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Uraguchi K, Matsumoto N, Mitsuhashi T, Takao S, Makihara S, Ando M, Yorifuji T. Association Between Clinical Remission of Infantile-Onset Allergic Rhinitis During the School-Age Period and the Type of Housing: A Longitudinal Population-Based Japanese Study. J Pediatr Health Care 2024; 38:629-636. [PMID: 38127044 DOI: 10.1016/j.pedhc.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Abstract
This study investigated the association between housing type and clinical remission of infantile-onset allergic rhinitis (AR) in 53,575 children born in 2001 in Japan. Infantile-onset AR was defined as the presence of AR symptoms reported between ages 1.5 and 4.5 years, and remission was assessed between ages 10 and 12. The type of housing was categorized into detached houses and multi-unit residential buildings with 1-2, 3-5, or ≥6 floors. Among the 4,352 infantile-onset AR, 42.9% experienced remission. Notably, living in multi-unit residential buildings, particularly those with 1-2 and ≥6 floors, was positively associated with AR remission.
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Kloster S, Kirkegaard AM, Davidsen M, Christensen AI, Nielsen NS, Gunnarsen L, Vestbo J, Ersbøll AK. Housing conditions and risk of incident COPD: a Danish cohort study, 2000-2018. BMC Public Health 2024; 24:1714. [PMID: 38937765 PMCID: PMC11210200 DOI: 10.1186/s12889-024-19131-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 06/13/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND More knowledge is needed on the risk of developing chronic obstructive pulmonary disease (COPD) associated with housing conditions and indoor environment based on cohort studies with a long follow-up time. OBJECTIVE To examine the association between housing conditions and indoor environment and the risk of developing COPD. METHODS In this cohort study, we followed 11,590 individuals aged ≥ 30 years free of COPD at baseline. Information on incident COPD and housing conditions and indoor environment was obtained from the Danish national registers and the Danish Health and Morbidity Survey year 2000. Poisson regression of incidence rates (IRs) were used to estimate incidence rate ratios (IRRs) of COPD. RESULTS The overall IR of COPD was 8.6 per 1,000 person-years. Individuals living outside the biggest cities vs. living in the biggest cities (≥ 50,000) had a lower risk of COPD (200-4,999; IRR 0.77 (95% CI 0.65-0.90). Individuals living in semi-detached houses had a higher risk compared to individuals living in detached houses (IRR 1.29 (95% CI 1.07-1.55)). Likewise, individuals living in rented homes had a higher risk (IRR 1.47 (95% CI 1.27-1.70)) compared to individuals living in owned homes. The IR of COPD was 17% higher among individuals living in dwellings build > 1982 compared with individuals living in older dwellings (< 1962), not statistically significant though (IRR 0.83 (95% CI 0.68-1.03)). Likewise, the IR of COPD was 15% higher among individuals living in the densest households compared with individuals living in the least dense households, not statistically significant though (IRR 1.15 (95% CI 0.92-1.45)). This was primary seen among smokers. There was no difference in risk among individuals with different perceived indoor environments. Overall, similar patterns were seen when stratified by smoking status with exception of perceived indoor environment, where opposite patterns were seen for smokers and never smokers. CONCLUSION Individuals living in semi-detached houses or rented homes had a higher risk of developing COPD compared to individuals living in detached or owned homes. Individuals living in cities with < 50.000 residents had a lower risk of COPD compared to individuals living in cities with ≥ 50.000 residents.
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Affiliation(s)
- Stine Kloster
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark.
| | - Anne Marie Kirkegaard
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450, Copenhagen, SV, Denmark
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark
| | - Anne Illemann Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark
| | - Niss Skov Nielsen
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450, Copenhagen, SV, Denmark
| | - Lars Gunnarsen
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450, Copenhagen, SV, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, M13 9 PL, UK
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark
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Groot J, Keller A, Sigsgaard T, Loft S, Nybo Andersen AM. Residential exposure to mold, dampness, and indoor air pollution and risk of respiratory tract infections: a study among children ages 11 and 12 in the Danish National Birth Cohort. Eur J Epidemiol 2024; 39:299-311. [PMID: 38393605 PMCID: PMC10994992 DOI: 10.1007/s10654-024-01101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/10/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The burden of respiratory tract infections (RTIs) is high in childhood. Several residential exposures may affect relative rates. OBJECTIVES To determine risk of RTIs in children ages 11 and 12 by residential exposures. METHODS We included children in the Danish National Birth Cohort (DNBC) at ages 11 and 12. We estimated incidence risk ratios (IRR) and 95% confidence intervals (CI) for counts of RTIs within the last year by exposure to mold/dampness, gas stove usage, summer and winter candle-burning, fireplace usage, cats and dogs indoors, and farmhouse living. We also estimated IRR and 95% CI for RTIs for predicted scores of four extracted factors ('owned house', 'mold and dampness', 'candles', and 'density') from exploratory factor analyses (EFA). RESULTS We included 42 720 children with complete data. Mold/dampness was associated with all RTIs (common cold: IRRadj 1.09[1.07, 1.12]; influenza: IRRadj 1.10 [1.05, 1.15]; tonsillitis: IRRadj 1.19 [1.10, 1.28]; conjunctivitis: IRRadj 1.16 [1.02, 1.32]; and doctor-diagnosed pneumonia: IRRadj 1.05 [0.90, 1.21]), as was the EFA factor 'mold/dampness' for several outcomes. Gas stove usage was associated with conjunctivitis (IRRadj 1.25 [1.05, 1.49]) and with doctor-diagnosed pneumonia (IRRadj 1.14 [0.93, 1.39]). Candle-burning during summer, but not winter, was associated with several RTIs, for tonsillitis in a dose-dependent fashion (increasing weekly frequencies vs. none: [IRRadj 1.06 [0.98, 1.14], IRRadj 1.16 [1.04, 1.30], IRRadj 1.23 [1.06, 1.43], IRRadj 1.29 [1.00, 1.67], and IRRadj 1.41 [1.12, 1.78]). CONCLUSION Residential exposures, in particular to mold and dampness and to a lesser degree to indoor combustion sources, are related to the occurrence of RTIs in children.
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Affiliation(s)
- Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Keller A, Groot J, Clippet-Jensen C, Pinot de Moira A, Pedersen M, Sigsgaard T, Loft S, Budtz-Jørgensen E, Nybo Andersen AM. Exposure to different residential indoor characteristics during childhood and asthma in adolescence: a latent class analysis of the Danish National Birth Cohort. Eur J Epidemiol 2024; 39:51-65. [PMID: 37865616 PMCID: PMC10811114 DOI: 10.1007/s10654-023-01051-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/11/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Many residential indoor environments may have an impact on children's respiratory health. OBJECTIVES The aims of this study were to identify latent classes of children from the Danish National Birth Cohort (DNBC) who share similar patterns of exposure to indoor home characteristics, and to examine the association between membership in the latent classes and asthma in adolescence. METHODS We included data on residential indoor characteristics of offspring from the DNBC whose mothers had responded to the child's 11-year follow-up and who had data on asthma from the 18-year follow-up. Number of classes and associations were estimated using latent class analysis. To account for sample selection, we applied inverse probability weighting. RESULTS Our final model included five latent classes. The probability of current asthma at 18 years was highest among individuals in class one with higher clustering on household dampness (9, 95%CI 0.06-0.13). Individuals in class four (with higher clustering on pets ownership and living in a farm) had a lower risk of current asthma at age 18 compared to individuals in class one (with higher clustering on household dampness) (OR 0.53 (95%CI 0.32-0.88), p = .01). CONCLUSION Our findings suggest that, in a high-income country such as Denmark, groups of adolescents growing up in homes with mold and moisture during mid-childhood might be at increased risk of current asthma at age 18. Adolescents who grew-up in a farmhouse and who were exposed to pets seem less likely to suffer from asthma by age 18.
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Affiliation(s)
- Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Clara Clippet-Jensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Angela Pinot de Moira
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Esben Budtz-Jørgensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Casey JA, Daouda M, Babadi RS, Do V, Flores NM, Berzansky I, González DJ, Van Horne YO, James-Todd T. Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021. Curr Environ Health Rep 2023; 10:312-336. [PMID: 37581863 PMCID: PMC10504232 DOI: 10.1007/s40572-023-00406-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods. RECENT FINDINGS We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.
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Affiliation(s)
- Joan A. Casey
- University of Washington School of Public Health, Seattle, WA USA
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Misbath Daouda
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Ryan S. Babadi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Vivian Do
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Nina M. Flores
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Isa Berzansky
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - David J.X. González
- Department of Environmental Science, Policy & Management and School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | | | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
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Kloster S, Kirkegaard AM, Davidsen M, Christensen AI, Nielsen NS, Gunnarsen L, Ersbøll AK. Patterns of Perceived Indoor Environment in Danish Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11498. [PMID: 36141771 PMCID: PMC9517311 DOI: 10.3390/ijerph191811498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
The indoor environment is composed of several exposures existing simultaneously. Therefore, it might be useful to combine exposures into common combined measures when used to assess the association with health. The aim of our study was to identify patterns of the perceived indoor environment. Data from the Danish Health and Morbidity Survey in the year 2000 were used. The perceived indoor environment was assessed using a questionnaire (e.g., annoyances from noise, draught, and stuffy air; 13 items in total). Factor analysis was used to explore the structure of relationships between these 13 items. Furthermore, groups of individuals with similar perceived indoor environment were identified using latent class analysis. A total of 16,688 individuals ≥16 years participated. Their median age was 46 years. Four factors were extracted from the factor analysis. The factors were characterized by: (1) a mixture of items, (2) temperature, (3) traffic, and (4) neighbor noise. Moreover, three groups of individuals sharing the same perception of their indoor environment were identified. They were characterized by: a low (n = 14,829), moderate (n = 980), and large number of annoyances (n = 879). Observational studies need to take this correlation and clustering of perceived annoyances into account when studying associations between the indoor environment and health.
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Affiliation(s)
- Stine Kloster
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
| | - Anne Marie Kirkegaard
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450 Copenhagen SV, Denmark
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
| | - Anne Illemann Christensen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
| | - Niss Skov Nielsen
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450 Copenhagen SV, Denmark
| | - Lars Gunnarsen
- Department of the Built Environment, Aalborg University, A.C. Meyers Vaenge 15, 2450 Copenhagen SV, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
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Orru H, Olstrup H, Kukkonen J, López-Aparicio S, Segersson D, Geels C, Tamm T, Riikonen K, Maragkidou A, Sigsgaard T, Brandt J, Grythe H, Forsberg B. Health impacts of PM 2.5 originating from residential wood combustion in four nordic cities. BMC Public Health 2022; 22:1286. [PMID: 35787793 PMCID: PMC9252027 DOI: 10.1186/s12889-022-13622-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/10/2022] [Indexed: 11/26/2022] Open
Abstract
Background Residential wood combustion (RWC) is one of the largest sources of fine particles (PM2.5) in the Nordic cities. The current study aims to calculate the related health effects in four studied city areas in Sweden, Finland, Norway, and Denmark. Methods Health impact assessment (HIA) was employed as the methodology to quantify the health burden. Firstly, the RWC induced annual average PM2.5 concentrations from local sources were estimated with air pollution dispersion modelling. Secondly, the baseline mortality rates were retrieved from the national health registers. Thirdly, the concentration-response function from a previous epidemiological study was applied. For the health impact calculations, the WHO-developed tool AirQ + was used. Results Amongst the studied city areas, the local RWC induced PM2.5 concentration was lowest in the Helsinki Metropolitan Area (population-weighted annual average concentration 0.46 µg m− 3) and highest in Oslo (2.77 µg m− 3). Each year, particulate matter attributed to RWC caused around 19 premature deaths in Umeå (95% CI: 8–29), 85 in the Helsinki Metropolitan Area (95% CI: 35–129), 78 in Copenhagen (95% CI: 33–118), and 232 premature deaths in Oslo (95% CI: 97–346). The average loss of life years per premature death case was approximately ten years; however, in the whole population, this reflects on average a decrease in life expectancy by 0.25 (0.10–0.36) years. In terms of the relative contributions in cities, life expectancy will be decreased by 0.10 (95% CI: 0.05–0.16), 0.18 (95% CI: 0.07–0.28), 0.22 (95% CI: 0.09–0.33) and 0.63 (95% CI: 0.26–0.96) years in the Helsinki Metropolitan Area, Umeå, Copenhagen and Oslo respectively. The number of years of life lost was lowest in Umeå (172, 95% CI: 71–260) and highest in Oslo (2458, 95% CI: 1033–3669). Conclusions All four Nordic city areas have a substantial amount of domestic heating, and RWC is one of the most significant sources of PM2.5. This implicates a substantial predicted impact on public health in terms of premature mortality. Thus, several public health measures are needed to reduce the RWC emissions.
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Affiliation(s)
- Hans Orru
- Umeå University, Sustainable Health, 901 87, Umeå, Sweden. .,University of Tartu, Ravila 19, 50411, Tartu, Estonia.
| | | | - Jaakko Kukkonen
- Finnish Meteorological Institute, P.O. Box 503, Erik Palménin aukio 1, 00101, Helsinki, Finland.,Centre for Atmospheric and Climate Physics Research, and Centre for Climate Change Research, University of Hertfordshire; College Lane, AL10 9AB, Hatfield, UK
| | - Susana López-Aparicio
- Norwegian Institute for Air Research, Instituttveien 18, P.O. Box 100, 2027, Kjeller, Norway
| | - David Segersson
- Swedish Meteorological and Hydrological Institute, SE-60176, Norrköping, Sweden
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Tanel Tamm
- University of Tartu, Ravila 19, 50411, Tartu, Estonia
| | - Kari Riikonen
- Finnish Meteorological Institute, P.O. Box 503, Erik Palménin aukio 1, 00101, Helsinki, Finland
| | - Androniki Maragkidou
- Finnish Meteorological Institute, P.O. Box 503, Erik Palménin aukio 1, 00101, Helsinki, Finland
| | - Torben Sigsgaard
- Department of Public Health , Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark
| | - Jørgen Brandt
- Umeå University, Sustainable Health, 901 87, Umeå, Sweden.,iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Henrik Grythe
- Norwegian Institute for Air Research, Instituttveien 18, P.O. Box 100, 2027, Kjeller, Norway
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Lim YH, Hersoug LG, Lund R, Bruunsgaard H, Ketzel M, Brandt J, Jørgensen JT, Westendorp R, Andersen ZJ, Loft S. Inflammatory markers and lung function in relation to indoor and ambient air pollution. Int J Hyg Environ Health 2022; 241:113944. [PMID: 35176573 DOI: 10.1016/j.ijheh.2022.113944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 12/16/2022]
Abstract
Ambient air pollution causes a range of adverse health effects, whereas effects of indoor sources of air pollution are not well described in high-income countries. We compared hazards of ambient air pollution and indoor sources with respect to important biomarkers of cardiorespiratory effects in terms of lung function and systemic inflammation in a middle-aged Danish cohort. Our cohort comprised 5199 men and women aged 49-63 years at the recruitment during April 2009 to March 2011, with information on exposure to second-hand smoke (SHS) and use of candles, wood stove, kerosene heater and gas cooker as well as relevant covariates. Ambient air pollution exposure was assessed as 2-year mean nitrogen dioxide (NO2) at the address (mean ± SD: 17.1 ± 9.9 μg/m3) and 4-day average levels of particulate matter with diameter <2.5 μm (PM2.5; mean ± SD: 12.5 ± 6.0 μg/m3) in urban background. Lung function was assessed as % predicted forced expiratory volume in the first second (FEV1) and inflammatory markers comprised interleukin-6 (IL-6), IL-10, IL-18, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), and high sensitivity C-reactive protein (hs-CRP). We used random-effect regression models controlling for potential confounders as well as models with further adjustment for self-reported health or for all other exposures. In models adjusted for confounders FEV1 was inversely associated with exposure to NO2, (-0,83% per 10 μg/m3; 95% CI: -1.26; -0.41%), SHS (-0.56% per 1 of 5 categories increment; 95% CI: -0.89; -0.23%), and gas cooker without hood (-0.89%; 95% CI: -1.62; -0.17%), whereas use of wood stove and candles showed positive associations, although these attenuated by mutual adjustment for all exposures or self-reported health. IL-6 showed positive associations with NO2 (6.30% increase in log-transformed values per 10 μg/m3; 95% CI: 3.54; 9.05%), PM2.5 (7.82% per 10 μg/m3; 95% CI: 3.35; 12.4%), SHS (4.38% per increase of 1 of 5 categories; 95% CI: 2.22; 6.54%) and use of kerosene (13.8%; 95% CI: 2.51; 25.1%), whereas the associations with use of wood stove and candles were inverse. PM2.5 and NO2 showed positive associations with IFN-γ and TNF-α, while PM2.5 further associated with IL-10 and IL-18. Hs-CRP was inversely associated with use of candles. These results suggest that the levels of exposure to ambient air pollution and SHS are more harmful than are the levels of exposure to indoor combustion sources from candles and wood stoves in a high-income setting.
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Affiliation(s)
- Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars-Georg Hersoug
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Helle Bruunsgaard
- Department of Clinical Immunology 7631, Rigshospitalet, University Hospital of Copenhagen, Copenhagen and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, United Kingdom
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Jeanette Therming Jørgensen
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rudi Westendorp
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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