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Long-term exposure to ambient ozone and lung function decline over 20 years in adults: The ECRHS study
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Edité par CCSD ; EHP Publishing -
International audience. BACKGROUND AND AIM: Short-term exposure to ambient ozone consistently shows adverse effects on lung function in children and adults. However, little is known whether long-term exposure also has detrimental effects on lung function. We explored the association between long-term exposure to ozone and lung function decline over 20 years in 3014 adults from 17 centers in 8 countries participating in the population-based cohort of the European Community Respiratory Health Survey (ECRHS). METHOD: Pre-bronchodilation forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured by spirometry when participants were 25–44, 30–55, and 40–64 years old. Annual mean values of daily maximum running 8-hour average ozone concentrations were assigned to the individual residential addresses at each lung function measurement. Co-pollutants (PM2.5 and NO2) and greenness (Normalized Difference Vegetation Index, NDVI) were also considered for adjustment. Associations between rate of lung function decline and ozone concentrations were analyzed by adjusted linear mixed effects regression models. RESULTS: Mean ambient ozone concentrations were around 65 µg/m³. An increase by an interquartile range of 7 µg/m³ ozone concentration was associated with a faster decline in FEV1 by -2.08 mL/year (95% confidence interval: -2.79, -1.36) and in FVC by -2.86 mL/year (-3.73, -1.99) mL/year. Associations were robust across different models, including adjustments for co-exposure to PM2.5, NO2, and NDVI. They were more pronounced in residents of northern Europe and those with higher education or older. No consistent associations were detected with the FEV1/FVC ratio. CONCLUSIONS: Long-term exposure to elevated ambient ozone concentrations was associated with a faster decline of spirometric lung function over 20 years in middle-aged European adults. Nevertheless, further studies in other regions with other populations and exposure levels are needed to substantiate the associations identified in this study.