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Publikation Reduced exposure to PM10 and attenuated age-related decline in lung function(Massachusetts Medical Society, 2007) Downs, Sara H.; Schindler, Christian; Liu, L.-J. Sally; Keidel, Dirk; Bayer-Oglesby, Lucy; Brutsche, Martin H.; Gerbase, Margaret W.; Keller, Roland; Künzli, Nino; Leuenberger, Philippe; Probst-Hensch, Nicole M.; Tschopp, Jean-Marie; Zellweger, Jean-Pierre; Rochat, Thierry; Schwartz, Joel; Ackermann-Liebrich, UrsulaBackground: 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.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Follow-up of the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA 2) 1991–2003: methods and characterization of participants(Birkhäuser, 2005) Ackermann-Liebrich, Ursula; Kuna-Dibbert, Birgit; Probst-Hensch, Nicole M.; Schindler, Christian; Dietrich, Denise Felber; Stutz, Elisabeth Zemp; Bayer-Oglesby, Lucy; Baum, Felix; Brändli, Otto; Brutsche, Martin; Downs, Sara H.; Keidel, Dirk; Gerbase, Margaret W.; Imboden, Medea; Keller, Roland; Knöpfli, Bruno; Künzli, Nino; Nicod, Laurent; Pons, Marco; Staedele, Patricia; Tschopp, Jean-Marie; Zellweger, Jean-Pierre; Leuenberger, PhilippeObjectives: The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) was designed to investigate the health effects from long-term exposure to air pollution. Methods: The health assessment at recruitment (1991) and at the first reassessment (2001-3) consisted of an interview about respiratory health, occupational and other exposures, spirometry, a methacholine bronchial challenge test, end-expiratory carbon monoxide (CO) measurement and measurement for atopy. A bio bank for DNA and blood markers was established. Heart rate variability was measured using a 24-hour ECG (Holter) in a random sample of participants aged 50 years and older. Concentrations of nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3) and particulates in ambient air have been monitored in all study areas since 1991. Residential histories collected over the 11 year follow-up period coupled with GIS modelling will provide individual long-term air pollutant exposure estimates. Results: Of 9651 participants examined in 1991, 8715 could be traced for the cohort study and 283 died. Basic information about health status was obtained for 8047 individuals (86% of alive persons), 6 528 individuals (70%) agreed to the health examination and 5 973 subjects (62%) completed the entire protocol. Non-participants in the reassessment were on average younger than participants and more likely to have been smokers and to have reported respiratory symptoms in the first assessment. Average weight had increased by 5.5 kg in 11 years and 28% of smokers in 1991 had quit by the time of the reassessment.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Validity of Annoyance Scores for Estimation of Long Term Air Pollution Exposure in Epidemiologic Studies. The Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA)(Oxford University Press, 01.07.2000) Bayer-Oglesby, Lucy; Künzli, Nino; Monn, Christian; Schindler, Christian; Ackermann-Liebrich, Ursula; Leuenberger, PhilippeIn air pollution epidemiology, estimates of long term exposure are often based on measurements made at one fixed site monitor per area. This may lead to exposure misclassification. The present paper validates a questionnaire-based indicator of ambient air pollution levels and its applicability to assess their within-area variability. Within the framework of the SAPALDIA (Swiss Study on Air Pollution and Lung Diseases in Adults) cross-sectional study (1991), 9,651 participants reported their level of annoyance caused by air pollution on an 11-point scale. This subjective measure was compared with annual mean concentrations of particulate matter less than 10 μm in diameter (PM10) and nitrogen dioxide. The impact of individual factors on reported scores was evaluated. Nitrogen dioxide concentrations at home outdoors (measured in 1993), smoking, workplace dust exposure, and respiratory symptoms were found to be predictors of individual annoyance scores. Regression of population mean annoyance scores against annual mean PM10 and nitrogen dioxide concentrations (measured in 1993 and 1991, respectively) across areas showed a linear relation and strong correlations (r > 0.85). Analysis within areas yielded consistent results. The observed associations between subjective and objective air pollution exposure estimates suggest that population mean scores, but not individual scores, may serve as a simple tool for grading air quality within areas. Reported annoyance due to air pollution should be considered an indicator for a complex environmental condition and thus might be used for evaluating the implementation of environmental policies.01A - Beitrag in wissenschaftlicher ZeitschriftPublikation Living near main streets and respiratory symptoms in adults. the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults(Oxford University Press, 10.10.2006) Bayer-Oglesby, Lucy; Schindler, Christian; Hazenkamp-von Arx, Marianne E.; Braun-Fahrländer, Charlotte; Keidel, Dirk; Rapp, Regula; Künzli, Nino; Braendli, Otto; Burdet, Luc; Sally Liu, L-J; Leuenberger, Philippe; Ackermann-Liebrich, UrsulaThe Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA), conducted in 1991 (SAPALDIA 1) in eight areas among 9,651 randomly selected adults aged 18-60 years, reported associations among the prevalence of respiratory symptoms, nitrogen dioxide, and particles with an aerodynamic diameter of less than 10 microg/m3. Later, 8,047 subjects reenrolled in 2002 (SAPALDIA 2). The effects of individually assigned traffic exposures on reported respiratory symptoms were estimated, while controlling for socioeconomic and exposure- and health-related factors. The risk of attacks of breathlessness increased for all subjects by 13% (95% confidence interval: 3, 24) per 500-m increment in the length of main street segments within 200 m of the home and decreased in never smokers by 12% (95% confidence interval: 0, 22) per 100-m increment in distance from home to a main street. Living within 20 m of a main street increased the risks of regular phlegm by 15% (95% confidence interval: 0, 31) and wheezing with breathing problems by 34% (95% confidence interval: 0, 79) in never smokers. In 2002, the effects related to road distance were different from those in 1991, which could be due to changes in the traffic pollution mixture. These findings among a general population provide strong confirmation that living near busy streets leads to adverse respiratory health effects.01A - Beitrag in wissenschaftlicher Zeitschrift