PT  - JOURNAL ARTICLE
AU  - Ane Johannessen
AU  - Ingrid Nordeide Kuiper
AU  - Simone Accordini
AU  - Randi Jacobsen Bertelsen
AU  - Bertil Forsberg
AU  - Thorarinn Gislason
AU  - Joachim Heinrich
AU  - Mathias Holm
AU  - Rain Jögi
AU  - Jorunn Kirkeleit
AU  - Andrei Malinovschi
AU  - Alessandro Marcon
AU  - Iana Markevych
AU  - Anna Oudin
AU  - Vivi Schlünssen
AU  - Torben Sigsgaard
AU  - Cecilie Svanes
AU  - Kjell Torén
AU  - Christer Janson
TI  - Long-term air pollution exposure is associated with sick leave 20 years later
AID  - 10.1183/13993003.congress-2018.OA5182
DP  - 2018 Sep 15
TA  - European Respiratory Journal
PG  - OA5182
VI  - 52
IP  - suppl 62
4099  - http://erj.ersjournals.com/content/52/suppl_62/OA5182.short
4100  - http://erj.ersjournals.com/content/52/suppl_62/OA5182.full
SO  - Eur Respir J2018 Sep 15; 52
AB  - 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 In the Nordic countries, recent pollution health impact assessments have had to rely on outdated studies.Aims: To investigate if air pollution exposure is associated with sick leave 20 years later.Methods: We analysed self-reported sick leave (all-cause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.FootnotesCite 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).