Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia

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• dc.contributor.author Alari, Anna
• dc.contributor.author Ranzani, Otavio
• dc.contributor.author Milà, Carles
• dc.contributor.author Olmos, Sergio
• dc.contributor.author Basagaña Flores, Xavier
• dc.contributor.author Dadvand, Payam
• dc.contributor.author Duarte Salles, Talita, 1985-
• dc.contributor.author Nieuwenhuijsen, Mark J.
• dc.contributor.author Tonne, Cathryn
• dc.date.accessioned 2025-02-11T07:21:36Z
• dc.date.available 2025-02-11T07:21:36Z
• dc.date.issued 2024
• dc.description.abstract Background: Evidence is limited regarding the role of air pollution in acute lower respiratory infections among adults. We assessed the influence of long-term air pollution exposure on hospital admission for lower respiratory infections and whether there are vulnerable subgroups. Methods: We used a populational cohort in Catalonia, Spain, comprising 3,817,820 adults residing in Catalonia as of January 1, 2015. Air pollution exposure was assigned to individuaĺs residential address using locally-developed models. We characterized the concentration-response functions between long-term air pollution exposure and hospital admission for lower respiratory infections between 2015 and 2019. We assessed interaction between exposure and clinical and socio-economic factors on multiplicative and additive scales. Results: An interquartile range exposure increase was associated with an 8 % (95 % Confidence Interval: 5 %-11 %) for Nitrogen Dioxide, 10 % (95 % Confidence Interval: 8 %-13 %) for Particulate Matter with diameter equal to or smaller than 2.5 µm, 5 % (95 % Confidence Interval: 3 %-7%) for Particulate Matter with diameter equal to or smaller than 10 µm and 18 % (95 % Confidence Interval: 14 %-22%) for ozone (adjusted by Nitrogen Dioxide) increase in hospital admissions for respiratory infections. Concentration-response functions were non-linear, with steeper slopes at exposures below the median or at most extreme high values. Associations were consistently greater for individuals over 65 years or with hypertension diagnosis and males. Conclusions: Long-term exposure to air pollution was positively associated with hospital admission for lower respiratory infections. Individuals who were older than 65 years, hypertensive or male were most vulnerable.
• dc.description.sponsorship This work was supported by the Health Effects Institute (HEI) research agreement (grant No 4980-RFA20-1B/21-3). We acknowledge support from the Spanish Ministry of Science and Innovation and State Research Agency through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S) and from the Generalitat de Catalunya through the CERCA Program. We thank Rosa Vivanco and the Public Data Analysis for Health Research and Innovation Program of Catalonia (PADRIS) for their support with the data linkage. We acknowledge ELAPSE team for the 2010 exposure estimates for Catalonia.
• dc.format.mimetype application/pdf
• dc.identifier.citation Alari A, Ranzani O, Milà C, Olmos S, Basagaña X, Dadvand P, et al. Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia. Environ Int. 2024 Dec 25;195:109230. DOI: 10.1016/j.envint.2024.109230
• dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2024.109230
• dc.identifier.issn 0160-4120
• dc.identifier.uri http://hdl.handle.net/10230/69536
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Environ Int. 2024 Dec 25;195:109230
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/CEX2018-000806-S
• dc.rights © 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
• dc.subject.keyword Adults
• dc.subject.keyword Air pollution
• dc.subject.keyword Long-term exposure
• dc.subject.keyword Lower respiratory infections
• dc.subject.keyword Time-to-event analysis
• dc.title Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion