2011-12-27, Bayer-Oglesby, Lucy, Künzli, Nino, Röösli, Martin, Braun-Fahrländer, Charlotte, Mathys, Patrick, Stern, Willem, Jantunen, Matti, Kousa, Anu

To evaluate the validity of fixed-site fine particle levels as exposure surrogates in air pollution epidemiology, we considered four indicator groups: (1) PM2.5 total mass concentrations, (2) sulfur and potassium for regional air pollution, (3) lead and bromine for traffic-related particles, and (4) calcium for crustal particles. Using data from the European EXPOLIS (Air Pollution Exposure Distribution within Adult Urban Populations in Europe) study, we assessed the associations between 48-hr personal exposures and home outdoor levels of the indicators. Furthermore, within-city variability of fine particle levels was evaluated. Personal exposures to PM2.5 mass were not correlated to corresponding home outdoor levels (n = 44, rSpearman (Sp) = 0.07). In the group reporting neither relevant indoor sources nor relevant activities, personal exposures and home outdoor levels of sulfur were highly correlated (n = 40, rSp = 0.85). In contrast, the associations were weaker for traffic (Pb: n = 44, rSp = 0.53; Br: n = 44, rSp = 0.21) and crustal (Ca: n = 44, rSp = 0.12) indicators. This contrast is consistent with spatially homogeneous regional pollution and higher spatial variability of traffic and crustal indicators observed in Basel, Switzerland. We conclude that for regional air pollution, fixed-site fine particle levels are valid exposure surrogates. For source-specific exposures, however, fixed-site data are probably not the optimal measure. Still, in air pollution epidemiology, ambient PM2.5 levels may be more appropriate exposure estimates than total personal PM2.5 exposure, since the latter reflects a mixture of indoor and outdoor sources.

2000-07-27, Bayer-Oglesby, Lucy, Rotko, Tuulia, Krütli, Pius, Boudet, Céline, Kruize, Hanneke, Jantunen, Matti, Künzli, Nino

We evaluated exposure-relevant selection bias within the framework of a study on personal air pollution exposure, using traffic data as exposure proxy. Based on random samples of 3000 (Basel) and 2532 (Helsinki) persons, 50 and 250 subjects, respectively, were recruited for direct monitoring and 250 (Basel, Helsinki) for indirect monitoring. In Basel, participants of direct monitoring as compared to non-participants were more likely to live at streets with low traffic volume (49% below 1st quartile vs. 27%). Adjusted for sex, age and nationality, an increase of 100 cars per hour was associated with 14% less participation (odds ratio (OR): 0.861; 95% CI: 0.731, 1.007). Although in Helsinki, traffic volume was neither significantly related to participation in direct nor indirect monitoring, the point estimates indicate a tendency to decreased participation with increasing traffic intensity at home. We conclude that selection bias regarding exposure-relevant characteristics is likely to occur when recruiting participants for studies including demanding personal exposure assessment. Correction for factors routinely collected may not fully account for exposure-relevant bias. This is of particular importance when using exposure data for modelling population exposure distributions, whereas in epidemiological studies, a reduced range of exposure must not a priori distort the exposure-response relationship.

2006-10-10, 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, Ursula

The 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.

2000-07-01, Bayer-Oglesby, Lucy, Künzli, Nino, Monn, Christian, Schindler, Christian, Ackermann-Liebrich, Ursula, Leuenberger, Philippe

In 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.

2005-11, Bayer-Oglesby, Lucy, Grize, Leticia, Gassner, Markus, Takken-Sahli, Kathy, Sennhauser, Felix H., Neu, Urs, Schindler, Christian, Braun-Fahrländer, Charlotte

The causality of observed associations between air pollution and respiratory health in children is still subject to debate. If reduced air pollution exposure resulted in improved respiratory health of children, this would argue in favor of a causal relation. We investigated whether a rather moderate decline of air pollution levels in the 1990s in Switzerland was associated with a reduction in respiratory symptoms and diseases in school children. In nine Swiss communities, 9,591 children participated in cross-sectional health assessments between 1992 and 2001. Their parents completed identical questionnaires on health status and covariates. We assigned to each child an estimate of regional particles with an aerodynamic diameter < 10 μg/m3 (PM10) and determined change in PM10 since the first survey. Adjusted for socioeconomic, health-related, and indoor factors, declining PM10 was associated in logistic regression models with declining prevalence of chronic cough [odds ratio (OR) per 10-μg/m3 decline = 0.65, 95% confidence interval (CI), 0.54–0.79], bronchitis (OR = 0.66; 95% CI, 0.55–0.80), common cold (OR = 0.78; 95% CI, 0.68–0.89), nocturnal dry cough (OR = 0.70; 95% CI, 0.60–0.83), and conjunctivitis symptoms (OR = 0.81; 95% CI, 0.70–0.95). Changes in prevalence of sneezing during pollen season, asthma, and hay fever were not associated with the PM10 reduction. Our findings show that the reduction of air pollution exposures contributes to improved respiratory health in children. No threshold of adverse effects of PM10 was apparent because we observed the beneficial effects for relatively small changes of rather moderate air pollution levels. Current air pollution levels in Switzerland still exceed limit values of the Swiss Clean Air Act; thus, children’s health can be improved further.