarinn Gislason, Joachim Heinrich, Mathias Holm, Rain Jögi, Jorunn Kirkeleit, Andrei Malinovschi, Alessandro Marcon, Iana Markevych, Anna Oudin, Vivi Schlünssen, Torben Sigsgaard, Cecilie Svanes, Kjell Torén, Christer Janson
European Respiratory Journal Sep 2018, 52 (suppl 62) OA5182; DOI: 10.1183/13993003.congress-2018.OA5182
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