INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France; Univ Paris-Sud, Kremlin-Bicêtre, France.
INSERM, U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, F-94807 Villejuif, France; Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180 Montigny le Bretonneux, France.
Environ Int. 2017 Apr;101:117-124. doi: 10.1016/j.envint.2016.12.026. Epub 2017 Feb 1.
Inconsistent associations between socioeconomic position (SEP) and outdoor air pollution have been reported in Europe, but methodological differences prevent any direct between-study comparison.
Assess and compare the association between SEP and outdoor nitrogen dioxide (NO) exposure as a marker of traffic exhaust, in 16 cities from eight Western European countries.
Three SEP indicators, two defined at individual-level (education and occupation) and one at neighborhood-level (unemployment rate) were assessed in three European multicenter cohorts. NO annual concentration exposure was estimated at participants' addresses with land use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE; http://www.escapeproject.eu/). Pooled and city-specific linear regressions were used to analyze associations between each SEP indicator and NO. Heterogeneity across cities was assessed using the Higgins' I-squared test (I).
The study population included 5692 participants. Pooled analysis showed that participants with lower individual-SEP were less exposed to NO. Conversely, participants living in neighborhoods with higher unemployment rate were more exposed. City-specific results exhibited strong heterogeneity (I>76% for the three SEP indicators) resulting in variation of the individual- and neighborhood-SEP patterns of NO exposure across cities. The coefficients from a model that included both individual- and neighborhood-SEP indicators were similar to the unadjusted coefficients, suggesting independent associations.
Our study showed for the first time using homogenized measures of outcome and exposure across 16 cities the important heterogeneity regarding the association between SEP and NO in Western Europe. Importantly, our results showed that individual- and neighborhood-SEP indicators capture different aspects of the association between SEP and exposure to air pollution, stressing the importance of considering both in air pollution health effects studies.
在欧洲，社会经济地位（SEP）与室外空气污染之间的关联并不一致，但由于方法学的差异，无法进行直接的研究间比较。
评估并比较 8 个西欧国家的 16 个城市中，SE 与室外二氧化氮（NO）暴露（交通废气的标志物）之间的关联。
在三个欧洲多中心队列中评估了三个 SEP 指标，两个指标在个体水平上定义（教育和职业），一个指标在社区水平上定义（失业率）。利用在欧洲空气污染效应队列研究（ESCAPE；http://www.escapeproject.eu/）中开发的土地利用回归模型，在参与者的住址处估算了 NO 年浓度暴露值。采用汇总和城市特异性线性回归分析了每个 SEP 指标与 NO 之间的关系。采用 Higgins 的 I-squared 检验（I）评估城市间的异质性。
研究人群包括 5692 名参与者。汇总分析表明，SE 较低的个体接触到的 NO 较少。相反，居住在失业率较高的社区的参与者接触到的 NO 较多。城市特异性结果显示出很强的异质性（三个 SEP 指标的 I>76%），导致城市间的 NO 暴露的个体和社区 SEP 模式存在差异。包含个体和社区 SEP 指标的模型的系数与未调整的系数相似，表明存在独立的关联。
本研究首次使用在 16 个城市中统一的结局和暴露措施，显示了西欧 SEP 与 NO 之间关联的重要异质性。重要的是，我们的结果表明，个体和社区 SEP 指标捕捉到了 SEP 与空气污染暴露之间关联的不同方面，强调了在空气污染健康影响研究中同时考虑这两个因素的重要性。
