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Objectives: To assess the association between socioeconomic status (SES) and selfreported adherence to preventive measures in Switzerland during the COVID-19 pandemic. Methods: 4,299 participants from a digital cohort were followed between September 2020 and November 2021. Baseline equivalised disposable income and education were used as SES proxies. Adherence was assessed over time. We investigated the association between SES and adherence using multivariable mixed logistic regression, stratifying by age (below/above 65 years) and two periods (before/after June 2021, to account for changes in vaccine coverage and epidemiological situation). Results: Adherence was high across all SES strata before June 2021. After, participants with higher equivalised disposable income were less likely to adhere to preventive measures compared to participants in the first (low) quartile [second (Adj.OR, 95% CI) (0.56, 0.37-0.85), third (0.38, 0.23-0.64), fourth (0.60, 0.36-0.98)]. We observed similar results for education. Conclusion: No differences by SES were found during the period with high SARS-CoV-2 incidence rates and stringent measures. Following the broad availability of vaccines, lower incidence, and eased measures, differences by SES started to emerge. Our study highlights the need for contextual interpretation when assessing SES impact on adherence to preventive measures. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is some evidence for an association between traffic noise and ischemic heart disease; however, associations with blood pressure have been inconsistent, and little is known about health effects [...]

The impact of clean air and reduced exposure to [PM.sub.10] on the lung function in children, as well as adults is discussed. Findings shows that reduction in the exposure to polluted air affects only the lung function that is related to [PM.sub.10].

BACKGROUND: Although the dispersion model approach has been used in some epidemiologic studies to examine health effects of traffic-specific air pollution, no study has evaluated the model predictions vigorously. METHODS: We evaluated total and traffic-specific particulate matter < 10 and < 2.5 [micro]m in aerodynamic diameter ([PM.sub.10], [PM.sub.2.5]), nitrogren dioxide, and nitrogen oxide concentrations predicted by Gaussian dispersion models against fixed-site measurements at different locations, including traffic-impacted, urban-background, and alpine settings between and across cities. The model predictions were then used to estimate individual subjects&apos; historical and cumulative exposures with a temporal trend model. RESULTS: Modeled [PM.sub.10] and [NO.sub.2] predicted at least 55% and 72% of the variability of the measured [PM.sub.10] and [NO.sub.2], respectively. Traffic-specific pollution estimates correlated with the [NO.sub.x] measurements ([R.sup.2] [greater than or equal to] 0.77) for background sites but not for traffic sites. Regional background [PM.sub.10] accounted for most [PM.sub.10] mass in all cities. Whereas traffic [PM.sub.10] accounted for < 20% of the total [PM.sub.10], it varied significantly within cities. The modeling error for [PM.sub.10] was similar within and between cities. Traffic [NO.sub.x] accounted for the majority of [NO.sub.x] mass in urban areas, whereas background [NO.sub.x] accounted for the majority of [NO.sub.x] in rural areas. The within-city [NO.sub.2] modeling error was larger than that between cities. CONCLUSIONS: The dispersion model predicted well the total [PM.sub.10], [NO.sub.x], and [NO.sub.2] and trafficspecific pollution at background sites. However, the model underpredicted traffic [NO.sub.x] and [NO.sub.2] at traffic sites and needs refinement to reflect local conditions. The dispersion model predictions for [PM.sub.10] are suitable for examining individual exposures and health effects within and between cities. KEY WORDS: cohort study, cumulative exposure, dispersion model, exposure assessment, long-term exposure. Environ Health Perspect 115:1638-1645 (2007). doi:10.1289/ehp.10177 available via http://dx.doi.org/ [Online 14 August 2007], Long-term exposure to air pollution, especially particulate matter (PM), has been linked to reduced lung capacity (Ackermann-Liebrich et al. 1997; Gauderman et al. 2004), elevated mortality (Dockery et al. 1993; [...]

BACKGROUND: Subclinical atherosclerosis has been associated with long-term exposure to particulate matter (PM), but the relevance of particle size and sources of exposure remains unclear. OBJECTIVES: We investigated the association of long-term exposure to [PM.sub.10] (≤ 10 µm), [PM.sub.2.5] ([less than or equal to] 2.5 µm: total mass, vehicular, and crustal sources), and ultrafine particles [UFP < 0.1 µm: particle number concentration (PNC) and lung-deposited surface area (LDSA)] with carotid intima-media thickness (CIMT). METHODS: We used data from 1,503 participants [greater than or equal to] 50 years old who participated in the third examination of the Swiss SAPALDIA cohort. Exposures were obtained from dispersion models and land-use regression models. Covariate information, including previous cardiovascular risk factors, was obtained from the second and third SAPALDIA examinations. RESULTS: The adjusted percent difference in CIMT associated with an exposure contrast between the 10th and 90th percentile was 1.58% (95% CI: -0.30, 3.47%) for [PM.sub.10], 2.10% (95% CI: 0.04, 4.16%) for [PM.sub.2.5], 1.67% (95% CI: -0.13, 3.48%) for the vehicular source of [PM.sub.2.5], -0.58% (95% CI: -3.95, 2.79%) for the crustal source of [PM.sub.2.5], 2.06% (95% CI: 0.03, 4.10%) for PNC, and 2.32% (95% CI: 0.23, 4.40%) for LDSA. Stronger associations were observed among diabetics, subjects with low-educational level, and those at higher cardiovascular risk. CONCLUSIONS: CIMT was associated with exposure to [PM.sub.10], [PM.sub.2.5], and UFP. The [PM.sub.2.5] sourcespecific analysis showed a positive association for the vehicular source but not for the crustal source. Although the effects of PNC and LDSA were similar in magnitude, two-pollutant and residual-based models suggested that LDSA may be a better marker for the health relevance of UFP. http://dx.doi.org/10.1289/EHP161, Introduction Epidemiological and experimental research has provided sufficient evidence for a causal effect of ambient air pollution [mainly particulate matter (PM)] on cardiovascular mortality and morbidity (Brook et al. 2010). [...]

Previous research has shown that the built environment plays a crucial role for health-related quality of life (HRQoL) and health care utilization. But, there is limited evidence on the independence of this association from lifestyle and social environment. The objective of this cross-sectional study was to investigate these associations, independent of the social environment, physical activity and body mass index (BMI). We used data from the third follow-up of the Swiss study on Air Pollution and Lung and Heart diseases In Adults (SAPALDIA), a population based cohort with associated biobank. Covariate adjusted multiple quantile and polytomous logistic regressions were performed to test associations of variables describing the perceived built environment with HRQoL and health care utilization. Higher HRQoL and less health care utilization were associated with less reported transportation noise annoyance. Higher HRQoL was also associated with greater satisfaction with the living environment and more perceived access to greenspaces. These results were independent of the social environment (living alone and social engagement) and lifestyle (physical activity level and BMI). This study provides further evidence that the built environment should be designed to integrate living and green spaces but separate living and traffic spaces in order to improve health and wellbeing and potentially save health care costs. [ABSTRACT FROM AUTHOR]

We estimated the association between regular physical activity and the incidence of restrictive spirometry pattern. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and physical activity were assessed in 2 population-based European cohorts (European Community Respiratory Health Survey: n  = 2,757, aged 39–67 years; and Swiss Study on Air Pollution and Lung and Heart Diseases in Adults: n  = 2,610, aged 36–82 years) first in 2000–2002 and again approximately 10 years later (2010–2013). Subjects with restrictive or obstructive spirometry pattern at baseline were excluded. We assessed the association of being active at baseline (defined as being physically active at least 2–3 times/week for ≥1 hour) with restrictive spirometry pattern at follow-up (defined as a postbronchodilation FEV1/FVC ratio of at least the lower limit of normal and FVC of <80% predicted) using modified Poisson regression, adjusting for relevant confounders. After 10 years of follow-up, 3.3% of participants had developed restrictive spirometry pattern. Being physically active was associated with a lower risk of developing this phenotype (relative risk = 0.76, 95% confidence interval: 0.59, 0.98). This association was stronger among those who were overweight and obese than among those of normal weight (P for interaction = 0.06). In 2 large European studies, adults practicing regular physical activity were at lower risk of developing restrictive spirometry pattern over 10 years. [ABSTRACT FROM AUTHOR]

Background: It has been debated, but not yet established, whether increased airway responsiveness can predict COPD. Recognising this link may help in identifying subjects at risk.Objective: We studied prospectively whether airway responsiveness is associated with the risk of developing COPD.Methods: We pooled data from two multicentre cohort studies that collected data from three time points using similar methods (European Community Respiratory Health Survey and Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). We classified subjects (median age 37 years, 1st-3rd quartiles: 29-44) by their level of airway responsiveness using quintiles of methacholine dose-response slope at the first examination (1991-1994). Then, we excluded subjects with airflow obstruction at the second examination (1999-2003) and analysed incidence of COPD (postbronchodilator FEV1/FVC below the lower limit of normal) at the third examination (2010-2014) as a function of responsiveness, adjusting for sex, age, education, body mass index, history of asthma, smoking, occupational exposures and indicators of airway calibre.Results: We observed 108 new cases of COPD among 4205 subjects during a median time of 9 years. Compared with the least responsive group (incidence rate 0.6 per 1000/year), adjusted incidence rate ratios for COPD ranged from 1.79 (95% CI 0.52 to 6.13) to 8.91 (95% CI 3.67 to 21.66) for increasing airway responsiveness. Similar dose-response associations were observed between smokers and non-smokers, and stronger associations were found among subjects without a history of asthma or asthma-like symptoms.Conclusions: Our study suggests that increased airway responsiveness is an independent risk factor for COPD. Further research should clarify whether early treatment in patients with high responsiveness can slow down disease progression. [ABSTRACT FROM AUTHOR]

Background: Land Use Regression (LUR) is a popular method to explain and predict spatial contrasts in air pollution concentrations, but LUR models for ultrafine particles, such as particle number concentration (PNC) are especially scarce. Moreover, no models have been previously presented for the lung deposited surface area (LDSA) of ultrafine particles. The additional value of ultrafine particle metrics has not been well investigated due to lack of exposure measurements and models.Methods: Air pollution measurements were performed in 2011 and 2012 in the eight areas of the Swiss SAPALDIA study at up to 40 sites per area for NO2 and at 20 sites in four areas for markers of particulate air pollution. We developed multi-area LUR models for biannual average concentrations of PM2.5, PM2.5 absorbance, PM10, PMcoarse, PNC and LDSA, as well as alpine, non-alpine and study area specific models for NO2, using predictor variables which were available at a national level. Models were validated using leave-one-out cross-validation, as well as independent external validation with routine monitoring data.Results: Model explained variance (R(2)) was moderate for the various PM mass fractions PM2.5 (0.57), PM10 (0.63) and PMcoarse (0.45), and was high for PM2.5 absorbance (0.81), PNC (0.87) and LDSA (0.91). Study-area specific LUR models for NO2 (R(2) range 0.52-0.89) outperformed combined-area alpine (R (2)  = 0.53) and non-alpine (R (2)  = 0.65) models in terms of both cross-validation and independent external validation, and were better able to account for between-area variability. Predictor variables related to traffic and national dispersion model estimates were important predictors.Conclusions: LUR models for all pollutants captured spatial variability of long-term average concentrations, performed adequately in validation, and could be successfully applied to the SAPALDIA cohort. Dispersion model predictions or area indicators served well to capture the between area variance. For NO2, applying study-area specific models was preferable over applying combined-area alpine/non-alpine models. Correlations between pollutants were higher in the model predictions than in the measurements, so it will remain challenging to disentangle their health effects. [ABSTRACT FROM AUTHOR]

Summary Background Low concentrations of the anti-inflammatory protein CC16 (approved symbol SCGB1A1) in serum have been associated with accelerated decline in forced expiratory volume in 1 s (FEV 1 ) in patients with chronic obstructive pulmonary disease (COPD). We investigated whether low circulating CC16 concentrations precede lung function deficits and incidence of COPD in the general population. Methods We assessed longitudinal data on CC16 concentrations in serum and associations with decline in FEV 1 and incidence of airflow limitation for adults who were free from COPD at baseline in the population-based Tucson Epidemiological Study of Airway Obstructive Disease ([TESAOD] n=960, mean follow-up 14 years), European Community Respiratory Health Survey ([ECRHS-Sp] n=514, 11 years), and Swiss Cohort Study on Air Pollution and Lung Diseases in Adults ([SAPALDIA] n=167, 8 years) studies. Additionally, we measured circulating CC16 concentrations in samples from children aged 4–6 years in the Tucson Children's Respiratory Study (n=427), UK Manchester Asthma and Allergy Study (n=481), and the Swedish Barn/children, Allergy, Milieu, Stockholm, Epidemiological survey (n=231) birth cohorts to assess whether low CC16 concentrations in childhood were predictive for subsequent lung function. Findings After adjustment for sex, age, height, smoking status and intensity, pack-years, asthma, and FEV 1 at baseline, we found an inverse association between CC16 concentration and decline in FEV 1 in adults in TESAOD (4·4 mL/year additional FEV 1 decline for each SD decrease in baseline CC16 concentration, p=0·0014) and ECRHS-Sp (2·4 mL/year, p=0·023); the effect in SAPALDIA was marginal (4·5 mL/year, p=0·052). Low CC16 concentration at baseline was also associated with increased risk of incident stage 2 airflow limitation (ratio of FEV 1 to forced expiratory volume [FEV 1 /FVC] less than 70% plus FEV 1 % predicted less than 80%) in TESAOD and ECRHS-Sp. In children, the lowest tertile of CC16 concentrations was associated with a subsequent FEV 1 deficit of 68 mL up to age 16 years (p=0·0001), which was confirmed in children who had never smoked by age 16 years (−71 mL, p<0·0001). Interpretation Low concentrations of CC16 in serum are associated with reduced lung function in childhood, accelerated lung function decline in adulthood, and development of moderate airflow limitation in the general adult population. Funding National Heart, Lung, and Blood Institute and European Union Seventh Framework Programme. [ABSTRACT FROM AUTHOR]

Abstract: Although recent air pollution epidemiologic studies have embraced land-use regression models for estimating outdoor traffic exposure, few have examined the spatio-temporal variability of traffic related pollution over a long term period and the optimal methods to take these factors into account for exposure estimates. We used home outdoor NO2 measurements taken from eight geographically diverse areas to examine spatio-temporal variations, construct, and evaluate models that could best predict the within-city contrasts in observations. Passive NO2 measurements were taken outside of up to 100 residences per area over three seasons in 1993 and 2003 as part of the Swiss cohort study on air pollution and lung and heart disease in adults (SAPALDIA). The spatio-temporal variation of NO2 differed by area and year. Regression models constructed using the annual NO2 means from central monitoring stations and geographic parameters predicted home outdoor NO2 levels better than a dispersion model. However, both the regression and dispersion models underestimated the within-city contrasts of NO2 levels. Our results indicated that the best models should be constructed for individual areas and years, and would use the dispersion estimates as the urban background, geographic information system (GIS) parameters to enhance local characteristics, and temporal and meteorological variables to capture changing local dynamics. Such models would be powerful tools for assessing health effects from long-term exposure to air pollution in a large cohort. [ABSTRACT FROM AUTHOR]

Rationale: The association between early menarche and new onset of asthma warrants further investigation in those aged >30 years.Objectives: Using data from the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), we investigated whether early menarche was associated with new onset of asthma in women aged 18-60 years at baseline.Methods: Our analysis included 2492 women with information on age at menarche and doctor-diagnosed asthma, who had been asthma free at the time of menarche and had complete covariate information. New onset of asthma was defined as newly reported doctor-diagnosed asthma which occurred at least one year after menarche. Asthma incidence and its association with early menarche was analysed using logistic regression, adjusting for age, atopy, smoking, BMI, parental asthma, urbanity, education and study area, and additionally stratifying by atopy and BMI.Results: After adjustment of relevant confounders, women with early menarche did not have a significantly higher risk of onset of asthma than women without early menarche (OR 1.23, 95% CI 0.85-1.80). Young atopic women with early menarche appeared to have an increased risk of asthma compared with non-atopic women (OR 2.21, 95% CI 0.90-5.43); however, our results did not reach statistical significance.Conclusion: We could not substantiate an association of early menarche with new onset of asthma in this Swiss population-based cohort aged 18-60 years at baseline. Future studies may need to prospectively assess age of menarche to investigate the association with new onset of asthma in those aged >30 years. [ABSTRACT FROM AUTHOR]

Background Inconsistent associations between socioeconomic position (SEP) and outdoor air pollution have been reported in Europe, but methodological differences prevent any direct between-study comparison. Objectives Assess and compare the association between SEP and outdoor nitrogen dioxide (NO 2 ) exposure as a marker of traffic exhaust, in 16 cities from eight Western European countries. Methods 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 2 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 2 . Heterogeneity across cities was assessed using the Higgins' I-squared test (I 2 ). Results The study population included 5692 participants. Pooled analysis showed that participants with lower individual-SEP were less exposed to NO 2 . Conversely, participants living in neighborhoods with higher unemployment rate were more exposed. City-specific results exhibited strong heterogeneity (I 2 > 76% for the three SEP indicators) resulting in variation of the individual- and neighborhood-SEP patterns of NO 2 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. Conclusions 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 2 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. [ABSTRACT FROM AUTHOR]

Abstract: Improved air quality has been found associated with attenuated age-related decline in lung function. But whether genetic polymorphisms strongly associated with lung function play a modifying role in this attenuation process has so far not been investigated. We selected ten single nucleotide polymorphisms derived from the largest genome-wide association studies on lung function and examined whether they modified the association between the change in exposure to particulate matter ≤10μm (ΔPM10) and lung function decline. 4310 participants from the SAPALDIA cohort provided valid spirometry measurements, a detailed pulmonary health questionnaire both at baseline and 11years later as well as blood samples for genetic testing. Spatially and temporally resolved air pollution exposures were assigned on an individual level based on participants' residences. Statistically significant interactions of moderate strength with ΔPM10 were detected for rs2284746. Individuals with the CC genotype had a 21ml slower annual decline of the mid expiratory flow per 10μg/m3 PM10 reduction over an 10-year period, while the benefits of CG and GG carriers were smaller (14 and 7ml per year, respectively; Pinteraction =0.04). The attenuated annual decline in the percentage of the forced expiratory volume in one second relative to the forced vital capacity (FEV1/FVC) was also increased with the presence of each C-allele (Pinteraction =0.009). We observed further suggestive interactions of similar magnitude in never-smokers, but none of the results would remain statistically significant after correction for multiple testing. We could not find strong evidence that lung function benefits from improved air quality are modified by polymorphisms associated with lung function level in large meta-analyzed genome-wide association studies. [Copyright &y& Elsevier]

Background: Air pollution has been associated with impaired health, including reduced lung function in adults. Moving to cleaner areas has been shown to attenuate adverse effects of air pollution on lung function in children but not in adults. Methods: We conducted a prospective study of 9651 adults (18 to 60 years of age) randomly selected from population registries in 1990 and assessed in 1991, with 8047 participants reassessed in 2002. There was complete information on lung volumes and flows (e.g., forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1 as a percentage of FVC, and forced expiratory flow between 25 and 75% of the FVC [FEF25–75]), smoking habits, and spatially resolved concentrations of particulate matter that was less than 10 μm in aerodynamic diameter (PM10) from a validated dispersion model assigned to residential addresses for 4742 participants at both the 1991 and the 2002 assessments and in the intervening years. Results: Overall exposure to individual home outdoor PM10 declined over the 11-year follow-up period (median, −5.3 μg per cubic meter; interquartile range, −7.5 to −4.2). In mixed-model regression analyses, with adjustment for confounders, PM10 concentrations at baseline, and clustering within areas, there were significant negative associations between the decrease in PM10 and the rate of decline in FEV1 (P=0.045), FEV1 as a percentage of FVC (P=0.02), and FEF25–75 (P=0.001). The net effect of a decline of 10 μg of PM10 per cubic meter over an 11-year period was to reduce the annual rate of decline in FEV1 by 9% and of FEF25–75 by 16%. Cumulative exposure in the interval between the two examinations showed similar associations. Conclusions: Decreasing exposure to airborne particulates appears to attenuate the decline in lung function related to exposure to PM10. The effects are greater in tests reflecting small-airway function. N Engl J Med 2007;357:2338-47. [ABSTRACT FROM AUTHOR]