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1.
BMJ Open ; 11(10): e049243, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34607861

RESUMO

OBJECTIVE: We aimed to identify factors associated with all-cause mortality in adults with incident asthma. DESIGN AND SETTING: Cross-sectional cohort study, in the metropolitan areas of Copenhagen and Aarhus, Denmark. PARTICIPANTS: Adults aged 50-64 years enrolled in the Danish Diet, Cancer, and Health cohort were followed up from baseline (1993-1997) in the National Patients Registry for first-time admissions for asthma and vital status. We defined incident asthma as at least one first-time hospital admission with asthma as the primary registered diagnosis between baseline and end of follow-up (2013) in participants without previously known asthma. Among the cohort comprising 57 053 individuals, we identified 785 adults (aged 50-64) with incident asthma, of whom 76 died during follow-up. PRIMARY AND SECONDARY OUTCOME MEASURES: Baseline reported socioeconomic and lifestyle traits, and comorbidities associated with all-cause mortality. RESULTS: Self-reported leisure-time physical activity was associated with a substantial reduction in risk with an HR of 0.53 (95% CI 0.33 to 0.85). Being male, single and having a diagnosis of hypertension or diabetes were associated with an increased risk of all-cause mortality with an HR of 1.83 (95% CI 1.14 to 2.38), 2.16 (95% CI 2.06 to 4.40), 2.47 (95% CI 1.54 to 3.95) and of 2.42 (95% CI 0.96 to 6.11), respectively. CONCLUSIONS: This long-term study of adults with hospital contacts for incident asthma revealed that self-reported leisure-time physical activity is associated with an approximately 50% reduction in all-cause mortality. In contrast, both hypertension and diabetes were associated with a higher risk of mortality.


Assuntos
Asma , Estilo de Vida , Adulto , Asma/epidemiologia , Estudos de Coortes , Estudos Transversais , Demografia , Dinamarca/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
3.
Eur Respir J ; 57(6)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34088754

RESUMO

BACKGROUND: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 µm (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in adults. METHODS: We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land-use regression models at participants' baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders. RESULTS: Of 98 326 participants, 1965 developed asthma during a mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 µg·m-3 for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 µg·m-3 for NO2 and 1.15 (95% CI 1.08-1.23) per 0.5×10-5 m-1 for BC. Hazard ratios were larger in cohort subsets with exposure levels below the European Union and US limit values and possibly World Health Organization guidelines for PM2.5 and NO2. NO2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration-response curves showed no evidence of a threshold. CONCLUSIONS: Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Criança , Exposição Ambiental/análise , Europa (Continente) , Humanos , Incidência , Material Particulado/análise , Suécia
4.
J Psychiatr Res ; 139: 132-138, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34058652

RESUMO

BACKGROUND: Research on health effects of shift work has especially focused on somatic diseases, such as breast cancer and cardiometabolic disease, while less attention has been given to the association between shift work and mental health. METHODS: We used information on 19 964 female nurses (≥44 years) from the Danish Nurse Cohort, who reported current work schedule (day, evening, night, or rotating) at recruitment (1993/1999). In 5102 nurses who participated in both cohort waves, we defined persistent night shift work as working night shift in 1993 and 1999. We used Cox regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for relevant confounders. Through linkage of cohort participants to national registers, we defined incidence of mood and neurotic disorders as first hospital contact or redeemed prescription until November 2018. RESULTS: We found association between night shift work with mood disorders (HR = 1.31; 95%CI = 1.17-1.47) and neurotic disorders (1.29; 1.17-1.42), compared to day work. Associations were enhanced in nurses with persistent night shift work (1.85; 1.43-2.39 and 1.62; 1.26-2.09 for mood and neurotic disorders, respectively) and in nurses with specialist confirmed mood (1.69; 1.24-2.29) and neurotic (1.72; 1.22-2.44) disorders. Nurses with preexisting psychiatric disorders and full-time work seemed most susceptible. CONCLUSIONS: Night shift work is associated with increased risk of major psychiatric disorders. The novel suggestive findings of vulnerable groups, including nurses with a history of psychiatric disorders and full-time workers, are based on a limited number of cases, and further research is needed to confirm the results.


Assuntos
Transtornos Mentais , Jornada de Trabalho em Turnos , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Transtornos Mentais/epidemiologia , Fatores de Risco , Jornada de Trabalho em Turnos/efeitos adversos , Tolerância ao Trabalho Programado
5.
Environ Int ; 146: 106249, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33197787

RESUMO

BACKGROUND/AIM: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. METHODS: The "Effects of Low-level Air Pollution: a Study in Europe" (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O3) to assign exposure to cohort participants' residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. RESULTS: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O3 (warm season) were 24.2 µg/m3 (19.5, 29.7), 15.4 µg/m3 (12.8, 17.3), 1.6 10-5m-1 (1.3, 1.8), and 86.6 µg/m3 (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 µg/m3). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset of subjects with exposure below the EU limit value of 25 µg/m3. We did not observe associations between NO2, BC or O3 and lung cancer incidence. CONCLUSIONS: Long-term ambient PM2.5 exposure is associated with lung cancer incidence even at concentrations below current EU limit values and possibly WHO Air Quality Guidelines.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Neoplasias Pulmonares , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Exposição Ambiental/análise , Europa (Continente)/epidemiologia , Humanos , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/epidemiologia , Material Particulado/análise
6.
Environ Res ; 193: 110568, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33278469

RESUMO

BACKGROUND: An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study builds on recent findings from the "Effects of Low-level Air Pollution: A Study in Europe" (ELAPSE) collaboration and addresses the potential association between specific elemental components of PM2.5 and lung cancer incidence. METHODS: We pooled seven cohorts from across Europe and assigned exposure estimates for eight components of PM2.5 representing non-tail pipe emissions (copper (Cu), iron (Fe), and zinc (Zn)), long-range transport (sulfur (S)), oil burning/industry emissions (nickel (Ni), vanadium (V)), crustal material (silicon (Si)), and biomass burning (potassium (K)) to cohort participants' baseline residential address based on 100 m by 100 m grids from newly developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). RESULTS: The pooled study population comprised 306,550 individuals with 3916 incident lung cancer events during 5,541,672 person-years of follow-up. We observed a positive association between exposure to all eight components and lung cancer incidence, with adjusted HRs of 1.10 (95% CI 1.05, 1.16) per 50 ng/m3 PM2.5 K, 1.09 (95% CI 1.02, 1.15) per 1 ng/m3 PM2.5 Ni, 1.22 (95% CI 1.11, 1.35) per 200 ng/m3 PM2.5 S, and 1.07 (95% CI 1.02, 1.12) per 200 ng/m3 PM2.5 V. Effect estimates were largely unaffected by adjustment for nitrogen dioxide (NO2). After adjustment for PM2.5 mass, effect estimates of K, Ni, S, and V were slightly attenuated, whereas effect estimates of Cu, Si, Fe, and Zn became null or negative. CONCLUSIONS: Our results point towards an increased risk of lung cancer in connection with sources of combustion particles from oil and biomass burning and secondary inorganic aerosols rather than non-exhaust traffic emissions. Specific limit values or guidelines targeting these specific PM2.5 components may prove helpful in future lung cancer prevention strategies.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Neoplasias Pulmonares , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Exposição Ambiental/análise , Europa (Continente)/epidemiologia , Humanos , Incidência , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/epidemiologia , Material Particulado/análise
7.
Eur Respir J ; 2020 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-33303534

RESUMO

BACKGROUND: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, while evidence is still insufficient. Within the multicentre project "Effects of Low-Level Air Pollution: A Study in Europe" (ELAPSE), we examined the associations of long-term exposures to particulate matter with diameter<2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) with asthma incidence in adults. METHODS: We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land use regression models at participants' baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders. RESULTS: Of 98 326 participants, 1965 developed asthma during a 16.6 years mean follow-up. We observed associations in fully adjusted models with hazard ratios and 95% confidence intervals of 1.22 (1.04-1.43) per 5 µg·m-3 for PM2.5, 1.17 (1.10-1.25) per 10 µg·m-3 for NO2, and 1.15 (1.08-1.23) per 0.5 10-5 m-1 for BC. Hazard ratios were larger in cohort subsets with exposure levels below the EU and US limit values and possibly WHO guidelines for PM2.5 and NO2. NO2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration response curves showed no evidence of a threshold. CONCLUSIONS: Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.

8.
Occup Environ Med ; 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-33323454

RESUMO

OBJECTIVES: Evidence on the association between night work and Parkinson's disease (PD) is sparse and conflicting, calling for more definitive studies. METHODS: We included 20 138 female nurses from the Danish Nurse Cohort without PD who at baseline in 1993 and/or 1999 reported their most common current work schedule (day, evening, night, and rotating (a combination of at least two of these)), including information on lifetime cumulative duration (years) of each shift in a 2009 follow-up survey. We obtained information on PD hospital contacts and PD medication until November 2018 via linkage to the Danish National Patient (inpatient from 1977 and outpatient contacts from 1995 onwards) and Prescription Registers starting in 1995. We defined the incidence of PD as the first-ever hospital contact due to PD, or the first-ever redeemed levodopa prescription, whichever came first. We used Cox regression models to calculate HRs and 95% CIs, adjusting for age, smoking status, coffee consumption and use of hormone replacement therapy. RESULTS: We found no significant difference in PD risk among nurses who reported working evening (HR=0.86; 95% CI=0.55 to 1.34), night (HR=1.26; 95% CI=0.79 to 2.02) or rotating shifts (HR=0.83; 95% CI=0.56 to 1.21) at cohort baseline in 1993 or 1999, when compared with permanent day workers. Similarly, persistency of shift work (working the same work schedule for 6+ years) or duration of shift work was not associated with PD risk. CONCLUSIONS: Overall, there was little evidence for an association between various shift work schedules including night work and PD in this cohort of middle-aged female nurses.

9.
Environ Int ; 143: 105983, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32736159

RESUMO

BACKGROUND: The association between air pollution and mortality is well established, yet some uncertainties remain: there are few studies that account for road traffic noise exposure or that consider in detail the shape of the exposure-response function for cause-specific mortality outcomes, especially at low-levels of exposure. OBJECTIVES: We examined the association between long-term exposure to particulate matter [(PM) with a diameter of <2.5 µm (PM2.5), <10 µm (PM10)], and nitrogen dioxide (NO2) and total and cause-specific mortality, accounting for road traffic noise. METHODS: We used data on 24,541 females (age > 44 years) from the Danish Nurse Cohort, who were recruited in 1993 or 1999, and linked to the Danish Causes of Death Register for follow-up on date of death and its cause, until the end of 2013. Annual mean concentrations of PM2.5, PM10, and NO2 at the participants' residences since 1990 were estimated using the Danish DEHM/UBM/AirGIS dispersion model, and annual mean road traffic noise levels (Lden) were estimated using the Nord2000 model. We examined associations between the three-year running mean of PM2.5, PM10, and NO2 with total and cause-specific mortality by using time-varying Cox Regression models, adjusting for individual characteristics and residential road traffic noise. RESULTS: During the study period, 3,708 nurses died: 843 from cardiovascular disease (CVD), 310 from respiratory disease (RD), and 64 from diabetes. In the fully adjusted models, including road traffic noise, we detected associations of three-year running mean of PM2.5 with total (hazard ratio; 95% confidence interval: 1.06; 1.01-1.11), CVD (1.14; 1.03-1.26), and diabetes mortality (1.41; 1.05-1.90), per interquartile range of 4.39 µg/m3. In a subset of the cohort exposed to PM2.5 < 20 µg/m3, we found even stronger association with total (1.19; 1.11-1.27), CVD (1.27; 1.01-1.46), RD (1.27; 1.00-1.60), and diabetes mortality (1.44; 0.83-2.48). We found similar associations with PM10 and none with NO2. All associations were robust to adjustment for road traffic noise. DISCUSSION: Long-term exposure to low-levels of PM2.5 and PM10 is associated with total mortality, and mortality from CVD, RD, and diabetes. Associations were even stronger at the PM2.5 levels below EU limit values and were independent of road traffic noise.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Ruído dos Transportes , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Estudos de Coortes , Dinamarca/epidemiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Feminino , Humanos , Ruído dos Transportes/efeitos adversos , Material Particulado/efeitos adversos , Material Particulado/análise
10.
Alzheimers Dement ; 16(9): 1268-1279, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32652788

RESUMO

INTRODUCTION: A few studies suggest that working night and rotating shifts increase the risk of dementia. We examined the association between shift work and the incidence of dementia in a cohort of female Danish nurses. METHODS: We linked Danish Nurse Cohort participants, who reported work schedules (day, evening, night, rotating shifts) in 1993 and/or 1999 and their duration in 2009, to Danish registers to obtain information on dementia hospitalizations and prescription medication until November 2018. RESULTS: Among 6048 nurses who reported work schedules in 1993 and 1999, nurses working night shifts ≥6 years had higher dementia incidence (hazard ratio: 2.43, 95% confidence interval: 1.39 to 4.23) than those working day shifts ≥6 years. Among 8059 nurses who reported shift work duration, nurses working night shifts ≥6 years had higher dementia incidence than those working night shifts <1 year (1.47, 1.06 to 2.06). DISCUSSION: Persistent night shift work may increase the risk of dementia.

11.
Breast Cancer Res Treat ; 182(3): 555-579, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32572713

RESUMO

PURPOSE: Hormone replacement therapy (HRT) is used to reduce climacteric symptoms of menopause and prevent osteoporosis; however, it increases risk of breast cancer. Mammographic density (MD) is also a strong risk factor for breast cancer. We conducted this review to investigate the association between HRT use and MD and to assess the effect of different HRT regimens on MD. METHODS: Two of authors examined articles published between 2002 and 2019 from PubMed, Embase, and OVID using Covidence systematic review platform. Any disagreements were discussed until consensus was reached. The protocol used in this review was created in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Quality of each eligible study was assessed using the Oxford Center for Evidence-Based Medicine (OCEBM) hierarchy. RESULTS: Twenty-two studies met the inclusion criteria. Six studies showed that using estrogen plus progestin (E + P) HRT was associated with higher MD than estrogen alone. Four studies reported that continuous estrogen plus progestin (CEP) users had higher MD than sequential estrogen plus progestin (SEP) and estrogen alone users. However, two studies showed that SEP users had slightly higher MD than CEP users and estrogen alone users. CONCLUSIONS: Epidemiological evidence is rather consistent suggesting that there is a positive association between HRT use and MD with the highest increase in MD among current users, and CEP users. Our results suggest that due to increase in MD and masking effect, current E + P users may require additional screening procedures, shorter screening intervals, or using advanced imaging techniques.


Assuntos
Densidade da Mama , Neoplasias da Mama/epidemiologia , Terapia de Reposição Hormonal/estatística & dados numéricos , Neoplasias da Mama/etiologia , Neoplasias da Mama/patologia , Feminino , Terapia de Reposição Hormonal/efeitos adversos , Humanos , Fatores de Risco
12.
Environ Res ; 176: 108545, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31280030

RESUMO

This study systematically reviewed scientific evidence linking ambient air pollution to physical activity and sedentary behavior in China. A keyword and reference search was conducted in PubMed, Web of Science, and the Cochrane Library. Predetermined selection criteria included-study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies, and case-control studies; subjects: people of all ages; exposures: specific air pollutants and/or overall air quality; outcomes: physical activity and/or sedentary behavior; and country/area: mainland China. Ten studies met the selection criteria and were included in the review. Six adopted a cross-sectional design and the remaining four adopted a prospective cohort design. Four studies assessed a specific air pollutant namely particulate matter with diameter <2.5 µg/m3 (PM2.5), whereas the remaining six focused on overall air quality, defined using air quality indexes. Decline in overall air quality and increase in PM2.5 concentration were found to be associated with reduced daily/weekly duration of outdoor leisure-time and/or transportation-related physical activity such as walking but increased duration of daytime/nighttime sleeping among Chinese residents. In contrast, evidence linking overall air quality and PM2.5 concentration to sedentary behavior remains mixed and inconclusive. In conclusion, preliminary evidence indicates that ambient air pollution impacts Chinese residents' daily physical activity-related behaviors. Future studies adopting objective measures of physical activity and a longitudinal or experimental study design are warranted to examine the impact of air pollution on sensitive sub-populations such as children, older adults and people with pre-existing conditions, and in locations outside China.


Assuntos
Poluição do Ar/estatística & dados numéricos , Recuperação e Remediação Ambiental/estatística & dados numéricos , Exercício Físico , Comportamento Sedentário , Poluentes Atmosféricos , China , Estudos Transversais , Humanos , Material Particulado , Estudos Prospectivos , Estudos Retrospectivos
13.
Environ Health Perspect ; 127(5): 57006, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31084449

RESUMO

BACKGROUND: Evidence on the association between road traffic noise and diabetes risk is sparse and inconsistent with respect to how confounding by air pollution was treated. OBJECTIVES: In this study, we aimed to examine whether long-term exposure to road traffic noise over 25 years is associated with incidence of diabetes, independent of air pollution. METHODS: A total of 28,731 female nurses from the Danish Nurse cohort ([Formula: see text] at recruitment in 1993 or 1999) were linked to the Danish National Diabetes Register with information on incidence of diabetes from 1995 until 2013. The annual mean weighted levels of 24-h average road traffic noise ([Formula: see text]) at nurses' residences from 1970 until 2013 were estimated with the Nord2000 method and annual mean levels of particulate matter (PM) with diameter [Formula: see text] and [Formula: see text] ([Formula: see text] and [Formula: see text]), nitrogen dioxide ([Formula: see text]), and nitrogen oxide ([Formula: see text]) with the Danish AirGIS modeling system. Cox proportional hazards regression models were used to examine the association between residential [Formula: see text] in four different exposure windows (1-, 5-, 10-, and 25-years) and the incidence of diabetes, adjusted for lifestyle factors and air pollutants. RESULTS: Of 23,762 nurses free of diabetes at the cohort baseline, 1,158 developed diabetes during a mean follow-up of 15.2 years. We found weak positive associations between 5-y mean exposure to [Formula: see text] (per [Formula: see text] increase) and diabetes incidence in a crude model [hazard ratio (HR): 1.07; 95% confidence interval (CI): 0.99, 1.12], which attenuated in a model adjusted for lifestyle factors (HR:1.04; 95% CI: 0.97, 1.12), and reached unity after additional adjustment for [Formula: see text] (HR: 0.99; 0.91, 1.08). In analyses by level of urbanization, we found a positive association between noise and diabetes in urban areas (HR:1.27; 95% CI: 0.98, 1.63) that was unchanged after adjusting for [Formula: see text] (HR: 1.25; 95% CI: 0.97, 1.62), but we found no apparent association in provincial (HR: 1.02; 95% CI: 0.88, 1.18) or rural areas (HR: 0.97; 95% CI: 0.87, 1.08). CONCLUSION: In the nationwide cohort of Danish nurses 44 years of age and older, we found no association between long-term exposure to road traffic noise and diabetes incidence after adjustment for [Formula: see text] but found suggestive evidence of an association limited to urban areas. https://doi.org/10.1289/EHP4389.


Assuntos
Diabetes Mellitus/epidemiologia , Exposição Ambiental/efeitos adversos , Ruído dos Transportes/efeitos adversos , Adulto , Idoso , Poluentes Atmosféricos/análise , Estudos de Coortes , Dinamarca/epidemiologia , Diabetes Mellitus/etiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade
14.
Environ Res ; 172: 502-510, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30852453

RESUMO

BACKGROUND: Studies have suggested that traffic noise is associated with markers of obesity. We investigated the association of exposure to road traffic noise with body mass index (BMI) and waist circumference in the Danish Nurse Cohort. METHODS: We used data on 15,501 female nurses (aged >44 years) from the nationwide Danish Nurse Cohort who, in 1999, reported information on self-measured height, weight, and waist circumference, together with information on socioeconomic status, lifestyle, work and health. Road traffic noise at the most exposed façade of the residence was estimated using Nord2000 as the annual mean of a weighted 24-h average (Lden). We used multiple linear regression models to examine associations of road traffic noise levels in 1999 (1-year mean) with BMI and waist circumference, adjusting for potential confounders, and evaluated effect modification by degree of urbanization, air pollution levels, night shift work, job strain, sedative use, sleep aid use, and family history of obesity. RESULTS: We did not observe associations between road traffic noise (per 10 dB increase in the 1-year mean Lden) and BMI (kg/m2) (ß: 0.00; 95% confidence interval (CI): -0.07, 0.07) or waist circumference (cm) (ß: -0.09; 95% CI: -0.31, 0.31) in the fully adjusted model. We found significant effect modification of job strain and degree of urbanization on the associations between Lden and both BMI and waist circumference. Job strained nurses were associated with a 0.41 BMI-point increase, (95% CI: 0.06, 0.76) and a 1.00 cm increase in waist circumference (95% CI: 0.00, 2.00). Nurses living in urban areas had a statistically significant positive association of Lden with BMI (ß: 0.26; 95% CI: 0.11, 0.42), whilst no association was found for nurses living in suburban and rural areas. CONCLUSION: Our results suggest that road traffic noise exposure in nurses with particular susceptibilities, such as those with job strain, or living in urban areas, may lead to increased BMI, a marker of adiposity.


Assuntos
Adiposidade , Índice de Massa Corporal , Ruído dos Transportes , Circunferência da Cintura , Adulto , Estudos Transversais , Dinamarca , Exposição Ambiental , Feminino , Humanos , Obesidade/diagnóstico
15.
Environ Int ; 121(Pt 1): 973-980, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30408890

RESUMO

BACKGROUND: Health impact assessment (HIA) of exposure to air pollution is commonly based on city level (fine) particle concentration and may underestimate health consequences of changing local traffic. Exposure to traffic-related air pollution can be assessed at a high resolution by modelling levels of nitrogen dioxide (NO2), which together with ultrafine particles mainly originate from diesel-powered vehicles in urban areas. The purpose of this study was to estimate the health benefits of reduced exposure to vehicle emissions assessed as NO2 at the residence among the citizens of Copenhagen Municipality, Denmark. METHODS: We utilized residential NO2 concentrations modelled by use of chemistry transport models to calculate contributions from emission sources to air pollution. The DYNAMO-HIA model was applied to the population of Copenhagen Municipality by using NO2 concentration estimates combined with demographic data and data from nationwide registers on incidence and prevalence of selected diseases, cause specific mortality, and total mortality of the population of Copenhagen. We used exposure-response functions linking NO2 concentration estimates at the residential address with the risk of diabetes, cardiovascular diseases, and respiratory diseases derived from a large Danish cohort study with the majority of subjects residing in Copenhagen between 1971 and 2010. Different scenarios were modelled to estimate the dynamic impact of NO2 exposure on related diseases and the potential health benefits of lowering the NO2 level in the Copenhagen Municipality. RESULTS: The annual mean NO2 concentration was 19.6 µg/m3 and for 70% of the population the range of exposure was between 15 and 21 µg/m3. If NO2 exposure was reduced to the annual mean rural level of 6 µg/m3, life expectancy in 2040 would increase by one year. The greatest gain in disease-free life expectancy would be lifetime without ischemic heart disease (1.4 years), chronic obstructive pulmonary disease (1.5 years for men and 1.6 years for women), and asthma (1.3 years for men and 1.5 years for women). Lowering NO2 exposure by 20% would increase disease-free life expectancy for the different diseases by 0.3-0.5 years. Using gender specific relative risks affected the results. CONCLUSIONS: Reducing the NO2 exposure by controlling traffic-related air pollution reduces the occurrence of some of the most prevalent chronic diseases and increases life expectancy. Such health benefits can be quantified by DYNAMO-HIA in a high resolution exposure modelling. This paper demonstrates how traffic planners can assess health benefits from reduced levels of traffic-related air pollution.


Assuntos
Poluentes Atmosféricos/análise , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Dióxido de Nitrogênio/análise , Doenças Respiratórias/epidemiologia , Poluição Relacionada com o Tráfego/análise , Emissões de Veículos/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar/análise , Criança , Pré-Escolar , Cidades/epidemiologia , Estudos de Coortes , Dinamarca/epidemiologia , Exposição Ambiental/análise , Exposição Ambiental/prevenção & controle , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
16.
Clin Epidemiol ; 10: 1275-1287, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30288123

RESUMO

Background and aim: Knowledge of the impact of social determinants driving asthma- chronic obstructive pulmonary disease overlap (ACO) is lacking. Our objective was to identify determinants of incident ACO. Methods: A total of 55,053 adults (50-64 years) enrolled in the Danish Diet, Cancer, and Health cohort (1993-97) was followed in the National Patient Registry for admissions for asthma (DJ45-46) and chronic obstructive pulmonary disease (COPD; DJ40-44) and vital status. Incident ACO was defined as at least one hospital admission for both asthma and COPD (different time points, one after baseline). Detailed case history was obtained at baseline. Cox proportional hazards model was used to examine associations between possible determinants and incident ACO, in terms of hazard ratio (HR) and 95% confidence interval (CI). Results: During follow-up, 561 incident cases of ACO were identified. Age (HR 4.4, 95% CI 3.3-5.9, age group 60-65 years), current smoking (HR 3.6, 95% CI 2.8-4.6), unemployment (HR 1.5, 95% CI 1.2-1.8), and being divorced (HR 1.5, 95% CI 1.2-1.9) determined a higher risk of incident ACO, whereas the opposite was found for leisure-time physical activity (HR 0.7, 95% CI 0.6-0.8) and high educational level (HR 0.7, 95% CI 0.5-0.9). In contrast to ACO, preexisting myocardial infarction (MI; HR 1.5, 95% CI 1.2-1.8) and stroke (HR 1.5, 95% CI 1.2-1.9) were associated with a higher risk of COPD. Conclusion: Incident ACO is to a large extent determined by factors related to lifestyle and socioeconomic status.

17.
Breast Cancer Res ; 20(1): 119, 2018 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-30290832

RESUMO

BACKGROUND: Exposure to road traffic noise was associated with increased risk of estrogen receptor (ER)-negative (ER-) breast cancer in a previous cohort study, but not with overall or ER-positive (ER+) breast cancer, or breast cancer prognosis. We examined the association between long-term exposure to road traffic noise and incidence of breast cancer, overall and by ER and progesterone receptor (PR) status. METHODS: We used the data from a nationwide Danish Nurse Cohort on 22,466 female nurses (age > 44 years) who at recruitment in 1993 or 1999 reported information on breast cancer risk factors. We obtained data on the incidence of breast cancer from the Danish Cancer Registry, and on breast cancer subtypes by ER and PR status from the Danish Breast Cancer Cooperative Group, up to 31 December 2012. Road traffic noise levels at the nurses' residences were estimated by the Nord2000 method between 1970 and 2013 as annual means of a weighted 24 h average (Lden) at the most exposed facade. We used time-varying Cox regression to analyze the associations between the 24-year, 10-year, and 1-year mean of Lden and breast cancer, separately for total breast cancer and by ER and PR status. RESULTS: Of the 22,466 women, 1193 developed breast cancer in total during 353,775 person-years of follow up, of whom 611 had complete information on ER and PR status. For each 10 dB increase in 24-year mean noise levels at their residence, we found a statistically significant 10% (hazard ratio and 95% confidence interval 1.10; 1.00-1.20) increase in total breast cancer incidence and a 17% (1.17; 1.02-1.33) increase in analyses based on 611 breast cancer cases with complete ER and PR information. We found positive, statistically significant association between noise levels and ER+ (1.23; 1.06-1.43, N = 494) but not ER- (0.93; 0.70-1.25, N = 117) breast cancers, and a stronger association between noise levels and PR+ (1.21; 1.02-1.42, N = 393) than between noise levels and PR- (1.10; 0.89-1.37, N = 218) breast cancers. Association between noise and ER+ breast cancer was statistically significantly stronger in nurses working night shifts (3.36; 1.48-7.63) than in those not working at night (1.21; 1.02-1.43) (p value for interaction = 0.05). CONCLUSION: Long-term exposure to road traffic noise may increase risk of ER+ breast cancer.


Assuntos
Neoplasias da Mama/etiologia , Ruído dos Transportes/efeitos adversos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/metabolismo , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Fatores de Tempo
18.
Clin Epidemiol ; 10: 605-612, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29872349

RESUMO

Background: Excess body weight in adulthood is associated with risk for asthma admission (AA). Our aim was to investigate if this association also applies to the relation between body mass index (BMI) in childhood and AAs in early adulthood (age 20-45 years). Methods: This was a prospective study of 310,211 schoolchildren (born 1930-1989) from the Copenhagen School Health Records Register. Height and weight were measured annually, and generated BMI z-scores were categorized as low (lower quartile), normal (interquartile) and high (upper quartile). Associations between BMI at ages 7-13 and AA were estimated by Cox regressions, and presented as hazard ratios (HRs) and 95% confidence intervals (CI). Main outcome was incident hospital AAs (extracted from the Danish National Patient Register) in early adulthood. Results: During 4,708,607 person-years of follow-up, 1,813 incident AAs were observed. Nonlinear associations were detected between childhood BMI and AAs. The risk of AA increased for females in the highest BMI category in childhood, with the highest HR of 1.3 (95% CI 1.16-1.55) at the age of 13 years. By contrast, males in the low BMI category had a higher risk of AA in early adulthood, with the highest HR of 1.24 (95% CI 1.03-1.51) at the age of 12 years. Females with an increase in BMI between ages 7 and 13 years had an increased risk of AA compared with females with stable BMI (HR 1.28, 95% CI 1.10-1.50). Conclusion: The association between childhood BMI and AA in early adulthood is non-linear. High BMI increases the risk of AA in females, whereas low BMI increases the risk in males.

19.
Environ Int ; 116: 186-196, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29689465

RESUMO

BACKGROUND: Although epidemiological studies have reported associations between mortality and both ambient air pollution and air temperature, it remains uncertain whether the mortality effects of air pollution are modified by temperature and vice versa. Moreover, little is known on the interactions between ultrafine particles (diameter ≤ 100 nm, UFP) and temperature. OBJECTIVE: We investigated whether the short-term associations of particle number concentration (PNC in the ultrafine range (≤100 nm) or total PNC ≤ 3000 nm, as a proxy for UFP), particulate matter ≤ 2.5 µm (PM2.5) and ≤ 10 µm (PM10), and ozone with daily total natural and cardiovascular mortality were modified by air temperature and whether air pollution levels affected the temperature-mortality associations in eight European urban areas during 1999-2013. METHODS: We first analyzed air temperature-stratified associations between air pollution and total natural (nonaccidental) and cardiovascular mortality as well as air pollution-stratified temperature-mortality associations using city-specific over-dispersed Poisson additive models with a distributed lag nonlinear temperature term in each city. All models were adjusted for long-term and seasonal trend, day of the week, influenza epidemics, and population dynamics due to summer vacation and holidays. City-specific effect estimates were then pooled using random-effects meta-analysis. RESULTS: Pooled associations between air pollutants and total and cardiovascular mortality were overall positive and generally stronger at high relatively compared to low air temperatures. For example, on days with high air temperatures (>75th percentile), an increase of 10,000 particles/cm3 in PNC corresponded to a 2.51% (95% CI: 0.39%, 4.67%) increase in cardiovascular mortality, which was significantly higher than that on days with low air temperatures (<25th percentile) [-0.18% (95% CI: -0.97%, 0.62%)]. On days with high air pollution (>50th percentile), both heat- and cold-related mortality risks increased. CONCLUSION: Our findings showed that high temperature could modify the effects of air pollution on daily mortality and high air pollution might enhance the air temperature effects.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar , Doenças Cardiovasculares/mortalidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Cidades/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Material Particulado/análise , Estudos Retrospectivos , Temperatura
20.
Cancer Causes Control ; 29(4-5): 399-404, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29520472

RESUMO

OBJECTIVES: Traffic is the most important source of community noise, and it has been proposed to be associated with a range of disease outcomes, including breast cancer. As mammographic breast density (MD) is one of the strongest risk factors for developing breast cancer, the present study investigated whether there is an association between residential exposure to traffic noise and MD in a Danish cohort. METHODS: We included women with reproductive and lifestyle information available from the Diet, Cancer, and Health cohort, who also participated in the Copenhagen Mammography Screening Programme (n = 5,260). Present and historical addresses from 1987 to 2011 were found in national registries, and traffic noise was modeled 5 years before mammogram. Analyses between residential traffic noise and MD were performed using logistic regression. RESULTS: We found no association between residential road and railway noise exposure 5 years before mammogram, and having a mixed/dense versus a fatty mammogram, and no interaction with menopausal status, BMI, HRT use, and railway noise exposure, for analyses on road traffic noise. CONCLUSION: The present study does not suggest an association between residential traffic noise exposure and subsequent MD in a cohort of middle-aged Danish women.


Assuntos
Densidade da Mama , Exposição Ambiental/efeitos adversos , Mamografia/métodos , Ruído dos Transportes/efeitos adversos , Idoso , Estudos de Coortes , Detecção Precoce de Câncer , Feminino , Habitação , Humanos , Estilo de Vida , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco
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