ENVIRONMENTAL EXPOSURE

Traffic-related air pollution correlates with adult-onset asthma among never-smokers

N Künzli^1,2,3,4, P-O Bridevaux⁵, L-J S Liu^6,7, R Garcia-Esteban^1,3,4, C Schindler⁶, M W Gerbase⁵, J Sunyer^1,3,4,8, D Keidel⁶, T Rochat⁵ on behalf of SAPALDIA Team (Swiss Cohort Study on Air Pollution and Lung Diseases in Adults)

¹ Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
² Catalan Institution for Research and Advanced Studies (ICREA), Spain
³ Municipal Institute of Medical Research (IMIM), Barcelona, Spain
⁴ CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
⁵ University Hospitals of Geneva, Geneva, Switzerland
⁶ Institute of Social and Preventive Medicine, University of Basel, Switzerland
⁷ University of Washington, Seattle, Washington, USA
⁸ Universitat Pompeu Fabra (UPF), Barcelona, Spain

Dr N Künzli, Center for Research in Environmental Epidemiology (CREAL), C Doctor Aiguader 88, 08003 Barcelona, Spain; kuenzli{at}creal.cat

Background: Traffic-related pollution is associated with the onset of asthma in children. Its effect on adult-onset asthma is poorly investigated. The SAPALDIA cohort study was used to investigate associations between the 11-year change (1991–2002) in home outdoor traffic-related particulate matter up to 10 µm in diameter (TPM₁₀) and the incidence of asthma.

Methods: Never-smokers without asthma at baseline aged 18–60 years in 1991 were eligible for inclusion in the study. Subjects reporting doctor-diagnosed asthma at follow-up were considered incident cases. TPM₁₀ at baseline and follow-up was predicted and interpolated to subjects’ place of residence by dispersion models using emission and meteorological data. Cox proportional hazard models for time to asthma onset were adjusted (age, gender, baseline atopy, body mass index, bronchial reactivity, maternal allergies).

Results: Of 2725 never-smokers, 41 reported asthma onset in 2002. Home outdoor TPM₁₀ concentrations improved during the interval (mean –0.6; range –9 to +7.2; IQR 0.6 µg/m³). The incidence of asthma was associated with a change in TPM₁₀. The hazard ratio (1.30; 95% CI 1.05 to 1.61) per 1 µg/m³ change in TPM₁₀ (IQR) was not sensitive to further adjustments (education, workplace exposure, passive smoking, parental asthma or allergies, random area effects, lung function or co-pollutants such as regional, secondary, total PM₁₀ or proximity to busy roads).

Conclusion: The data suggest a role for traffic-related pollution in adult-onset asthma. Space, time and source-specific individual assignment of exposure to traffic-related pollution is a key strength of SAPALDIA. It may explain why findings were statistically significant despite the limited number of new cases. As traffic-related pollution prevails, the finding may be of substantial public health relevance.

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