The Role of Socioeconomic Status in the Association of Lung Function and Air Pollution—A Pooled Analysis of Three Adult ESCAPE Cohorts

Dirk Keidel, Josep Maria Anto, Xavier Basagaña, Roberto Bono, Emilie Burte, Anne-Elie Carsin, Bertil Forsberg, Elaine Fuertes, Bruna Galobardes, Joachim Heinrich, Kees de Hoogh, Debbie Jarvis, Nino Künzli, Bénédicte Leynaert, Alessandro Marcon, Nicole Le Moual, Audrey de Nazelle, Christian Schindler, Valérie Siroux, Morgane Stempfelet, Jordi Sunyer, Sofia Temam, Ming-Yi Tsai, Raphaëlle Varraso, Bénédicte Jacquemin and Nicole Probst-Hensch
Additional contact information
Dirk Keidel: Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
Josep Maria Anto: ISGlobal, 08003 Barcelona, Spain
Xavier Basagaña: ISGlobal, 08003 Barcelona, Spain
Roberto Bono: Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
Emilie Burte: ISGlobal, 08003 Barcelona, Spain
Anne-Elie Carsin: ISGlobal, 08003 Barcelona, Spain
Bertil Forsberg: Public Health and Clinical Medicine, Umea University, University Hospital, 901 87 Umea, Sweden
Elaine Fuertes: National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
Bruna Galobardes: School of Social and Community Medicine, University of Bristol, Bristol BS8 1QU, UK
Joachim Heinrich: Institute of Epidemiology, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, 85764 Neuherberg, Germany
Kees de Hoogh: Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
Debbie Jarvis: National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
Nino Künzli: Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
Bénédicte Leynaert: INSERM UMR1152, Physiopathologie et épidémiologie des Maladies Respiratoires, équipe Epidémiologie, 75018 Paris, France
Alessandro Marcon: Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
Nicole Le Moual: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, 94807 Villejuif, France
Audrey de Nazelle: Centre for Environmental Policy, Imperial College London, Exhibition Road, South Kensington Campus, London SW7 2AZ, UK
Christian Schindler: Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland
Valérie Siroux: Institute for Advanced Biosciences, Inserm U1209, UMR CNRS 5309, Université Grenoble-Alpes, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, 38700 Grenoble, France
Morgane Stempfelet: InVS, French Institute for Public Health Surveillance, 94415 Saint-Maurice, France
Jordi Sunyer: ISGlobal, 08003 Barcelona, Spain
Sofia Temam: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, 94807 Villejuif, France
Ming-Yi Tsai: Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
Raphaëlle Varraso: INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, 94807 Villejuif, France
Bénédicte Jacquemin: ISGlobal, 08003 Barcelona, Spain
Nicole Probst-Hensch: Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland

IJERPH, 2019, vol. 16, issue 11, 1-14

Abstract: Ambient air pollution is a leading environmental risk factor and its broad spectrum of adverse health effects includes a decrease in lung function. Socioeconomic status (SES) is known to be associated with both air pollution exposure and respiratory function. This study assesses the role of SES either as confounder or effect modifier of the association between ambient air pollution and lung function. Cross-sectional data from three European multicenter adult cohorts were pooled to assess factors associated with lung function, including annual means of home outdoor NO 2 . Pre-bronchodilator lung function was measured according to the ATS-criteria. Multiple mixed linear models with random intercepts for study areas were used. Three different factors (education, occupation and neighborhood unemployment rate) were considered to represent SES. NO 2 exposure was negatively associated with lung function. Occupation and neighborhood unemployment rates were not associated with lung function. However, the inclusion of the SES-variable education improved the models and the air pollution-lung function associations got slightly stronger. NO 2 associations with lung function were not substantially modified by SES-variables. In this multicenter European study we could show that SES plays a role as a confounder in the association of ambient NO 2 exposure with lung function.

Keywords: Europe; socioeconomic position; air pollution; environmental equality; lung function (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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