Health effects of air pollution

Projects at the Unit of Environmental Epidemiology, Institute of Environmental Medicine (IMM)

Traffic-related air pollution in relation to respiratory and other health effects from infancy to adulthood

The main objective of the project is to study adverse health effects in children, adolescents and young adults related to exposure to air pollution from traffic. A particular aim is to try to disentangle effects of exposure to exhaust emissions, such as ultrafine particles, from those related to coarse particles resulting from road and tire wear. Health effects of interest include wheezing, asthma, allergic sensitization, disturbances of lung function as well as pregnancy outcomes. Much of this research is based on several birth cohorts, including BAMSE with 4,000 subjects followed until 24 years of age (https://ki.se/en/imm/bamse-project), as well as EMIL (https://ki.se/imm/valkommen-till-emil). BAMSE has a strong focus on epidemiology, environmental exposures and molecular markers, along with extensive international collaborations (e.g. through the ESCAPE, PACE, EXPANSE and MeDALL Consortia). A special feature of the BAMSE study is the longitudinal prospective follow-up from birth with repeated questionnaires and clinical tests, including blood samples and lung function measurements. In the EMIL study, detailed lung function measurements have been made during infancy. A methodology is used enabling detailed individual assessment of exposure to various air pollution components from different sources based on longitudinal information regarding addresses of homes, day care centers and schools as well as on emission data bases and dispersion modeling. The combination of longitudinal information on exposure and various health outcomes from birth until adulthood and detailed air pollution exposure assessment based on residential as well as other relevant addresses makes this project unique in the world.

Financing

  • Swedish Research Council
  • Swedish Research Council FORMAS
  • Swedish Research Council for Health, Working Life and Welfare (FORTE)
  • Swedish Environmental Protection Agency

Contact persons

Olena Gruzieva

Assistant professor

Selected publications

Gruzieva O, et al. Air pollution and IgE sensitization in four European birth cohorts - the MeDALL project. J Allergy Clin Immunol. 2020 In Press.

Schultz ES, et al. Early-Life Exposure to Traffic-related Air Pollution and Lung Function in Adolescence. Am J Resp Crit Care Med 2016;193(2):171-7.                    

Gehring U, et al. Exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence: a population-based birth cohort study. Lancet Resp Med. 2015;3(12):933-42.

Pedersen M, et al. Ambient air pollution and low birthweight: a European cohort study (ESCAPE). Lancet Resp Med. 2013;1(9):695-704.

Gruzieva O, et al. Traffic-related air pollution and development of allergic sensitization in children during the first 8 years of life. J Allergy Clin Immunol. 2012;129(1):240-6.

   

Health effects of air pollution from different sources in relation to cardiovascular and metabolic diseases as well as cancer

Large parts of the population are exposed to increased levels of ambient air pollution, particularly in urban areas. Long-term exposure to air pollution can cause severe health effects, such as respiratory, cardiovascular and/or metabolic diseases. In this project we will significantly strengthen the basis for the risk assessment using data from a number of adult cohorts based in Stockholm county. These cohorts include the CEANS cohort, with a total of more than 22 000 individuals from four sub-cohorts as well as the Stockholm Public Health Cohort with almost 90 000 participants, Individual long-term exposure to air pollutants from different sources is estimated for the cohort members using models with high spatial resolution. Exposure-response relationships will then be assessed for several adverse health outcomes, including ischemic heart disease, stroke, various types of cancer and type 2 diabetes.  The project involves extensive national and international collaboration, such as in the Swedish SCAC project as well as the European projects ESCAPE and ELAPSE. It is expected that the results will provide important guidance for prioritization of preventive measures as well as for health sustainable urban development.

Financing

  • European Union
  • Swedish Environmental Protection Agency
  • US Health Effects Institute

Contact persons

    Selected publications

    Ljungman PLS et al. Long-Term Exposure to Particulate Air Pollution, Black Carbon, and Their Source Components in Relation to Ischemic Heart Disease and Stroke. Environ Health Perspect. 2019;127(10):107012.

    Beelen R et al. Natural Cause Mortality and Long-Term Exposure to Particle Components: An Analysis of 19 European Cohorts within the Multi-Center ESCAPE Project. Environ Health Perspect. 2015;123:523-33.

    Cesaroni G et al. Long term exposure to ambient air pollution and incidence of acute coronary events: prospective cohort study and meta-analysis in 11 European cohorts from the ESCAPE Project. BMJ 2014;348:f7412.

    Beelen R et al. Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project. Lancet 2014;383:785-95.

    Raaschou-Nielsen O et al. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol 2013;14:813-22.

       

    Environmental exposures and atrial fibrillation

    Atrial fibrillation is the most common cardiac arrhythmia with a prevalence of almost 4 % in the general population and much higher in the elderly population. Many patients suffer from multiple symptoms and atrial fibrillation leads to multiple health care contacts and hospital admissions and significantly increases the risk for stroke, dementia and heart failure. A growing body of evidence suggests that environmental stressors may affect the onset of atrial fibrillation, potentially providing opportunities for prevention of major public health threats. In a series of investigations, we are exploring how short-term and long-term air pollution as well as ambient temperature may trigger or increase the burden of paroxysmal atrial fibrillation in patients with pacemaker devices enrolled at Danderyd Hospital (Project DANTE). Also, using a large-scale screening study for paroxysmal atrial fibrillation in 75 year olds in Stockholm, we are investigating associations between short-term air pollution exposure as well as temperature and the onset of atrial fibrillation (Project AIRFIB).

    Financing

    • Swedish Society for Medical Research
    • The Swedish Research Council for Health, Working Life and Welfare (FORTE)

    Contact persons

    Selected publications

    Dahlquist M, Frykman V, Kemp-Gudmunsdottir K, Svennberg E, Wellenius GA, L S Ljungman P. Short-term associations between ambient air pollution and acute atrial fibrillation episodes. Environ Int. 2020;141:105765. doi:10.1016/j.envint.2020.105765

       

    Climate, Health and AIr pollution Research Study in India (CHAIR-India): Addressing Gaps in Achieving the Sustainable Development Goals

    Providing actionable evidence highlighting synergies and conflicts between global sustainable development goals of climate action, reducing air pollution and promoting better health, while interacting with key stakeholders is an important step forward to achieving Agenda 2030. India, with 1.3 billion inhabitants, extreme exposures to air pollution and high temperatures and large vulnerable populations requires urgent action. Indian policy has made slow progress often due to lack of locally generated evidence to support action primarily due to the absence of high-quality assessment of exposure to air pollution and temperature, and their joint adverse impacts on human health. In an international multidisciplinary consortium of leading experts, we will leverage cutting-edge methodologies, already developed for Delhi, using multiple sources for 1x1 km predictions of fine particulate matter pollution and temperature across India. Linking this data to health datasets we will study associations of long-term air pollution and temperature with mortality and cardiometabolic and respiratory disease in rural and urban India. To foster public awareness, collaboration and policy change, we will provide an interactive web-tool, open access to environmental data, and an ambitious stakeholder communications and engagement strategy. Our success in India will significantly contribute to sustainable development benefiting both the large Indian population and the global community.

    Financing

    • Donation from Carl Bennet AB
    • IMM strategic funding
    • The Swedish Research Council FORMAS

    Contact Persons

         

      MiljöSCAPIS- Noise and Air pollution Exposures and Cardiometabolic Health and Atherosclerosis in the Swedish Cardiopulmonary BioImage Study

      Road traffic noise and air pollution are environmental exposures of growing concern with mounting evidence of adverse health effects. Close to two million people in Sweden are exposed to traffic noise levels exceeding the European Environment Agency indicator level. We will leverage detailed road traffic noise and air pollution exposure models to investigate associations with several measures of cardiometabolic risk and atheroslerosis in the Swedish CArdiopulmonary BioImage Study (SCAPIS) comprising 30 000 50-64 year olds from 6 Swedish major cities. This presents a unique opportunity to gain insight into subclinical processes using detailed computer tomography of fat deposits and coronary atherosclerosis in addition to ultrasonographic measure of carotid arteries, ankle-brachial index, lipid profiles glucose metabolism and blood pressure. This is collaborative research effort with environmental health departments at all 6 study locations (PI Noise: KI, PI Air pollution: Gothenburg University) considerably strengthening Swedish environmental epidemiology addressing substantial knowledge gaps regarding noise and air pollution exposure and cardiometabolic disease. Our results may have significant implications for the risk assessment and affect public health policy, especially considering the recently relaxed noise guidelines in Sweden.

      Financing

      • The Swedish Research Council for Health, Working Life and Welfare (FORTE)

      Contact persons

           

        EXPANSE - EXposome Powered tools for healthy living in urbAN SEttings

        The EU-funded EXPANSE project is designed to study the urban exposome, which is the sum of all non-genetic drivers of health and disease. Its overall aim is to identify ways to maximize people's health in a modern urban environment. The project involves: 1) bringing together the Exposome and health data of more than 55 million Europeans in administrative cohorts, in-depth Exposome, phenotype, and -omics information for more than 2 million Europeans, and personalized Exposome assessment for 5,000 individuals living in five “Urban Labs”; 2) applying a novel approach to use ultra-high-resolution mass-spectrometry to agnostically screen for exogenous chemicals in 10,000 blood samples; 3) studying the evolution of the Exposome and health through the life-course via matured birth and adult cohorts; and 4) evaluating the impact of changes in the Urban Exposome on the burden of cardio-metabolic and pulmonary disorders. The project involves 19 academic and non-academic partners located in 14 European countries and the USA. For more information please visit project´s homepage: https://expanseproject.eu/

        Financing

        • European Union

        Contact persons

        Olena Gruzieva

        Assistant professor