Mortality and morbidity effects of long-term exposure to low-level PM2.5, Black Carbon, NO2 and O3: an analysis of European cohorts (4954-RFA14-3/16-5)
This project will address health effects at low air pollution levels by performing targeted analyses of all-cause and cause-specific mortality and morbidity endpoints within the ESCAPE study and 6 European cohorts.
Epidemiological cohort studies have consistently found associations between long-term exposure to outdoor air pollution and a range of morbidity and mortality endpoints. Recent evaluations by the World Health Organization and the Global Burden of Disease study have suggested that these associations may be non-linear, and persist at very low concentrations. However, uncertainty about the shape of the concentration-response function exists especially for the low and high end of the concentration distribution, partly related to the scarcity of observations in particularly the low range. In this proposal we focus on analyses contributing to knowledge about health effects of spatially resolved air pollution concentrations at low concentrations, defined as less than current EU, EPA and WHO Limit Values or guidelines for fine particles with an aerodynamic diameter of less than 2.5μm (PM2.5), nitrogen dioxide (NO2) and Ozone (O3). Studies have focused especially on PM2.5, but increasingly associations with NO2 are reported, particularly in studies that accounted for the fine spatial scale variation of NO2. Very few studies have evaluated long-term morbidity and mortality effects of ozone.
We propose to address the issue of health effects at low air pollution levels by performing targeted analyses of all-cause and cause-specific mortality and morbidity endpoints within selected cohorts of the ESCAPE study with detailed individual data (~340,000 subjects) and in 6 very large European administrative cohorts (>25 million subjects). The analysis will focus on the pollutants PM2.5, NO2, and O3, but will also exploit the rich monitoring data of black carbon (BC) available from the ESCAPE study with high spatial resolution. Our exposure assessment will characterize fine-scale intra-urban as well as between urban air pollution contrasts using novel combinations of land use regression and dispersion models, routine monitoring data and satellite observations. By combining ESCAPE cohorts and large administrative cohorts in one proposal, we will substantially increase sample size while utilizing in-depth individual characterization. Thereby, we leverage the strengths and overcome the weaknesses of each approach.
The proposal addresses the first overall aim of the call (Assess health effects of long-term exposure to low levels of ambient air pollution). The proposal addresses especially specific objective 1 (different methods to characterize the exposure-response function), and also contributes to objectives 2 and 3 (exploring variability across population and different exposure assessment methods), and to objectives 4, 5 and 6 (investigating correction methods for exposure measurement error, co-occurring pollutants, and indirect approaches for confounder control).
Bente Margaret Oftedal, Norwegian Institute of Public Health
Bente Margaret Oftedal, Infection Control, Norwegian Institute of Public Health
Per Everhard Schwarze, Infection Control, Norwegian Institute of Public Health
Kristine Bjerve Gützkow, Air Quality and Sound, Norwegian Institute of Public Health
Richard Aubrey White, Method Development and Analytics, Norwegian Institute of Public Health
Jorunn Evandt, Air Quality and Sound, Norwegian Institute of Public Health
Doris Tove Kristoffersen, Health Services Research, Norwegian Institute of Public Health
Carl Fredrik Nordheim, Infection Control and Preparedness, Norwegian Institute of Public Health
Shilpa Rao-Skirbekk, Method Development and Analytics, Norwegian Institute of Public Health
Terese Bekkevold, Method Development and Analytics, Norwegian Institute of Public Health
Norun Hjertager Krog, Infection Control, Norwegian Institute of Public Health
Ruby Del Risco Kollerud, Infection Control, Norwegian Institute of Public Health
Gunn Marit Aasvang, Infection Control, Norwegian Institute of Public Health