|
|
Background Air pollution has been associated with impaired health, including reduced lung function in adults. Moving to cleaner areas has been shown to attenuate adverse effects of air pollution on lung function in children but not in adults.
Methods We conducted a prospective study of 9651 adults (18 to 60 years of age) randomly selected from population registries in 1990 and assessed in 1991, with 8047 participants reassessed in 2002. There was complete information on lung volumes and flows (e.g., forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1 as a percentage of FVC, and forced expiratory flow between 25 and 75% of the FVC [FEF25–75]), smoking habits, and spatially resolved concentrations of particulate matter that was less than 10 µm in aerodynamic diameter (PM10) from a validated dispersion model assigned to residential addresses for 4742 participants at both the 1991 and the 2002 assessments and in the intervening years.
Results Overall exposure to individual home outdoor PM10 declined over the 11-year follow-up period (median, –5.3 µg per cubic meter; interquartile range, –7.5 to –4.2). In mixed-model regression analyses, with adjustment for confounders, PM10 concentrations at baseline, and clustering within areas, there were significant negative associations between the decrease in PM10 and the rate of decline in FEV1 (P=0.045), FEV1 as a percentage of FVC (P=0.02), and FEF25–75 (P=0.001). The net effect of a decline of 10 µg of PM10 per cubic meter over an 11-year period was to reduce the annual rate of decline in FEV1 by 9% and of FEF25–75 by 16%. Cumulative exposure in the interval between the two examinations showed similar associations.
Conclusions Decreasing exposure to airborne particulates appears to attenuate the decline in lung function related to exposure to PM10. The effects are greater in tests reflecting small-airway function.
Source Information
From the Institute of Social and Preventive Medicine, University of Basel, Basel (S.H.D., C.S., L.-J.S.L., D.K., L.B.-O., U.A.-L.); Division of Pneumology, University Hospital Basel, Basel (M.H.B.); Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva (M.W.G., T.R.); Hirslanden Klinik, Hospital Aarau, Aarau (R.K.); Service of Pulmonology, University Hospital Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne (P.L., J.-P.Z.); Department of Molecular Epidemiology and Cancer Registry, Institutes of Social and Preventive Medicine and Clinical Pathology, Zurich (N.M.P.-H.); and Centre Valaisan de Pneumologie, Montana (J.-M.T.) — all in Switzerland; the Department of Environmental and Occupational Health Sciences, University of Washington, Seattle (L.-J.S.L.); Institució Catalana de Recerca i Estudis Avançats and Center for Research in Environmental Epidemiology, Institut Municipal d'Investigació Medica, Barcelona (N.K.); and the Department of Environmental Health, Harvard School of Public Health, Boston (J.S.).
Address reprint requests to Dr. Ackermann-Liebrich at the Institute of Social and Preventive Medicine, University of Basel, Steinengraben 49, CH4051 Basel, Switzerland, or at ursula.ackermann-liebrich{at}unibas.ch.
This article has been cited by other articles:
HOME | SUBSCRIBE | SEARCH | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | PRIVACY | HELP | beta.nejm.org Comments and questions? Please contact us. The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved. |
Previous
