Abstract：
BACKGROUND: Prolonged exposure to air pollution has been linked to adverse respiratory health, yet the evidence concerning its association with chronic obstructive pulmonary disease (COPD) is inconsistent. The evidence of a greenness effect on chronic respiratory diseases is limited.
OBJECTIVE: This study aimed to investigate the association between long-term exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (as measured by the normalized difference vegetation index - NDVI) and incidence of self-reported chronic bronchitis or COPD (CB/COPD).
METHODS: We analyzed data from 5355 adults from 7 centers participating in the Respiratory Health in Northern Europe (RHINE) study. Mean exposures to air pollution and greenness were assessed at available residential addresses in 1990, 2000 and 2010 using air dispersion models and satellite data, respectively. Poisson regression with log person-time as an offset was employed to analyze the association between air pollution, greenness, and CB/COPD incidence, adjusting for confounders.
RESULTS: Overall, there were 328 incident cases of CB/COPD during 2010-2023. Despite wide statistical uncertainty, we found a trend for a positive association between NO2 exposure and CB/COPD incidence, with incidence rate ratios (IRRs) per 10 μg/m³ difference ranging between 1.13 (95% CI: 0.90-1.41) in 1990 and 1.18 (95% CI: 0.96-1.45) in 2000. O3 showed a tendency for inverse association with CB/COPD incidence (IRR from 0.84 (95% CI: 0.66-1.07) in 2000 to 0.88 (95% CI: 0.69-1.14) in 2010. No consistent association was found between PM, BC and greenness with CB/COPD incidence across different exposure time windows.
CONCLUSIONS: Consistent with prior research, our study suggests that individuals exposed to higher concentrations of NO2 may face an elevated risk of developing COPD, although evidence remains inconclusive. Greenness was not associated with CB/COPD incidence, while O3 showed a tendency for an inverse association with the outcome.
OBJECTIVE: This study aimed to investigate the association between long-term exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (as measured by the normalized difference vegetation index - NDVI) and incidence of self-reported chronic bronchitis or COPD (CB/COPD).
METHODS: We analyzed data from 5355 adults from 7 centers participating in the Respiratory Health in Northern Europe (RHINE) study. Mean exposures to air pollution and greenness were assessed at available residential addresses in 1990, 2000 and 2010 using air dispersion models and satellite data, respectively. Poisson regression with log person-time as an offset was employed to analyze the association between air pollution, greenness, and CB/COPD incidence, adjusting for confounders.
RESULTS: Overall, there were 328 incident cases of CB/COPD during 2010-2023. Despite wide statistical uncertainty, we found a trend for a positive association between NO2 exposure and CB/COPD incidence, with incidence rate ratios (IRRs) per 10 μg/m³ difference ranging between 1.13 (95% CI: 0.90-1.41) in 1990 and 1.18 (95% CI: 0.96-1.45) in 2000. O3 showed a tendency for inverse association with CB/COPD incidence (IRR from 0.84 (95% CI: 0.66-1.07) in 2000 to 0.88 (95% CI: 0.69-1.14) in 2010. No consistent association was found between PM, BC and greenness with CB/COPD incidence across different exposure time windows.
CONCLUSIONS: Consistent with prior research, our study suggests that individuals exposed to higher concentrations of NO2 may face an elevated risk of developing COPD, although evidence remains inconclusive. Greenness was not associated with CB/COPD incidence, while O3 showed a tendency for an inverse association with the outcome.
摘要：
背景：长期暴露于空气污染与不良呼吸道健康有关，然而,关于其与慢性阻塞性肺疾病(COPD)相关的证据并不一致.对慢性呼吸系统疾病的绿色影响的证据是有限的。
目的：本研究旨在调查长期暴露于颗粒物（PM2.5和PM10）之间的关联。黑碳（BC），二氧化氮(NO2),臭氧（O3）和绿色（通过归一化差异植被指数-NDVI衡量）以及自我报告的慢性支气管炎或COPD（CB/COPD）的发生率。
方法：我们分析了来自参与北欧呼吸健康（RHINE）研究的7个中心的5355名成年人的数据。在1990年，2000年和2010年，使用空气扩散模型和卫星数据在可用的住宅地址评估了空气污染和绿色的平均暴露。分别。采用对数人时作为偏移量的泊松回归分析空气污染之间的关联，绿色,和CB/COPD发病率，适应混杂因素。
结果：总体而言，2010-2023年有328例CB/COPD事件.尽管统计不确定性很大，我们发现NO2暴露与CB/COPD发病率呈正相关的趋势，发生率比率（IRRs）每10μg/m3差异在1990年的1.13（95％CI：0.90-1.41）和2000年的1.18（95％CI：0.96-1.45）之间。O3显示出与CB/COPD发病率呈负相关的趋势（IRR从2000年的0.84（95％CI：0.66-1.07）到2010年的0.88（95％CI：0.69-1.14）。PM之间没有发现一致的关联，BC和绿色与CB/COPD发病率在不同的暴露时间窗口。
结论：与先前的研究一致，我们的研究表明，暴露于较高浓度NO2的个体可能面临发展为COPD的高风险，尽管证据确凿.绿色与CB/COPD发病率无关，而O3显示出与结果呈负相关的趋势。
目的：本研究旨在调查长期暴露于颗粒物（PM2.5和PM10）之间的关联。黑碳（BC），二氧化氮(NO2),臭氧（O3）和绿色（通过归一化差异植被指数-NDVI衡量）以及自我报告的慢性支气管炎或COPD（CB/COPD）的发生率。
方法：我们分析了来自参与北欧呼吸健康（RHINE）研究的7个中心的5355名成年人的数据。在1990年，2000年和2010年，使用空气扩散模型和卫星数据在可用的住宅地址评估了空气污染和绿色的平均暴露。分别。采用对数人时作为偏移量的泊松回归分析空气污染之间的关联，绿色,和CB/COPD发病率，适应混杂因素。
结果：总体而言，2010-2023年有328例CB/COPD事件.尽管统计不确定性很大，我们发现NO2暴露与CB/COPD发病率呈正相关的趋势，发生率比率（IRRs）每10μg/m3差异在1990年的1.13（95％CI：0.90-1.41）和2000年的1.18（95％CI：0.96-1.45）之间。O3显示出与CB/COPD发病率呈负相关的趋势（IRR从2000年的0.84（95％CI：0.66-1.07）到2010年的0.88（95％CI：0.69-1.14）。PM之间没有发现一致的关联，BC和绿色与CB/COPD发病率在不同的暴露时间窗口。
结论：与先前的研究一致，我们的研究表明，暴露于较高浓度NO2的个体可能面临发展为COPD的高风险，尽管证据确凿.绿色与CB/COPD发病率无关，而O3显示出与结果呈负相关的趋势。
