Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland.
Department of Public Health, University of Basel, 4001 Basel, Switzerland.
Int J Environ Res Public Health. 2019 May 29;16(11):1901. doi: 10.3390/ijerph16111901.
Ambient air pollution is a leading environmental risk factor and its broad spectrum of adverse health effects includes a decrease in lung function. Socioeconomic status (SES) is known to be associated with both air pollution exposure and respiratory function. This study assesses the role of SES either as confounder or effect modifier of the association between ambient air pollution and lung function. Cross-sectional data from three European multicenter adult cohorts were pooled to assess factors associated with lung function, including annual means of home outdoor NO. Pre-bronchodilator lung function was measured according to the ATS-criteria. Multiple mixed linear models with random intercepts for study areas were used. Three different factors (education, occupation and neighborhood unemployment rate) were considered to represent SES. NO exposure was negatively associated with lung function. Occupation and neighborhood unemployment rates were not associated with lung function. However, the inclusion of the SES-variable education improved the models and the air pollution-lung function associations got slightly stronger. NO associations with lung function were not substantially modified by SES-variables. In this multicenter European study we could show that SES plays a role as a confounder in the association of ambient NO exposure with lung function.
大气污染是一个主要的环境风险因素，其广泛的健康不良影响包括肺功能下降。社会经济地位（SES）已知与空气污染暴露和呼吸功能都有关。本研究评估 SES 作为大气污染与肺功能之间关联的混杂因素或效应修饰剂的作用。从三个欧洲多中心成人队列中汇集了横断面数据，以评估与肺功能相关的因素，包括家庭室外 NO 的年平均浓度。根据 ATS 标准测量预支气管扩张剂肺功能。使用具有研究区域随机截距的多个混合线性模型。三种不同的因素（教育、职业和社区失业率）被认为代表 SES。NO 暴露与肺功能呈负相关。职业和社区失业率与肺功能无关。然而，SES 变量教育的纳入改善了模型，空气污染与肺功能的关联略有增强。SES 变量对 NO 与肺功能的关联没有实质性的改变。在这项多中心欧洲研究中，我们可以表明 SES 作为大气 NO 暴露与肺功能之间关联的混杂因素发挥作用。
