Bayer-Oglesby, Lucy
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Improvements in PM10 Exposure and Reduced Rates of Respiratory Symptoms in a Cohort of Swiss Adults (SAPALDIA)
2009, Schindler, Christian, Keidel, Dirk, Gerbase, Margaret W., Zemp, Elisabeth, Bettschart, Robert, Brändli, Otto, Brutsche, Martin H., Burdet, Luc, Karrer, Werner, Knöpfli, Bruno, Pons, Marco, Rapp, Regula, Bayer-Oglesby, Lucy, Künzli, Nino, Schwartz, Joel, Liu, Lee-Jane S., Ackermann-Liebrich, Ursula, Rochat, Thierry
Rationale: Reductions in mortality following improvements in air quality were documented by several studies, and our group found, in an earlier analysis, that decreasing particulate levels attenuate lung function decline in adults. Objectives: We investigated whether decreases in particulates with an aerodynamic diameter of less than 10 microm (PM10) were associated with lower rates of reporting respiratory symptoms (i.e., decreased morbidity) on follow-up. Methods: The present analysis includes 7,019 subjects who underwent detailed baseline examinations in 1991 and a follow-up interview in 2002. Each subject was assigned model-based estimates of average PM10 during the 12 months preceding each health assessment and the difference was used as the exposure variable of interest (DeltaPM10). Analyses were stratified by symptom status at baseline and associations between DeltaPM10 and change in symptom status during follow-up were adjusted for important baseline characteristics, smoking status at follow-up, and season. We then estimated adjusted odds ratios for symptoms at follow-up and numbers of symptomatic cases prevented due to the observed reductions in PM10. Measurements and main results: Residential exposure to PM10 was lower in 2002 than in 1991 (mean decline 6.2 microg/m3; SD = 3.9 microg/m3). Estimated benefits (per 10,000 persons) attributable to the observed changes in PM10-levels were: 259 (95% confidence interval [CI]: 102-416) fewer subjects with regular cough, 179 (95% CI, 30-328) fewer subjects with chronic cough or phlegm and 137 (95% CI, 9-266) fewer subjects with wheezing and breathlessness. Conclusions: Reductions in particle levels in Switzerland over the 11-year follow-up period had a beneficial effect on respiratory symptoms among adults.
Indoor time-microenvironment-activity patterns in seven regions of Europe
2006, Schweizer, Christian, Edwards, Rufus David, Bayer-Oglesby, Lucy, Gauderman, William James, Ilacqua, Vito, Juhani Jantunen, Matti, Lai, Hak Kan, Nieuwenhuijsen, Mark, Künzli, Nino
Personal exposure to environmental substances is largely determined by time-microenvironment-activity patterns while moving across locations or microenvironments. Therefore, time-microenvironment-activity data are particularly useful in modeling exposure. We investigated determinants of workday time-microenvironment-activity patterns of the adult urban population in seven European cities. The EXPOLIS study assessed workday time-microenvironment-activity patterns among a total of 1427 subjects (age 19-60 years) in Helsinki (Finland), Athens (Greece), Basel (Switzerland), Grenoble (France), Milan (Italy), Prague (Czech Republic), and Oxford (UK). Subjects completed time-microenvironment-activity diaries during two working days. We present time spent indoors--at home, at work, and elsewhere, and time exposed to tobacco smoke indoors for all cities. The contribution of sociodemographic factors has been assessed using regression models. More than 90% of the variance in indoor time-microenvironment-activity patterns originated from differences between and within subjects rather than between cities. The most common factors that were associated with indoor time-microenvironment-activity patterns, with similar contributions in all cities, were the specific work status, employment status, whether the participants were living alone, and whether the participants had children at home. Gender and season were associated with indoor time-microenvironment-activity patterns as well but the effects were rather heterogeneous across the seven cities. Exposure to second-hand tobacco smoke differed substantially across these cities. The heterogeneity of these factors across cities may reflect city-specific characteristics but selection biases in the sampled local populations may also explain part of the findings. Determinants of time-microenvironment-activity patterns need to be taken into account in exposure assessment, epidemiological analyses, exposure simulations, as well as in the development of preventive strategies that focus on time-microenvironment-activity patterns that ultimately determine exposures.
Personal exposures to VOC in the upper end of the distribution—relationships to indoor, outdoor and workplace concentrations
2005, Edwards, Rufus D., Schweizer, Christian, Jantunen, Matti, Lai, Hak Kan, Bayer-Oglesby, Lucy, Katsouyanni, Klea, Nieuwenhuijsen, Mark, Saarela, Kristiina, Sram, Radim, Künzli, Nino
Evaluation of relationships between median residential indoor, indoor workplace and population exposures may obscure potential strategies for exposure reduction. Evaluation of participants with personal exposures above median levels in the EXPOLIS study in Athens, Helsinki, Oxford and Prague illustrated that these participants frequently showed a different relationship to indoor and workplace levels than that shown by the population median. Thus, prioritization of environments for control measures based on median exposures may exclude important areas where effectively focused control measures are possible, and may therefore have little impact on the highest and most harmful exposures. Further, personal exposures at the upper end of the distribution may exceed the US EPA inhalation reference concentration (Rfc), illustrated here using hexane, naphthalene and benzene. For example upper 90th percentile personal exposures to benzene in Athens and Prague were 64 and 27 μg m−3 with peak exposures of 217 and 38 μg m−3, respectively for non-ETS exposed participants relative to an Rfc of 30 μg m−3. Strategies to reduce exposures to individual compounds, therefore, may benefit from focus on the high end of the distribution to identify activities and behaviors that result in elevated exposures. Control strategies targeting activities that lead to exposures in the upper end of the distribution would reduce the variability associated with population median values by bringing the upper end of the exposure distribution closer to median values. Thus, compliance with health-based standards would be more protective of the higher exposed fraction of the population, in whom health effects would be more expected.
Determinants of perceived air pollution annoyance and association between annoyance scores and air pollution (PM2.5, NO2) concentrations in the European EXPOLIS study
2002, Rotko, Tuulia, Bayer-Oglesby, Lucy, Künzli, Nino, Carrer, Paolo, Nieuwenhuijsen, Mark J, Jantunen, Matti
Apart from its traditionally considered objective impacts on health, air pollution can also have perceived effects, such as annoyance. The psychological effects of air pollution may often be more important to well-being than the biophysical effects. Health effects of perceived annoyance from air pollution are so far unknown. More knowledge of air pollution annoyance levels, determinants and also associations with different air pollution components is needed. In the European air pollution exposure study, EXPOLIS, the air pollution annoyance as perceived at home, workplace and in traffic were surveyed among other study objectives. Overall 1736 randomly drawn 25–55-yr-old subjects participated in six cities (Athens, Basel, Milan, Oxford, Prague and Helsinki). Levels and predictors of individual perceived annoyances from air pollution were assessed. Instead of the usual air pollution concentrations at fixed monitoring sites, this paper compares the measured microenvironment concentrations and personal exposures of PM2.5 and NO2 to the perceived annoyance levels. A considerable proportion of the adults surveyed was annoyed by air pollution. Female gender, self-reported respiratory symptoms, downtown living and self-reported sensitivity to air pollution were directly associated with high air pollution annoyance score while in traffic, but smoking status, age or education level were not significantly associated. Population level annoyance averages correlated with the city average exposure levels of PM2.5 and NO2. A high correlation was observed between the personal 48-h PM2.5 exposure and perceived annoyance at home as well as between the mean annoyance at work and both the average work indoor PM2.5 and the personal work time PM2.5 exposure. With the other significant determinants (gender, city code, home location) and home outdoor levels the model explained 14% (PM2.5) and 19% (NO2) of the variation in perceived air pollution annoyance in traffic. Compared to Helsinki, in Basel and Prague the adult participants were more annoyed by air pollution while in traffic even after taking the current home outdoor PM2.5 and NO2 levels into account.
Annoyance due to air pollution in Europe
2007, Jacquemin, Bénédicte, Sunyer, Jordi, Forsberg, Bertil, Götschi, Thomas, Bayer-Oglesby, Lucy, Ackermann-Liebrich, Ursula, de Marco, Roberto, Heinrich, Joachim, Jarvis, Deborah, Torén, Kjell, Künzli, Nino
Background Annoyance due to air pollution is a subjective score of air quality, which has been incorporated into the National Environmental monitoring of some countries. The objectives of this study are to describe the variations in annoyance due to air pollution in Europe and its individual and environmental determinants. Methods This study took place in the context of the European Community Respiratory Health Survey II (ECRHS II) that was conducted during 1999–2001. It included 25 centres in 12 countries and 7867 randomly selected adults from the general population. Annoyance due to air pollution was self-reported on an 11-point scale. Annual mean mass concentration of fine particles (PM2.5) and its sulphur (S) content were measured in 21 centres as a surrogate of urban air pollution. Results Forty-three per cent of participants reported moderate annoyance (1–5 on the scale) and 14% high annoyance (≥6) with large differences across centres (2–40% of high annoyance). Participants in the Northern European countries reported less annoyance. Female gender, nocturnal dyspnoea, phlegm and rhinitis, self-reported car and heavy vehicle traffic in front of the home, high education, non-smoking and exposure to environmental tobacco smoke were associated with higher annoyance levels. At the centre level, adjusted means of annoyance scores were moderately associated with sulphur urban levels (slope 1.43 μg m−3, standard error 0.40, r = 0.61). Conclusions Annoyance due to air pollution is frequent in Europe. Individuals’ annoyance may be a useful measure of perceived ambient quality and could be considered a complementary tool for health surveillance.
Time–activity relationships to VOC personal exposure factors
2006, Edwards, Rufus D., Schweizer, Christian, Llacqua, Vito, Lai, Hak Kan, Jantunen, Matti, Bayer-Oglesby, Lucy, Künzli, Nino
Social and demographic factors have been found to play a significant role in differences between time–activity patterns of population subgroups. Since time–activity patterns largely influence personal exposure to compounds as individuals move across microenvironments, exposure subgroups within the population may be defined by factors that influence daily activity patterns. Socio-demographic and environmental factors that define time–activity subgroups also define quantifiable differences in VOC personal exposures to different sources and individual compounds in the Expolis study. Significant differences in exposures to traffic-related compounds ethylbenzene, m- and p-xylene and o-xylene were observed in relation to gender, number of children and living alone. Categorization of exposures further indicated time exposed to traffic at work and time in a car as important determinants. Increased exposures to decane, nonane and undecane were observed for males, housewives and self-employed. Categorization of exposures indicated exposure subgroups related to workshop use and living downtown. Higher exposures to 3-carene and a-pinene commonly found in household cleaning products and fragrances were associated with more children, while exposures to traffic compounds ethylbenzene, m- and p-xylene and o-xylene were reduced with more children. Considerable unexplained variation remained in categorization of exposures associated with home product use and fragrances, due to individual behavior and product choice. More targeted data collection methods in VOC exposure studies for these sources should be used. Living alone was associated with decreased exposures to 2-methyl-1-propanol and 1-butanol, and traffic-related compounds. Identification of these subgroups may help to reduce the large amount of unexplained variation in VOC exposure studies. Further they may help in assessing impacts of urban planning that result in changes in behavior of individuals, resulting in shifts in the patterns of exposure experienced by the population.
PM2.5 assessment in 21 European study centers of ECRHS II: method and first winter results
2003, Hazenkamp-von Arx, Marianne E., Fellmann, Thomas Götschi, Bayer-Oglesby, Lucy, Ackermann-Liebrich, Ursula, Gíslason, Thórarinn, Heinrich, Joachim, Jarvis, Deborah, Luczynska, Christina, Manzanera, Angeles Jaén, Modig, Lars, Norbäck, Dan, Pfeifer, Annette, Poli, Albino, Ponzio, Michela, Soon, Argo, Vermeire, Paul, Künzli, Nino
The follow-up of a cohort of adults from 29 European centers of the former European Community Respiratory Health Survey (ECRHS) I (1989–1992) will examine the long-term effects of exposure to ambient air pollution on the incidence, course, and prognosis of respiratory diseases, in particular asthma and decline in lung function. The purpose of this article is to describe the methodology and the European-wide quality control program for the collection of particles with 50% cut-off size of 2.5 µm aerodynamic diameter (PM2.5 ) in the ECRHS II and to present the PM2.5 results from the winter period 2000–2001. Because PM2.5 is not routinely monitored in Europe, we measured PM2.5 mass concentrations in 21 participating centers to estimate background exposure in these cities. A standardized protocol was developed using identical equipment in each center (U.S. Environmental Protection Agency Well Impactor Ninety-Six [WINS] and PQ167 from BGI, Inc.). Filters were weighed in a single central laboratory. Sampling was conducted for 7 days per month for a year. Winter mean PM2.5 mass concentrations (November 2000–February 2001) varied substantially, with Iceland reporting the lowest value (5 µg/m3) and northern Italy the highest (69 µg/m3). A standardized procedure appropriate for PM2.5 exposure assessmnt in a multicenter study was developed. We expect ECRHS II to have sufficient variation in exposure to assess long-term effects of air pollution in this cohort. Any bias caused by variation in the characteristics of the chosen monitoring location (e.g., proximity to traffic sources) will be addressed in later analyses. Given the homogenous spatial distribution of PM2.5 , however, concentrations measured near traffic are not expected to differ substantially from those measured at urban background sites.
Determinants of indoor air concentrations of PM2.5, black smoke and NO2 in six European cities (EXPOLIS study)
2006, Lai, Hak Kan, Bayer-Oglesby, Lucy, Colvile, Roy N., Götschi, Thomas, Jantunen, Matt J., Künzli, Nino, Kulinskaya, Elena, Schweizer, Christian, Nieuwenhuijsen, Mark J.
EXPOLIS was a large-scale population-based study of urban adult exposures to multiple pollutants, and was conducted between 1996 and 2000 in six European cities. Measurements made using standardised protocols in Athens (Greece), Basel (Switzerland), Helsinki (Finland), Milan (Italy), Oxford (UK), and Prague (Czech Republic), allow similarities and differences between contrasting European regions, climates and populations to be identified. Two consecutive days of home indoor and home outdoor measurements of fine particulate matter (PM2.5), black smoke (BS), and nitrogen dioxide (NO2) were carried out at the homes of adult participants on different dates and seasons during the sampling period. Regression models with interactions searched by all-possible subset method were used to assess the city effects and the determinants of home indoor PM2.5 (adj R2 ¼ 0:60, n ¼ 413), BS (adj R2 ¼ 0:79, n ¼ 382) and NO2 (adj R2 ¼ 0:67, n ¼ 302) levels. Both bi-directional (positive and negative signs of associations) and unidirectional (consistently either positive or negative sign of associations) city effects on different determinants in each indoor model were shown. Smoking, gas-stove usage, outdoor temperature, and wind speed were the common determinants in all three indoor models. Other determinants, including the presence of wooden material, heating, and being located in suburb area, were also identified. They were likely linked to cultural and socio-economic factors.
Follow-up of the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA 2) 1991–2003: methods and characterization of participants
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, Philippe
Objectives: 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.
Comparison of Black Smoke and PM2.5 Levels in Indoor and Outdoor Environments of Four European Cities
2002, Götschi, Thomas, Bayer-Oglesby, Lucy, Mathys, Patrick, Monn, Christian, Manalis, Nikos, Koistinen, Kimmo, Jantunen, Matti, Hänninen, Otto, Polanska, Liba, Künzli, Nino
Recent studies on separated particle-size fractions highlight the health significance of particulate matter smaller than 2.5 μm (PM2.5), but gravimetric methods do not identify specific particle sources. Diesel exhaust particles (DEP) contain elemental carbon (EC), the dominant light-absorbing substance in the atmosphere. Black smoke (BS) is a measure for light absorption of PM and, thus, an alternative way to estimating EC concentrations, which may serve as a proxy for diesel exhaust emissions. We analyzed PM2.5 and BS data collected within the EXPOLIS study (Air Pollution Exposure Distribution within Adult Urban Populations in Europe) in Athens, Basel, Helsinki, and Prague. 186 indoor/outdoor filter pairs were sampled and analyzed. PM2.5 and BS levels were lowest in Helsinki, moderate in Basel, and remarkably higher in Athens and Prague. In each city, Spearman correlation coefficients of indoor versus outdoor were higher for BS (range rSpearman: 0.57−0.86) than for PM2.5 (0.05−0.69). In a BS linear regression model (all data), outdoor levels explained clearly more of indoor variation (86%) than in the corresponding PM2.5 model (59%). In conclusion, ambient BS seizes a health-relevant fraction of fine particles to which people are exposed indoors and outdoors and exposure to which can be assessed by monitoring outdoor concentrations. BS measured on PM2.5 filters can be recommended as a valid and cheap additional indicator in studies on combustion-related air pollution and health.