Abstract
Background While air pollution has been linked to the development of chronic obstructive pulmonary disease (COPD), evidence on the role of environmental noise is just emerging. We examined the associations of long-term exposure to air pollution and road traffic noise with COPD incidence.
Methods We defined COPD incidence for 24 538 female nurses from the Danish Nurse Cohort (age >44 years) as the first hospital contact between baseline (1993 or 1999) and 2015. We estimated residential annual mean concentrations of particulate matter with an aerodynamic diameter <2.5 µm (PM2.5) since 1990 and nitrogen dioxide (NO2) since 1970 using the Danish Eulerian Hemispheric Model/Urban Background Model/Air Geographic Information System modelling system, and road traffic noise (Lden) since 1970 using the Nord2000 model. Time-varying Cox regression models were applied to assess the associations of air pollution and road traffic noise with COPD incidence.
Results 977 nurses developed COPD during a mean of 18.6 years’ follow-up. We observed associations with COPD for all three exposures with HRs and 95% CIs of 1.19 (1.01–1.41) per 6.26 µg·m−3 for PM2.5, 1.13 (1.05–1.20) per 8.19 µg·m−3 for NO2 and 1.15 (1.06–1.25) per 10 dB for Lden. Associations with NO2 and Lden attenuated slightly after mutual adjustment, but were robust to adjustment for PM2.5. Associations with PM2.5 were attenuated to null after adjustment for either NO2 or Lden. No potential interaction effect was observed between air pollutants and noise.
Conclusion Long-term exposure to air pollution, especially traffic-related NO2, and to road traffic noise were independently associated with COPD.
Abstract
Long-term exposure to air pollution, especially from traffic, and to road traffic noise were associated with increased risk of COPD, independent of each other https://bit.ly/3vaQY6q
Footnotes
This article has supplementary material available from erj.ersjournals.com
Author contributions: Study was conceptualised and designed by Z.J. Andersen and S. Liu. Statistical analysis and drafting of the manuscript was conducted by S. Liu. Y-H. Lim helped in statistical analysis. Z.J. Andersen helped in drafting the manuscript. J.T. Jørgensen prepared the individual cohort data for the analyses. M. Ketzel, O. Hertel, J. Brandt, S.S. Jensen, J.H. Christensen, C. Geels and L.M. Frohn developed the exposure modelling system and performed the air pollution exposure calculations. All authors have read and revised the manuscript for important intellectual content, and contributed to the interpretation of the results. All authors have approved the final draft of the manuscript.
Conflict of interest: S. Liu has nothing to disclose.
Conflict of interest: Y-H. Lim has nothing to disclose.
Conflict of interest: M. Pedersen has nothing to disclose.
Conflict of interest: J.T. Jørgensen has nothing to disclose.
Conflict of interest: H. Amini has nothing to disclose.
Conflict of interest: T. Cole-Hunter has nothing to disclose.
Conflict of interest: A.J. Mehta has nothing to disclose.
Conflict of interest: R. So has nothing to disclose.
Conflict of interest: L.H. Mortensen has nothing to disclose.
Conflict of interest: R.G.J. Westendorp has nothing to disclose.
Conflict of interest: S. Loft has nothing to disclose.
Conflict of interest: E.V. Bräuner has nothing to disclose.
Conflict of interest: M. Ketzel has nothing to disclose.
Conflict of interest: O. Hertel has nothing to disclose.
Conflict of interest: J. Brandt has nothing to disclose.
Conflict of interest: S.S. Jensen has nothing to disclose.
Conflict of interest: J.H. Christensen has nothing to disclose.
Conflict of interest: T. Sigsgaard has nothing to disclose.
Conflict of interest: C. Geels has nothing to disclose.
Conflict of interest: L.M. Frohn has nothing to disclose.
Conflict of interest: M. Brborić has nothing to disclose.
Conflict of interest: J. Radonić has nothing to disclose.
Conflict of interest: M. Turk Sekulic has nothing to disclose.
Conflict of interest: K. Bønnelykke has nothing to disclose.
Conflict of interest: C. Backalarz has nothing to disclose.
Conflict of interest: M.K. Simonsen has nothing to disclose.
Conflict of interest: Z.J. Andersen has nothing to disclose.
Support statement: This work was supported by the Danish Council for Independent Research (DFF-4183-00353), the Novo Nordisk Foundation Challenge Programme (NNF17OC0027812), the China Scholarship Council (number 201806010406) and the Science Fund of the Republic of Serbia, Program DIASPORA, #6461896, LiBAir. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received December 21, 2020.
- Accepted April 17, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org