Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • COVID-19 submission information
    • Peer reviewer login
  • Alerts
  • Podcasts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • COVID-19 submission information
    • Peer reviewer login
  • Alerts
  • Podcasts
  • Subscriptions

Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project

Shuo Liu, Jeanette Therming Jørgensen, Petter Ljungman, Göran Pershagen, Tom Bellander, Karin Leander, Patrik K.E. Magnusson, Debora Rizzuto, Ulla A. Hvidtfeldt, Ole Raaschou-Nielsen, Kathrin Wolf, Barbara Hoffmann, Bert Brunekreef, Maciej Strak, Jie Chen, Amar Mehta, Richard W. Atkinson, Mariska Bauwelinck, Raphaëlle Varraso, Marie-Christine Boutron-Ruault, Jørgen Brandt, Giulia Cesaroni, Francesco Forastiere, Daniela Fecht, John Gulliver, Ole Hertel, Kees de Hoogh, Nicole A.H. Janssen, Klea Katsouyanni, Matthias Ketzel, Jochem O. Klompmaker, Gabriele Nagel, Bente Oftedal, Annette Peters, Anne Tjønneland, Sophia P. Rodopoulou, Evangelia Samoli, Doris Tove Kristoffersen, Torben Sigsgaard, Massimo Stafoggia, Danielle Vienneau, Gudrun Weinmayr, Gerard Hoek, Zorana Jovanovic Andersen
European Respiratory Journal 2020; DOI: 10.1183/13993003.030992020
Shuo Liu
1Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeanette Therming Jørgensen
1Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Petter Ljungman
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Göran Pershagen
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
4Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tom Bellander
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
4Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karin Leander
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Karin Leander
Patrik K.E. Magnusson
5Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Patrik K.E. Magnusson
Debora Rizzuto
6Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
7The Stockholm Gerontology Research Center, Stockholm, Sweden
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ulla A. Hvidtfeldt
8Danish Cancer Society Research Center, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ole Raaschou-Nielsen
8Danish Cancer Society Research Center, Copenhagen, Denmark
9Department of Environmental Science, Aarhus University, Roskilde, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathrin Wolf
10Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Barbara Hoffmann
11Institute of Occupational, Social and Environmental Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bert Brunekreef
12Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maciej Strak
12Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
13National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jie Chen
12Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amar Mehta
1Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard W. Atkinson
14Population Health Research Institute, St George's, University of London, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mariska Bauwelinck
15Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Raphaëlle Varraso
16CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marie-Christine Boutron-Ruault
16CESP, Faculté de Médecine, Université Paris-Saclay, UVSQ, Inserm UMR 1018, Villejuif, France
17Gustave Roussy, Villejuif, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jørgen Brandt
9Department of Environmental Science, Aarhus University, Roskilde, Denmark
18iClimate, Aarhus University interdisciplinary center for climate change, Roskilde, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Giulia Cesaroni
19Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Francesco Forastiere
19Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Daniela Fecht
20MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John Gulliver
21UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, Imperial College London, London, United Kingdom
22Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ole Hertel
9Department of Environmental Science, Aarhus University, Roskilde, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kees de Hoogh
23Swiss Tropical and Public Health Institute, Basel, Switzerland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nicole A.H. Janssen
13National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Nicole A.H. Janssen
Klea Katsouyanni
24Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Matthias Ketzel
9Department of Environmental Science, Aarhus University, Roskilde, Denmark
25Global Centre for Clean Air Research, University of Surrey, Guildford, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jochem O. Klompmaker
12Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
13National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gabriele Nagel
26Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bente Oftedal
27Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Annette Peters
10Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
28Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anne Tjønneland
1Department of Public Health, University of Copenhagen, Copenhagen, Denmark
8Danish Cancer Society Research Center, Copenhagen, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Anne Tjønneland
Sophia P. Rodopoulou
24Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Evangelia Samoli
24Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Doris Tove Kristoffersen
29Cluster for Health Services Research, Norwegian Institute of Public Health, Oslo, Norway
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Torben Sigsgaard
30Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Massimo Stafoggia
2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
19Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danielle Vienneau
23Swiss Tropical and Public Health Institute, Basel, Switzerland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Danielle Vienneau
Gudrun Weinmayr
26Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gerard Hoek
12Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Zorana Jovanovic Andersen
1Department of Public Health, University of Copenhagen, Copenhagen, Denmark
31Center for Epidemiological Research, Nykøbing F Hospital, Nykøbing F, Denmark
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: zorana.andersen@sund.ku.dk
  • Article
  • Info & Metrics
  • PDF
Loading

Abstract

Background Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, while evidence is still insufficient. Within the multicentre project “Effects of Low-Level Air Pollution: A Study in Europe” (ELAPSE), we examined the associations of long-term exposures to particulate matter with diameter<2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) with asthma incidence in adults.

Methods We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land use regression models at participants’ baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders.

Results Of 98 326 participants, 1965 developed asthma during a 16.6 years mean follow-up. We observed associations in fully adjusted models with hazard ratios and 95% confidence intervals of 1.22 (1.04−1.43) per 5 μg·m−3 for PM2.5, 1.17 (1.10−1.25) per 10 µg·m−3 for NO2, and 1.15 (1.08−1.23) per 0.5 10−5 m−1 for BC. Hazard ratios were larger in cohort subsets with exposure levels below the EU and US limit values and possibly WHO guidelines for PM2.5 and NO2. NO2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration response curves showed no evidence of a threshold.

Conclusions Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Liu has nothing to disclose.

Conflict of interest: Dr. Jørgensen has nothing to disclose.

Conflict of interest: Dr. Ljungman has nothing to disclose.

Conflict of interest: Dr. Pershagen has nothing to disclose.

Conflict of interest: Dr. Bellander has nothing to disclose.

Conflict of interest: Dr. Leander has nothing to disclose.

Conflict of interest: Dr. Magnusson has nothing to disclose.

Conflict of interest: Dr. Rizzuto has nothing to disclose.

Conflict of interest: Dr. Hvidtfeldt has nothing to disclose.

Conflict of interest: Dr. Raaschou-Nielsen has nothing to disclose.

Conflict of interest: Dr. Wolf has nothing to disclose.

Conflict of interest: Dr. Hoffmann has nothing to disclose.

Conflict of interest: Dr. BRUNEKREEF has nothing to disclose.

Conflict of interest: Dr. Strak has nothing to disclose.

Conflict of interest: Ms. Chen has nothing to disclose.

Conflict of interest: Dr. Mehta has nothing to disclose.

Conflict of interest: Professor Atkinson has nothing to disclose.

Conflict of interest: Mariska Bauwelinck (MSc) has nothing to disclose.

Conflict of interest: Dr. Varraso has nothing to disclose.

Conflict of interest: Dr. Boutron-Ruault has nothing to disclose.

Conflict of interest: Dr. Brandt has nothing to disclose.

Conflict of interest: Dr. Cesaroni has nothing to disclose.

Conflict of interest: Dr. Forastiere has nothing to disclose.

Conflict of interest: Dr. Fecht has nothing to disclose.

Conflict of interest: Dr. Gulliver has nothing to disclose.

Conflict of interest: Dr. Hertel has nothing to disclose.

Conflict of interest: Dr. de Hoogh has nothing to disclose.

Conflict of interest: Dr. Janssen has nothing to disclose.

Conflict of interest: Dr. Katsouyanni has nothing to disclose.

Conflict of interest: Dr. Ketzel has nothing to disclose.

Conflict of interest: Dr. Klompmaker has nothing to disclose.

Conflict of interest: Dr. Nagel has nothing to disclose.

Conflict of interest: Dr. Oftedal has nothing to disclose.

Conflict of interest: Dr. Peters has nothing to disclose.

Conflict of interest: Dr. Tjønneland has nothing to disclose.

Conflict of interest: Dr. Rodopoulou has nothing to disclose.

Conflict of interest: Dr. Samoli has nothing to disclose.

Conflict of interest: Doris Tove Kristoffersen has nothing to disclose.

Conflict of interest: Dr. Sigsgaard has nothing to disclose.

Conflict of interest: Dr. Stafoggia has nothing to disclose.

Conflict of interest: Dr. Vienneau has nothing to disclose.

Conflict of interest: Dr. Weinmayr has nothing to disclose.

Conflict of interest: Dr. Hoek has nothing to disclose.

Conflict of interest: Dr. Andersen has nothing to disclose.

  • Received August 11, 2020.
  • Accepted November 17, 2020.
  • Copyright ©ERS 2020
View Full Text

ERS Members

myERS - ERS members : log in with your myERS username and password.

INDIVIDUALS

Log in Login as an individual user.

Forgot your username or password?

LIBRARY USERS

Log in through your institution

If your library has a subscription, you may already be logged in via your IP address. Otherwise you may be able to log in via one of the following routes.
You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.
If you think you should have access, please contact your librarian or email journals@ersnet.org

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.
PreviousNext
Back to top
View this article with LENS
Vol 59 Issue 5 Table of Contents
European Respiratory Journal: 59 (5)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project
Shuo Liu, Jeanette Therming Jørgensen, Petter Ljungman, Göran Pershagen, Tom Bellander, Karin Leander, Patrik K.E. Magnusson, Debora Rizzuto, Ulla A. Hvidtfeldt, Ole Raaschou-Nielsen, Kathrin Wolf, Barbara Hoffmann, Bert Brunekreef, Maciej Strak, Jie Chen, Amar Mehta, Richard W. Atkinson, Mariska Bauwelinck, Raphaëlle Varraso, Marie-Christine Boutron-Ruault, Jørgen Brandt, Giulia Cesaroni, Francesco Forastiere, Daniela Fecht, John Gulliver, Ole Hertel, Kees de Hoogh, Nicole A.H. Janssen, Klea Katsouyanni, Matthias Ketzel, Jochem O. Klompmaker, Gabriele Nagel, Bente Oftedal, Annette Peters, Anne Tjønneland, Sophia P. Rodopoulou, Evangelia Samoli, Doris Tove Kristoffersen, Torben Sigsgaard, Massimo Stafoggia, Danielle Vienneau, Gudrun Weinmayr, Gerard Hoek, Zorana Jovanovic Andersen
European Respiratory Journal Jan 2020, 2003099; DOI: 10.1183/13993003.030992020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Long-term exposure to low-level air pollution and incidence of asthma: the ELAPSE project
Shuo Liu, Jeanette Therming Jørgensen, Petter Ljungman, Göran Pershagen, Tom Bellander, Karin Leander, Patrik K.E. Magnusson, Debora Rizzuto, Ulla A. Hvidtfeldt, Ole Raaschou-Nielsen, Kathrin Wolf, Barbara Hoffmann, Bert Brunekreef, Maciej Strak, Jie Chen, Amar Mehta, Richard W. Atkinson, Mariska Bauwelinck, Raphaëlle Varraso, Marie-Christine Boutron-Ruault, Jørgen Brandt, Giulia Cesaroni, Francesco Forastiere, Daniela Fecht, John Gulliver, Ole Hertel, Kees de Hoogh, Nicole A.H. Janssen, Klea Katsouyanni, Matthias Ketzel, Jochem O. Klompmaker, Gabriele Nagel, Bente Oftedal, Annette Peters, Anne Tjønneland, Sophia P. Rodopoulou, Evangelia Samoli, Doris Tove Kristoffersen, Torben Sigsgaard, Massimo Stafoggia, Danielle Vienneau, Gudrun Weinmayr, Gerard Hoek, Zorana Jovanovic Andersen
European Respiratory Journal Jan 2020, 2003099; DOI: 10.1183/13993003.030992020
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
  • Info & Metrics
  • PDF

Subjects

  • Asthma and allergy
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • Lung volumes and survival in chronic lung allograft dysfunction
  • StO2 during weaning from mechanical ventilation
  • Automated quantification of radiological patterns predicts IPF survival
Show more Original article

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About the ERJ

  • Journal information
  • Editorial board
  • Reviewers
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • Podcasts
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN:  0903-1936
Online ISSN: 1399-3003

Copyright © 2022 by the European Respiratory Society