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Respiratory Effects of a Reduction in Outdoor Air Pollution Concentrations

Boogaard, Hannaa; Fischer, Paul H.b; Janssen, Nicole A. H.b; Kos, Gerard P. A.c; Weijers, Ernie P.c; Cassee, Flemming R.b; van der Zee, Saskia C.d; de Hartog, Jeroen J.a; Meliefste, Keesa; Wang, Menga; Brunekreef, Berta,e; Hoek, Gerarda

doi: 10.1097/EDE.0b013e31829e1639
Air Pollution

Background: Air pollution has been associated with respiratory health effects. There is little direct evidence that reductions in air pollution related to abatement policies lead to actual improvement in respiratory health. We assessed whether a reduction in (traffic policy-related) air pollution concentrations was associated with changes in respiratory health.

Methods: Air pollution concentrations and respiratory health were measured in 2008 and 2010 at eight busy urban streets and at four suburban background control locations. Respiratory function was assessed twice in 661 residents by spirometry and measurements of airway resistance. Nitric oxide (NO) in exhaled air was measured as a marker for airway inflammation.

Results: Air pollution concentrations were lower in 2010 than in 2008. The declines in pollutants varied among locations, with the largest decline observed in a street with a large reduction in traffic intensity. In regression analyses adjusted for important covariates, reductions in concentrations of soot, NO2, NOx, Cu, and Fe were associated with increases in forced vital capacity (FVC) (∼1% increase per interquartile range [IQR] decline). Airway resistance decreased with a decline in particulate matter (PM10) and PM2.5 (9% per IQR), although these associations were somewhat less consistent. No associations were found with exhaled NO. Results were driven largely by one street where traffic-related air pollution showed the largest reduction. Forced expiratory volume and FVC improved by 3% to 6% in residents of this street compared with suburban background residents. This was accompanied by a suggestive reduction in airway resistance.

Conclusions: Reductions in air pollution may lead to small improvements in respiratory function.

From the aInstitute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, Netherlands; bCentre for Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands; cDepartment of Environmental Assessment, Energy Research Centre of the Netherlands (ECN), Petten, Netherlands; dDepartment of Environmental Health, Municipal Health Service Amsterdam, Amsterdam, Netherlands; and eJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.

Supported by Dutch Ministry of Infrastructure and the Environment with additional funding from the Province of Noord-Brabant.

The authors report no conflicts of interest.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com). This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Correspondence: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, Netherlands. E-mail: g.hoek@uu.nl.

Received September 18, 2012

Accepted April 12, 2013

© 2013 by Lippincott Williams & Wilkins, Inc