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Exposure to fine particulate air pollution (PM2.5) is emerging as a risk factor for Alzheimer's disease (AD), but existing studies are still limited and heterogeneous. We have previously studied the association between dementia (AD and vascular dementia) and PM2.5 stemming from vehicle exhaust and wood-smoke in the Betula cohort in Northern Sweden. The aim of this commentary is to estimate the association between total PM2.5 and dementia in the Betula cohort, which is more relevant to include in future meta-estimates than the source-specific estimates. The hazard ratio for incident dementia associated with a 1μg/m3 increase in local PM2.5 was 1.38 (95% confidence interval: 0.99 -1.92). The interpretation of our results is that they indicate an association between local contrasts in concentration of PM2.5 at the residential address and incidence of dementia in a low-level setting.

BACKGROUND: Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse.OBJECTIVE: We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population.METHODS: We harmonized and pooled data from nine Scandinavian cohorts (seven Swedish, two Danish), totaling 135,951 participants. We identified residential address history and estimated road, railway, and aircraft noise for all addresses. Information on stroke incidence was acquired through linkage to national patient and mortality registries. We analyzed data using Cox proportional hazards models, including socioeconomic and lifestyle confounders, and air pollution.RESULTS: During follow-up (median=19.5y), 11,056 stroke cases were identified. Road traffic noise (Lden) was associated with risk of stroke, with a hazard ratio (HR) of 1.06 [95% confidence interval (CI): 1.03, 1.08] per 10-dB higher 5-y mean time-weighted exposure in analyses adjusted for individual- and area-level socioeconomic covariates. The association was approximately linear and persisted after adjustment for air pollution [particulate matter (PM) with an aerodynamic diameter of ≤2.5μm (PM2.5) and NO2]. Stroke was associated with moderate levels of 5-y aircraft noise exposure (40-50 vs. ≤40 dB) (HR=1.12; 95% CI: 0.99, 1.27), but not with higher exposure (≥50 dB, HR=0.94; 95% CI: 0.79, 1.11). Railway noise was not associated with stroke.DISCUSSION: In this pooled study, road traffic noise was associated with a higher risk of stroke. This finding supports road traffic noise as an important cardiovascular risk factor that should be included when estimating the burden of disease due to traffic noise. https://doi.org/10.1289/EHP8949.

It is widely known that the apolipoprotein E (APOE) ε4 allele imposes a higher risk for Alzheimer's disease (AD). Recent evidence suggests that exposure to air pollution is also a risk factor for AD, and results from a few studies indicate that the effect of air pollution on cognitive function and dementia is stronger in APOE ε4 carriers than in non-carriers. Air pollution and interaction with APOE ε4 on AD risk thus merits further attention. We studied dementia incidence over a 15-year period from the longitudinal Betula study in Northern Sweden. As a marker for long-term exposure to traffic-related air pollution, we used modelled annual mean nitrogen oxide levels at the residential address of the participants at start of follow-up. Nitrogen oxide correlate well with fine particulate air pollution levels in the study area. We had full data on air pollution, incidence of AD and vascular dementia (VaD), APOE ε4 carrier status, and relevant confounding factors for 1,567 participants. As expected, air pollution was rather clearly associated with dementia incidence. However, there was no evidence for a modifying effect by APOE ε4 on the association (p-value for interaction > 0.30 for both total dementia (AD+VaD) and AD). The results from this study do not imply that adverse effects of air pollution on dementia incidence is limited to, or stronger in, APOE ε4 carriers than in the total population.

På uppdrag av Naturvårdsverket har avdelningen för Arbets- och miljömedicin vid Lunds Universitet utfört studie kring luftföroreningssituationen på förskolegårdar. Denna studie består av tre delar vara av en är en kunskapsinventering bland landetskommuner kring luftkvalitén på förskolebarns utemiljöer och effekter/strategier för att eventuellt förbättra detta. (sedan tidigare publicerad i denna rapportserie (nr 10:2019). Utöver detta har det även genomförts mätningar av NO2 samt PM10 och PM2,5 på de tio mest luftförorenings drabbade förskolorna i Malmö. Dessa mätningar pågick mellan hösten 2018 till våren 2020 och låg till grund för del tre i studien där de uppmätta halternas hälsokonsekvenser hos barn beräknades. Studien visar att flertalet kommuner saknar aktuell mätdata kring hur luftförorenings situationen ser ut i kommunen och mycket få har kännedom om luftkvalitén i anslutning till kommunens förskolor. Mätningarna vid förskolorna i Malmö visar att partikelhalterna på förskolegårdarna i dessa trafikutsatta miljöer överskrider miljömålen men också att den kraftiga minskning av trafiken i Malmö som skedde i samband med Covid-19 restriktionerna hade en positiv effekt med en kraftig minskning av uppmätta halter. Något som även återspeglas hälsokonsekvens beräkningarna.

Denna rapport behandlar barns hälsa och miljöi Sveriges fyra nordligaste län, och baserasfrämst på nationella barnmiljöhälsoenkäter,särskilt den senaste från 2019. Dessa enkätundersökningarom tre åldersgrupper ger en bildav hur de som svarat upplevt barnens miljöochhälsoförhållanden, men har inte syftet attvetenskapligt fastställa samband mellan orsakoch verkan. Därför beskrivs enkätresultaten iljuset av bredare kunskaper, främst från forskningoch objektiva mätningar. Resultaten gerockså en viktig signal om hur läget och trendernaär i förhållandet till olika mål som berörmiljö och hälsa. De globala målen för hållbarutveckling som är grunden för Agenda 2030inrymmer i många fall de svenska miljö- ochfolkhälsomålen.Andelen barn i norra Sverige som rapporteratsha astma och/eller allergisk snuva har ökatfrån enkäten 2011 till enkäten 2019, och i denäldsta åldersgruppen (12-åringar) uppges astmavanligare i norra Sverige än i resten av landet.För besvär som upplevs bero på problem i inomhusmiljönses inga tydliga skillnader varkensedan förra enkäten eller mellan norra Sverigeoch övriga delar av landet. Trots att en ganskastor andel rapporterar att de har fuktskador ibostaden, så är det få som uppger att miljöni bostaden leder till besvär. Bland 12-åringarnaanges skolmiljön mer ofta orsaka besvär.Enligt enkäten utsätts nu endast cirka 1 % avbarnen för miljötobaksrök i bostaden, vilketkan jämföras med att drygt 6 % av de gravida inorra Sverige 2003 rökte under graviditeten .Var tionde tolvåring i norra Sverige lyssnardagligen på musik i hörlurar med hög volym.Fyra procent uppges ha tinnitus. Vidare uppgervar femte tolvåring att de blir mycket störda avljud när de är i skolan. I samma grupp har 12% svårt att somna på grund av trafikbuller.Luftkvaliteten utanför bostaden upplevs avsvarande från norra Sverige vara bättre jämförtmed övriga landet och skillnaden tycks haökat mellan 2011 och 2019. En lägre andel avtolvåringarna besväras ofta eller ibland av luktfrån bilavgaser i no, Hälsorelaterad RMÖ, Lst Västerbotten

Introduction: Asthma is a complex, heterogeneous disease and one of the most common chronic diseases among children. Exposure to ambient air pollution in early life and childhood may influence asthma aetiology, but it is uncertain which specific components of air pollution and exposure windows are of importance. The role of socioeconomic status (SES) is also unclear. The aims of the present study are, therefore, to investigate how various exposure windows of different pollutants affect risk-induced asthma in early life and to explore the possible effect SES has on that relationship. Methods: The study population was constructed using register data on all singleton births in the greater Stockholm area between 2006 and 2013. Exposure to ambient black carbon (BC), fine particulate matter (PM2.5), primary organic carbon (pOC) secondary organic aerosols (SOA), secondary inorganic aerosols, and oxidative potential at the residential address was modelled as mean values for the entire pregnancy period, the first year of life and the first three years of life. Swedish national registers were used to define the outcome: asthma diagnosis assessed at hospital during the first six years of life. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were modelled with Cox proportional hazards model with age as the underlying time-scale, adjusting for relevant potential confounding variables. Results: An increased risk for developing childhood asthma was observed in association with exposure to PM2.5, pOC and SOA during the first three years of life. With an interquartile range increase in exposure, the HRs were 1.06 (95% CI: 1.01-1.10), 1.05 (95% CI: 1.02-1.09) and 1.02 (95% CI: 1.00-1.04), for PM2.5, pOC and SOA, respectively, in the fully adjusted models. Exposure during foetal life or the first year of life was not associated with asthma risk, and the other pollutants were not statistically significantly associated with increased risk. Furthermore, the increase in risk

Exposure to fine particulate air pollution (PM2.5) is emerging as a risk factor for Alzheimer's disease (AD), but existing studies are still limited and heterogeneous. We have previously studied the association between dementia (AD and vascular dementia) and PM2.5 stemming from vehicle exhaust and wood-smoke in the Betula cohort in Northern Sweden. The aim of this commentary is to estimate the association between total PM2.5 and dementia in the Betula cohort, which is more relevant to include in future meta-estimates than the source-specific estimates. The hazard ratio for incident dementia associated with a 1 mu g/m(3) increase in local PM2.5 was 1.38 (95% confidence interval: 0.99 - 1.92). The interpretation of our results is that they indicate an association between local contrasts in concentration of PM2.5 at the residential address and incidence of dementia in a low-level setting.

På uppdrag av Naturvårdsverket har avdelningen för Arbets- och miljömedicin vid Lunds Universitet utfört studie kring luftföroreningssituationen på förskolegårdar.Denna studie består av tre delar vara av en är en kunskapsinventering bland landets kommuner kring luftkvalitén på förskolebarns utemiljöer och effekter/strategier för att eventuellt förbättra detta. (sedan tidigare publicerad i denna rapportserie (nr 10:2019). Utöver detta har det även genomförts mätningar av NO2 samt PM10 och PM2,5 på de tio mest luftföroreningsdrabbade förskolorna i Malmö. Dessa mätningar pågick mellan hösten 2018 till våren 2020 och låg till grund för del tre i studien där de uppmätta halternas hälsokonsekvenser hos barn beräknades.Studien visar att flertalet kommuner saknar aktuell mätdata kring hur luftföroreningssituationen ser ut i kommunen och mycket få har kännedom om luftkvalitén i anslutning till kommunens förskolor. Mätningarna vid förskolorna i Malmö visar att partikelhalterna på förskolegårdarna i dessa trafikutsatta miljöer överskrider miljömålen men också att den kraftiga minskning av trafiken i Malmö som skedde i samband med Covid-19 restriktionerna hade en positiv effekt med en kraftig minskning av uppmätta halter. Något som även återspeglas hälsokonsekvensberäkningarna.

The number of patients with Alzheimer's disease (AD) is likely to triple in a few decades as the world's population ages. Given the high personal and societal burden of this disease, it is imperative to identify its risk factors. The etiology of AD is still not fully understood, but environmental factors have emerged as plausible important risk factors on the population-level. In this short review, the author summarizes literature on air pollution, noise and (lack of) greenness as risk factors for AD. In conclusion, a link between air pollution and AD is supported by experimental studies as well as epidemiological studies, although a multi-exposure approach is lacking in most epidemiological studies. Although evidence is much more limited regarding noise and (lack of) greenness as risk factors for AD, future epidemiological studies should have a multi-exposure approach in order to separate potential effects of air pollution, noise and lack of greenness. Given the heavy toll of AD on individuals and society, as well as the ubiquitous nature of environmental factors, a link between environmental stressors and AD deserves special attention.

AIMS: The present study aimed to investigate if set thresholds in the Swedish heat-wave warning system are valid for all parts of Sweden and if the heat-wave warning system captures a potential increase in all-cause mortality and coronary heart disease (CHD) mortality. An additional aim was to investigate whether neighbourhood deprivation modifies the relationship between heat waves and mortality. METHODS: From 1990 until 2014, in 14 municipalities in Sweden, we collected data on daily maximum temperatures and mortality for the five warmest months. Heat waves were defined according to the categories used in the current Swedish heat-wave warning system. Using a case-crossover approach, we investigated the association between heat waves and mortality in Sweden, as well as a modifying effect of neighbourhood deprivation. RESULTS: On a national as well as a regional level, heat waves significantly increased both all-cause mortality and CHD mortality by approximately 10% and 15%, respectively. While neighbourhood deprivation did not seem to modify heat wave-related all-cause mortality, CHD mortality did seem to modify the risk. CONCLUSIONS: It may not be appropriate to assume that heat waves in Sweden will have the same impact in a northern setting as in a southern, or that the impact of heat waves will be the same in affluent and deprived neighbourhoods. When designing and implementing heat-wave warning systems, neighbourhood, regional and national information should be incorporated.