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1.
Res Rep Health Eff Inst ; (214): 1-41, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38286761

RESUMO

INTRODUCTION: Early ecological studies have suggested a link between air pollution and Coronavirus Diseases 2019 (COVID-19); however, the evidence from individual-level prospective cohort studies is still sparse. Here, we have examined, in a general population, whether long-term exposure to air pollution is associated with the risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and developing severe COVID-19, resulting in hospitalization or death and who is most susceptible. We also examined whether long-term exposure to air pollution is associated with hospitalization or death due to COVID-19 in those who have tested positive for SARS-CoV-2. METHODS: We included all Danish residents 30 years or older who resided in Denmark on March 1, 2020. and followed them in the National COVID-19 Surveillance System until first positive test (incidence), COVID-19 hospitalization, or death until April 26, 2021. We estimated mean levels of nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter <2.5 µm (PM2.5), black carbon (BC), and ozone (O3) at cohort participants' residence in 2019 by the Danish Eulerian Hemispheric Model/Urban Background Model. We used Cox proportional hazard models to estimate the associations of air pollutants with COVID-19 incidence, hospitalization, and mortality adjusting for age, sex, and socioeconomic status (SES) at the individual and area levels. We examined effect modification by age, sex, SES (education, income, wealth, employment), and comorbidities with cardiovascular disease, respiratory disease, acute lower respiratory infections, diabetes, lung cancer, and dementia. We used logistic regression to examine association of air pollutants with COVID-19-related hospitalization or death among SARS-CoV-2 positive patients, adjusting for age, sex, individual- and area-level SES. RESULTS: Of 3,721,810 people, 138,742 were infected, 11,270 hospitalized, and 2,557 died from COVID-19 during 14 months of follow-up. We detected strong positive associations with COVID-19 incidence, with hazard ratio (HR) and 95% confidence interval (CI) of 1.10 (CI: 1.05-1.14) per 0.5-µg/m3 increase in PM2.5 and 1.18 (CI: 1.14-1.23) per 3.6-µg/m3 increase in NO2. For COVID-19 hospitalizations and for COVID-19 deaths, corresponding HRs and 95% CIs were 1.09 (CI: 1.01-1.17) and 1.19 (CI: 1.12-1.27), respectively for PM2.5, and 1.23 (CI: 1.04-1.44) and 1.18 (CI: 1.03-1.34), respectively for NO2. We also found strong positive and statistically significant associations with BC and negative associations with O3. Associations were strongest in those aged 65 years old or older, participants with the lowest SES, and patients with chronic cardiovascular, respiratory, metabolic, lung cancer, and neurodegenerative disease. Among 138,742 individuals who have tested positive for SARS-Cov-2, we detected positive association with COVID-19 hospitalizations (N = 11,270) with odds ratio and 95% CI of 1.04 (CI: 1.01- 1.08) per 0.5-µg/m3 increase in PM2.5 and 1.06 (CI: 1.01-1.12) per 3.6-µg/m3 increase in NO2, but no association with PM with an aerodynamic diameter <10 µm (PM10), BC, or O3, and no association between any of the pollutants and COVID-19 mortality (N = 2,557). CONCLUSIONS: This large nationwide study provides strong new evidence in support of association between long-term exposure to air pollution and COVID-19.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Doenças Cardiovasculares , Neoplasias Pulmonares , Doenças Neurodegenerativas , Humanos , Idoso , Dióxido de Nitrogênio/toxicidade , Estudos Prospectivos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , COVID-19/epidemiologia , SARS-CoV-2 , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Poluentes Atmosféricos/toxicidade , Poluentes Atmosféricos/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Incidência , Dinamarca/epidemiologia
2.
Diabetologia ; 56(1): 36-46, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22918192

RESUMO

AIMS/HYPOTHESIS: The aim of this study was to investigate whether air pollution from traffic at a residence is associated with mortality related to type 1 or type 2 diabetes. METHODS: We followed up 52,061 participants in the Danish Diet, Cancer and Health cohort for diabetes-related mortality in the nationwide Register of Causes of Death, from baseline in 1993-1997 up to the end of 2009, and traced their residential addresses since 1971 in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO2) since 1971 and amount of traffic at the baseline residence as indicators of traffic-related air pollution and used Cox regression models to estimate mortality-rate ratios (MRRs) with adjustment for potential confounders. RESULTS: Mean levels of NO2 at the residence since 1971 were significantly associated with mortality from diabetes. Exposure above 19.4 µg/m³ (upper quartile) was associated with a MRR of 2.15 (95% CI 1.21, 3.83) when compared with below 13.6 µg/m³ (lower quartile), corresponding to an MRR of 1.31 (95% CI 0.98, 1.76) per 10 µg/m³ NO2 after adjustment for potential confounders. CONCLUSIONS/INTERPRETATION: This study suggests that traffic-related air pollution is associated with mortality from diabetes. If confirmed, reduction in population exposure to traffic-related air pollution could be an additional strategy against the global public health burden of diabetes.


Assuntos
Poluentes Atmosféricos/toxicidade , Diabetes Mellitus/mortalidade , Exposição Ambiental/efeitos adversos , Emissões de Veículos/toxicidade , Estudos de Coortes , Fatores de Confusão Epidemiológicos , Dinamarca/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Dióxido de Nitrogênio/toxicidade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Sistema de Registros , Características de Residência , Inquéritos e Questionários , Fatores de Tempo , Saúde da População Urbana
3.
Thorax ; 63(8): 710-6, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18267985

RESUMO

BACKGROUND: There is limited evidence for the role of air pollution in the development and triggering of wheezing symptoms in young children. A study was undertaken to examine the effect of exposure to air pollution on wheezing symptoms in children under the age of 3 years with genetic susceptibility to asthma. METHODS: Daily recordings of symptoms were obtained for 205 children participating in the birth cohort study Copenhagen Prospective Study on Asthma in Children and living in Copenhagen for the first 3 years of life. Daily air pollution levels for particulate matter <10 microm in diameter (PM(10)) and the concentrations of ultrafine particles, nitrogen dioxide (NO(2)), nitrogen oxide (NO(x)) and carbon monoxide (CO) were available from a central background monitoring station in Copenhagen. The association between incident wheezing symptoms and air pollution on the concurrent and previous 4 days was estimated by a logistic regression model (generalised estimating equation) controlling for temperature, season, gender, age, exposure to smoking and paternal history of asthma. RESULTS: Significant positive associations were found between concentrations of PM(10), NO(2), NO(x), CO and wheezing symptoms in infants (aged 0-1 year) with a delay of 3-4 days. Only the traffic-related gases (NO(2), NO(x)) showed significant effects throughout the 3 years of life, albeit attenuating after the age of 1 year. CONCLUSIONS: Air pollution related to traffic is significantly associated with triggering of wheezing symptoms in the first 3 years of life.


Assuntos
Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Sons Respiratórios/etiologia , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Asma/genética , Monóxido de Carbono/toxicidade , Pré-Escolar , Dinamarca , Métodos Epidemiológicos , Feminino , Predisposição Genética para Doença , Humanos , Lactente , Masculino , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/toxicidade , Óxidos de Nitrogênio/análise , Óxidos de Nitrogênio/toxicidade , Material Particulado/análise , Material Particulado/toxicidade , Linhagem , Estudos Prospectivos , Fatores de Tempo , Emissões de Veículos/análise , Emissões de Veículos/toxicidade
4.
Occup Environ Med ; 65(7): 458-66, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17989204

RESUMO

OBJECTIVES: To study the association between short-term exposure to ultrafine particles and morbidity in Copenhagen, Denmark. METHODS: We studied the association between urban background levels of the total number concentration of particles (NC(tot), 6-700 nm in diameter) measured at a single site (15 May 2001 to 31 December 2004) and hospital admissions due to cardiovascular (CVD) and respiratory disease (RD) in the elderly (age >or=65 years), and due to asthma in children (age 5-18 years). We examined these associations in the presence of PM(10), PM(2.5) (particulate matter <10 and 2.5 microm in diameter, respectively) and ambient gasses. We utilised data on size distribution to calculate NC(tot) for four modes with median diameters 12, 23, 57 and 212 nm, and NC(100) (number concentration of particles <100 nm in diameter) and examined their associations with health outcomes. We used a time series Poisson generalised additive model adjusted for overdispersion, season, day of the week, public holidays, school holidays, influenza, pollen and meteorology, with up to 5 days' lagged exposure. RESULTS AND CONCLUSIONS: The adverse health effects of particulate matter on CVD and RD hospital admissions in the elderly were mainly mediated by PM(10) and accumulation mode particles with lack of effects for NC(100). For paediatric asthma, accumulation mode particles, NC(100) and nitrogen oxides (mainly from traffic related sources) were relevant, whereas PM(10) appeared to have little effect. Our results suggest that particle volume/mass from long-range transported air pollution is relevant for CVD and RD admissions in the elderly, and possibly particle numbers from traffic sources for paediatric asthma.


Assuntos
Poluentes Atmosféricos/toxicidade , Asma/etiologia , Doenças Cardiovasculares/etiologia , Hospitalização/estatística & dados numéricos , Saúde da População Urbana , Adolescente , Idoso , Criança , Pré-Escolar , Dinamarca , Poeira , Exposição Ambiental , Monitoramento Ambiental/métodos , Humanos , Exposição por Inalação , Óxidos de Nitrogênio/toxicidade , Tamanho da Partícula , Tempo (Meteorologia)
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