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163 results on '"Norun Hjertager"'

1. Tinnitus and cardiovascular disease: the population-based Tromsø Study (2015–2016)

Author

Laila A Hopstock, Bo Engdahl, Norun Hjertager Krog, Bente Oftedal, Jannike Heyerdahl-Larsen Ausland, and Magnar Johnsen

Subjects
Public aspects of medicine, RA1-1270
Abstract

Introduction People with tinnitus are likely to have other co-occurring disorders that should be considered when diagnosing and understanding tinnitus as a health problem. The association between tinnitus and cardiovascular health in the general population is, however, unclear. This study aimed to examine whether tinnitus is associated with the prevalence of hypertension, myocardial infarction or stroke, in the general adult population.Methods We used data from the seventh survey of the Tromsø Study, a comprehensive population-based health study carried out in 2015–2016. All inhabitants aged ≥40 years in the municipality of Tromsø, Norway, (n=32 591) were invited, of which 21 083 individuals (65%), aged 40–99, participated. Poisson regression was used to analyse the relationships between tinnitus and cardiovascular disease, while adjusting for relevant covariates. We used three separate tinnitus variables as exposures in analyses: (1) ‘tinnitus status’, measured with the question ‘During the last 12 months, have you experienced ringing in your ears lasting more than five min?’; (2) ‘tinnitus symptom intensity’, generated as a function of tinnitus frequentness and tinnitus bother; and (3) ‘tinnitus bother’, analysed only among participants with tinnitus. Hypertension (measured blood pressure and/or self-reported use of antihypertensives), and self-reported myocardial infarction and stroke were the outcomes of analyses.Results Analyses of the complete sample (n=17 288, 51.2% women), in fully adjusted models, revealed non-significant and very weak associations between tinnitus status and all three cardiovascular outcomes (prevalence ratios (PRs): 1.04–1.11), while for tinnitus symptom intensity, we found significant positive associations between low-intensity tinnitus and hypertension (PR: 1.08, 95% CI: (1.01 to 1.16) and myocardial infarction (PR: 1.39, 95% CI: 1.07 to 1.81). Among participants with tinnitus (n=3570), there were no associations between tinnitus bother and cardiovascular outcomes.Conclusions Results from the present study indicate that there is a weak association between tinnitus and cardiovascular disease and that tinnitus should be taken seriously even at low intensities.

Published
2024
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2. Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort

Author

Ainhoa Bereziartua, Jie Chen, Kees de Hoogh, Sophia Rodopoulou, Zorana J. Andersen, Tom Bellander, Jørgen Brandt, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, W.M.Monique Verschuren, Karl-Heinz Jöckel, Jeanette T Jørgensen, Klea Katsouyanni, Matthias Ketzel, Norun Hjertager Krog, Boel Brynedal, Karin Leander, Shuo Liu, Petter Ljungman, Elodie Faure, Patrik K.E. Magnusson, Gabriele Nagel, Göran Pershagen, Annette Peters, Ole Raaschou-Nielsen, Matteo Renzi, Debora Rizzuto, Evangelia Samoli, Yvonne T. van der Schouw, Sara Schramm, Gianluca Severi, Massimo Stafoggia, Maciej Strak, Mette Sørensen, Anne Tjønneland, Gudrun Weinmayr, Kathrin Wolf, Emanuel Zitt, Bert Brunekreef, and Gerard Hoek

Subjects
Green space, Mortality, Air Pollution, Traffic Noise, Environmental sciences, GE1-350
Abstract

Background: The majority of studies have shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort. Methods: Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1-km radius were assigned to participants’ baseline home addresses as a measure of surrounding greenness exposure. We used Cox proportional hazards models to estimate the association of NDVI exposure with natural-cause and cause-specific mortality, adjusting for a number of potential confounders including socioeconomic status and lifestyle factors at individual and area-levels. We further assessed the associations between greenness exposure and mortality after adjusting for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and road traffic noise. Results: The pooled study population comprised 327,388 individuals who experienced 47,179 natural-cause deaths during 6,374,370 person-years of follow-up. The mean NDVI in the pooled cohort was 0.33 (SD 0.1) and 0.34 (SD 0.1) in the 300-m grid and 1-km buffer. In the main fully adjusted model, 0.1 unit increment of NDVI inside 300-m grid was associated with 5% lower risk of natural-cause mortality (Hazard Ratio (HR) 0.95 (95% CI: 0.94, 0.96)). The associations attenuated after adjustment for air pollution [HR (95% CI): 0.97 (0.96, 0.98) adjusted for PM2.5; 0.98 (0.96, 0.99) adjusted for NO2]. Additional adjustment for traffic noise hardly affected the associations. Consistent results were observed for NDVI within 1-km buffer. After adjustment for air pollution, NDVI was inversely associated with diabetes, respiratory and lung cancer mortality, yet with wider 95% confidence intervals. No association with cardiovascular mortality was found. Conclusions: We found a significant inverse association between surrounding greenness and natural-cause mortality, which remained after adjusting for spatially correlated air pollution and traffic noise.

Published
2022
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3. Urban environment and health behaviours in children from six European countries

Author

Sílvia Fernández-Barrés, Oliver Robinson, Serena Fossati, Sandra Márquez, Xavier Basagaña, Jeroen de Bont, Montserrat de Castro, David Donaire-Gonzalez, Léa Maitre, Mark Nieuwenhuijsen, Dora Romaguera, José Urquiza, Leda Chatzi, Minas Iakovides, Marina Vafeiadi, Regina Grazuleviciene, Audrius Dedele, Sandra Andrusaityte, Gunn Marit Aasvang, Jorunn Evandt, Norun Hjertager Krog, Johanna Lepeule, Barbara Heude, John Wright, Rosemary R.C. McEachan, Franco Sassi, Paolo Vineis, and Martine Vrijheid

Subjects
Urban environment, Health behaviours, Multiple exposures, Health patterns, Childhood, Principal component analysis, Environmental sciences, GE1-350
Abstract

Background: Urban environmental design is increasingly considered influential for health and wellbeing, but evidence is mostly based on adults and single exposure studies. We evaluated the association between a wide range of urban environment characteristics and health behaviours in childhood. Methods: We estimated exposure to 32 urban environment characteristics (related to the built environment, traffic, and natural spaces) for home and school addresses of 1,581 children aged 6–11 years from six European cohorts. We collected information on health behaviours including total amount of overall moderate-to-vigorous physical activity, physical activity outside school hours, active transport, sedentary behaviours and sleep duration, and developed patterns of behaviours with principal component analysis. We used an exposure-wide association study to screen all exposure-outcome associations, and the deletion-substitution-addition algorithm to build a final multi-exposure model. Results: In multi-exposure models, green spaces (Normalized Difference Vegetation Index, NDVI) were positively associated with active transport, and inversely associated with sedentary time (22.71 min/day less (95 %CI −39.90, −5.51) per interquartile range increase in NDVI). Residence in densely built areas was associated with more physical activity and less sedentary time, and densely populated areas with less physical activity outside school hours and more sedentary time. Presence of a major road was associated with lower sleep duration (-4.80 min/day (95 %CI −9.11, −0.48); compared with no major road). Results for the behavioural patterns were similar. Conclusions: This multicohort study suggests that areas with more vegetation, more building density, less population density and without major roads are associated with improved health behaviours in childhood.

Published
2022
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5. Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Author

Ulla Arthur Hvidtfeldt, Gianluca Severi, Zorana Jovanovic Andersen, Richard Atkinson, Mariska Bauwelinck, Tom Bellander, Marie-Christine Boutron-Ruault, Jørgen Brandt, Bert Brunekreef, Giulia Cesaroni, Jie Chen, Hans Concin, Francesco Forastiere, Carla H. van Gils, John Gulliver, Ole Hertel, Gerard Hoek, Barbara Hoffmann, Kees de Hoogh, Nicole Janssen, Karl-Heinz Jöckel, Jeanette Therming Jørgensen, Klea Katsouyanni, Matthias Ketzel, Jochem O. Klompmaker, Norun Hjertager Krog, Alois Lang, Karin Leander, Shuo Liu, Petter L.S. Ljungman, Patrik K.E. Magnusson, Amar Jayant Mehta, Gabriele Nagel, Bente Oftedal, Göran Pershagen, Raphael Simon Peter, Annette Peters, Matteo Renzi, Debora Rizzuto, Sophia Rodopoulou, Evangelia Samoli, Per Everhard Schwarze, Torben Sigsgaard, Mette Kildevæld Simonsen, Massimo Stafoggia, Maciek Strak, Danielle Vienneau, Gudrun Weinmayr, Kathrin Wolf, Ole Raaschou-Nielsen, and Daniela Fecht

Subjects
Air pollution, Lung cancer incidence, Particulate matter, Dose response relationship, Environmental sciences, GE1-350
Abstract

Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods: The “Effects of Low-level Air Pollution: a Study in Europe” (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O3) to assign exposure to cohort participants’ residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O3 (warm season) were 24.2 µg/m3 (19.5, 29.7), 15.4 µg/m3 (12.8, 17.3), 1.6 10−5m−1 (1.3, 1.8), and 86.6 µg/m3 (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 µg/m3). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset of subjects with exposure below the EU limit value of 25 µg/m3. We did not observe associations between NO2, BC or O3 and lung cancer incidence. Conclusions: Long-term ambient PM2.5 exposure is associated with lung cancer incidence even at concentrations below current EU limit values and possibly WHO Air Quality Guidelines.

Published
2021
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6. Road traffic noise and children’s inattention

Author

Kjell Vegard Weyde, Norun Hjertager Krog, Bente Oftedal, Per Magnus, Simon Øverland, Stephen Stansfeld, Mark J. Nieuwenhuijsen, Martine Vrijheid, Montserrat de Castro Pascual, and Gunn Marit Aasvang

Subjects
Road traffic noise, Inattention, Children, Norwegian mother and child cohort study, Industrial medicine. Industrial hygiene, RC963-969, Public aspects of medicine, RA1-1270
Abstract

Abstract Background An increasing number of children are exposed to road traffic noise levels that may lead to adverse effects on health and daily functioning. Childhood is a period of intense growth and brain maturation, and children may therefore be especially vulnerable to road traffic noise. The objective of the present study was to examine whether road traffic noise was associated with reported inattention symptoms in children, and whether this association was mediated by sleep duration. Methods This study was based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Parental reports of children’s inattention at age 8 were linked to modelled levels of residential road traffic noise. We investigated the association between inattention and noise exposure during pregnancy (n = 1934), noise exposure averaged over 5 years (age 3 to 8 years; n = 1384) and noise exposure at age 8 years (n = 1384), using fractional logit response models. The participants were children from Oslo, Norway. Results An association with inattention at age 8 years was found for road traffic noise exposure at age 8 years (coef = .0083, CI = [.0012, .0154]; 1.2% point increase in inattention score per 10 dB increase in noise level), road traffic noise exposure average for the last 5 years (coef = .0090, CI = [.0016, .0164]; 1.3% point increase/10 dB), and for pregnancy road traffic noise exposure for boys (coef = .0091, CI = [.0010, .0171]), but not girls (coef = −.0021, CI = [−.0094, .0053]). Criteria for doing mediation analyses were not fulfilled. Conclusion Results indicate that road traffic noise has a negative impact on children’s inattention. We found no mediation by sleep duration.

Published
2017
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7. Road traffic noise and registry based use of sleep medication

Author

Jorunn Evandt, Bente Oftedal, Norun Hjertager Krog, Svetlana Skurtveit, Per Nafstad, Per E. Schwarze, Eva Skovlund, Danny Houthuijs, and Gunn Marit Aasvang

Subjects
Traffic noise, Prescription registry, Sleep medication, Hypnotics, Sleep, Insomnia, Industrial medicine. Industrial hygiene, RC963-969, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Road traffic noise has been associated with adverse health effects including sleep disturbances. Use of sleep medication as an indicator of sleeping problems has rarely been explored in studies of the effects of traffic noise. Furthermore, using registry data on sleep medications provides an opportunity to study the effects of noise on sleep where attribution of sleep problems to noise is not possible. Methods We used questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009–10) (n = 13,019). Individual data on sleep medications was obtained from the Norwegian Prescription Database (NorPD). Noise levels (L night) were modeled for the most exposed façade of the building at each participant’s home address. Logistic regression models adjusted for potential confounders were used to analyze the association between traffic noise and sleep medication use both for one whole year and for the summer season. The results were reported as changes in the effect estimate per 5 decibel (dB) increase in noise level. Results We observed no association between traffic noise and sleep medication use during one year [odds ratio (OR) = 1.00; 95% confidence interval (CI): 0.96, 1.04]. For sleep medication use in the summer season, there was a positive, however non-significant association (OR = 1.04; 95% CI: 0.99, 1.10). Among individuals sleeping with the bedroom window open, the association increased slightly and was borderline statistically significant (OR = 1.06; 95% CI: 1.00, 1.12). Conclusions We found no evidence of an association between traffic noise and sleep medication use during one year. However, for the summer season, there was some suggestive evidence of an association. These findings indicate that season may play a role in the association between traffic noise and sleep, possibly because indoor traffic noise levels are likely to be higher during summer due to more frequent window opening. More studies are, however, necessary in order to confirm this.

Published
2017
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8. Long-term exposure to ambient air pollution and risk of lung cancer – A comparative analysis of incidence and mortality in four administrative cohorts in the ELAPSE study

Author

Chen, Jie, Atkinson, Richard W., Andersen, Zorana Jovanovic, Oftedal, Bente, Stafoggia, Massimo, Lim, Youn-Hee, Bekkevold, Terese, Krog, Norun Hjertager, Renzi, Matteo, Zhang, Jiawei, Bauwelinck, Mariska, Janssen, Nicole, Strak, Maciek, Forastiere, Francesco, de Hoogh, Kees, Rodopoulou, Sophia, Katsouyanni, Klea, Raaschou-Nielsen, Ole, Samoli, Evangelia, Brunekreef, Bert, Hoek, Gerard, and Vienneau, Danielle

Published
2024
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9. Associations between combined urban and lifestyle factors and respiratory health in European children

Author

Guillien, Alicia, Slama, Rémy, Andrusaityte, Sandra, Casas, Maribel, Chatzi, Leda, de Castro, Montserrat, de Lauzon-Guillain, Blandine, Granum, Berit, Grazuleviciene, Regina, Julvez, Jordi, Krog, Norun Hjertager, Lepeule, Johanna, Maitre, Léa, McEachan, Rosemary, Nieuwenhuijsen, Mark, Oftedal, Bente, Urquiza, Jose, Vafeiadi, Marina, Wright, John, Vrijheid, Martine, Basagaña, Xavier, and Siroux, Valérie

Published
2024
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10. Availability, accessibility, and use of green spaces and cognitive development in primary school children

Author

Fernandes, Amanda, Krog, Norun Hjertager, McEachan, Rosemary, Nieuwenhuijsen, Mark, Julvez, Jordi, Márquez, Sandra, de Castro, Montserrat, Urquiza, José, Heude, Barbara, Vafeiadi, Marina, Gražulevičienė, Regina, Slama, Rémy, Dedele, Audrius, Aasvang, Gunn Marit, Evandt, Jorunn, Andrusaityte, Sandra, Kampouri, Mariza, and Vrijheid, Martine

Published
2023
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13. Early-Life Environmental Exposures and Blood Pressure in Children

Author

Warembourg, Charline, Maitre, Léa, Tamayo-Uria, Ibon, Fossati, Serena, Roumeliotaki, Theano, Aasvang, Gunn Marit, Andrusaityte, Sandra, Casas, Maribel, Cequier, Enrique, Chatzi, Lida, Dedele, Audrius, Gonzalez, Juan-Ramon, Gražulevičienė, Regina, Haug, Line Smastuen, Hernandez-Ferrer, Carles, Heude, Barbara, Karachaliou, Marianna, Krog, Norun Hjertager, McEachan, Rosemary, Nieuwenhuijsen, Mark, Petraviciene, Inga, Quentin, Joane, Robinson, Oliver, Sakhi, Amrit Kaur, Slama, Rémy, Thomsen, Cathrine, Urquiza, Jose, Vafeiadi, Marina, West, Jane, Wright, John, Vrijheid, Martine, and Basagaña, Xavier

Published
2019
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15. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Wang, Haidong, Naghavi, Mohsen, Allen, Christine, Barber, Ryan M, Bhutta, Zulfiqar A, Carter, Austin, Casey, Daniel C, Charlson, Fiona J, Chen, Alan Zian, Coates, Matthew M, Coggeshall, Megan, Dandona, Lalit, Dicker, Daniel J, Erskine, Holly E, Ferrari, Alize J, Fitzmaurice, Christina, Foreman, Kyle, Forouzanfar, Mohammad H, Fraser, Maya S, Fullman, Nancy, Gething, Peter W, Goldberg, Ellen M, Graetz, Nicholas, Haagsma, Juanita A, Hay, Simon I, Huynh, Chantal, Johnson, Catherine O, Kassebaum, Nicholas J, Kinfu, Yohannes, Kulikoff, Xie Rachel, Kutz, Michael, Kyu, Hmwe H, Larson, Heidi J, Leung, Janni, Liang, Xiaofeng, Lim, Stephen S, Lind, Margaret, Lozano, Rafael, Marquez, Neal, Mensah, George A, Mikesell, Joe, Mokdad, Ali H, Mooney, Meghan D, Nguyen, Grant, Nsoesie, Elaine, Pigott, David M, Pinho, Christine, Roth, Gregory A, Salomon, Joshua A, Sandar, Logan, Silpakit, Naris, Sligar, Amber, Sorensen, Reed J D, Stanaway, Jeffrey, Steiner, Caitlyn, Teeple, Stephanie, Thomas, Bernadette A, Troeger, Christopher, VanderZanden, Amelia, Vollset, Stein Emil, Wanga, Valentine, Whiteford, Harvey A, Wolock, Timothy, Zoeckler, Leo, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abera, Semaw Ferede, Abreu, Daisy M X, Abu-Raddad, Laith J, Abyu, Gebre Yitayih, Achoki, Tom, Adelekan, Ademola Lukman, Ademi, Zanfina, Adou, Arsène Kouablan, Adsuar, José C, Afanvi, Kossivi Agbelenko, Afshin, Ashkan, Agardh, Emilie Elisabet, Agarwal, Arnav, Agrawal, Anurag, Kiadaliri, Aliasghar Ahmad, Ajala, Oluremi N, Akanda, Ali Shafqat, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Lami, Faris Hasan Al, Alabed, Samer, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore K M, Alasfoor, Deena, Aldhahri, Saleh Fahed, Aldridge, Robert William, Alegretti, Miguel Angel, Aleman, Alicia V, Alemu, Zewdie Aderaw, Alexander, Lily T, Alhabib, Samia, Ali, Raghib, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Martin, Elena Alvarez, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amegah, Adeladza Kofi, Ameh, Emmanuel A, Amini, Heresh, Ammar, Walid, Amrock, Stephen Marc, Andersen, Hjalte H, Anderson, Benjamin O, Anderson, Gregory M, Antonio, Carl Abelardo T, Aregay, Atsede Fantahun, Ärnlöv, Johan, Arsenijevic, Valentina S Arsic, Artaman, Al, Asayesh, Hamid, Asghar, Rana Jawad, Atique, Suleman, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Bahit, Maria C, Balakrishnan, Kalpana, Banerjee, Amitava, Barac, Aleksandra, Barker-Collo, Suzanne L, Bärnighausen, Till, Barregard, Lars, Barrero, Lope H, Basu, Arindam, Basu, Sanjay, Bayou, Yibeltal Tebekaw, Bazargan-Hejazi, Shahrzad, Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Belay, Haileeyesus Adamu, Bell, Brent, Bell, Michelle L, Bello, Aminu K, Bennett, Derrick A, Bensenor, Isabela M, Berhane, Adugnaw, Bernabé, Eduardo, Betsu, Balem Demtsu, Beyene, Addisu Shunu, Bhala, Neeraj, Bhalla, Ashish, Biadgilign, Sibhatu, Bikbov, Boris, Abdulhak, Aref A Bin, Biroscak, Brian J, Biryukov, Stan, Bjertness, Espen, Blore, Jed D, Blosser, Christopher D, Bohensky, Megan A, Borschmann, Rohan, Bose, Dipan, Bourne, Rupert R A, Brainin, Michael, Brayne, Carol E G, Brazinova, Alexandra, Breitborde, Nicholas J K, Brenner, Hermann, Brewer, Jerry D, Brown, Alexandria, Brown, Jonathan, Brugha, Traolach S, Buckle, Geoffrey Colin, Butt, Zahid A, Calabria, Bianca, Campos-Nonato, Ismael Ricardo, Campuzano, Julio Cesar, Carapetis, Jonathan R, Cárdenas, Rosario, Carpenter, David O, Carrero, Juan Jesus, Castañeda-Orjuela, Carlos A, Rivas, Jacqueline Castillo, Catalá-López, Ferrán, Cavalleri, Fiorella, Cercy, Kelly, Cerda, Jorge, Chen, Wanqing, Chew, Adrienne, Chiang, Peggy Pei-Chia, Chibalabala, Mirriam, Chibueze, Chioma Ezinne, Chimed-Ochir, Odgerel, Chisumpa, Vesper Hichilombwe, Choi, Jee-Young Jasmine, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G, Cirillo, Massimo, Cohen, Aaron J, Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M, Cooper, Cyrus, Cooper, Leslie Trumbull, Cortinovis, Monica, Cowie, Benjamin C, Crump, John A, Damsere-Derry, James, Danawi, Hadi, Dandona, Rakhi, Daoud, Farah, Darby, Sarah C, Dargan, Paul I, das Neves, José, Davey, Gail, Davis, Adrian C, Davitoiu, Dragos V, de Castro, E Filipa, de Jager, Pieter, Leo, Diego De, Degenhardt, Louisa, Dellavalle, Robert P, Deribe, Kebede, Deribew, Amare, Dharmaratne, Samath D, Dhillon, Preet K, Diaz-Torné, Cesar, Ding, Eric L, dos Santos, Kadine Priscila Bender, Dossou, Edem, Driscoll, Tim R, Duan, Leilei, Dubey, Manisha, Duncan, Bruce Bartholow, Ellenbogen, Richard G, Ellingsen, Christian Lycke, Elyazar, Iqbal, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Eshrati, Babak, Esteghamati, Alireza, Estep, Kara, Faghmous, Imad D A, Fahimi, Saman, Faraon, Emerito Jose Aquino, Farid, Talha A, Farinha, Carla Sofia e Sa, Faro, André, Farvid, Maryam S, Farzadfar, Farshad, Feigin, Valery L, Fereshtehnejad, Seyed-Mohammad, Fernandes, Jefferson G, Fernandes, Joao C, Fischer, Florian, Fitchett, Joseph R A, Flaxman, Abraham, Foigt, Nataliya, Fowkes, F Gerry R, Franca, Elisabeth Barboza, Franklin, Richard C, Friedman, Joseph, Frostad, Joseph, Fürst, Thomas, Futran, Neal D, Gall, Seana L, Gambashidze, Ketevan, Gamkrelidze, Amiran, Ganguly, Parthasarathi, Gankpé, Fortuné Gbètoho, Gebre, Teshome, Gebrehiwot, Tsegaye Tsewelde, Gebremedhin, Amanuel Tesfay, Gebru, Alemseged Aregay, Geleijnse, Johanna M, Gessner, Bradford D, Ghoshal, Aloke Gopal, Gibney, Katherine B, Gillum, Richard F, Gilmour, Stuart, Giref, Ababi Zergaw, Giroud, Maurice, Gishu, Melkamu Dedefo, Giussani, Giorgia, Glaser, Elizabeth, Godwin, William W, Gomez-Dantes, Hector, Gona, Philimon, Goodridge, Amador, Gopalani, Sameer Vali, Gosselin, Richard A, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Greaves, Felix, Gugnani, Harish Chander, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Gutiérrez, Reyna A, Hafezi-Nejad, Nima, Haile, Demewoz, Hailu, Alemayehu Desalegne, Hailu, Gessessew Bugssa, Halasa, Yara A, Hamadeh, Randah Ribhi, Hamidi, Samer, Hancock, Jamie, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Havmoeller, Rasmus, Heckbert, Susan R, Heredia-Pi, Ileana Beatriz, Heydarpour, Pouria, Hilderink, Henk B M, Hoek, Hans W, Hogg, Robert S, Horino, Masako, Horita, Nobuyuki, Hosgood, H Dean, Hotez, Peter J, Hoy, Damian G, Hsairi, Mohamed, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Guoqing, Huang, Cheng, Huang, Hsiang, Huiart, Laetitia, Husseini, Abdullatif, Huybrechts, Inge, Huynh, Grace, Iburg, Kim Moesgaard, Innos, Kaire, Inoue, Manami, Iyer, Veena J, Jacobs, Troy A, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, James, Peter, Javanbakht, Mehdi, Jayaraman, Sudha P, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Guohong, Jiang, Ying, Jibat, Tariku, Jimenez-Corona, Aida, Jonas, Jost B, Joshi, Tushar Kant, Kabir, Zubair, Kamal, Ritul, Kan, Haidong, Kant, Surya, Karch, André, Karema, Corine Kakizi, Karimkhani, Chante, Karletsos, Dimitris, Karthikeyan, Ganesan, Kasaeian, Amir, Katibeh, Marzieh, Kaul, Anil, Kawakami, Norito, Kayibanda, Jeanne Françoise, Keiyoro, Peter Njenga, Kemmer, Laura, Kemp, Andrew Haddon, Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khalil, Ibrahim A, Khan, Abdur Rahman, Khan, Ejaz Ahmad, Khang, Young-Ho, Khera, Sahil, Khoja, Tawfik Ahmed Muthafer, Kieling, Christian, Kim, Daniel, Kim, Yun Jin, Kissela, Brett M, Kissoon, Niranjan, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek A, Kosen, Soewarta, Koul, Parvaiz A, Koyanagi, Ai, Krog, Norun Hjertager, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kudom, Andreas A, Kuipers, Ernst J, Kulkarni, Veena S, Kumar, G Anil, Kwan, Gene F, Lal, Aparna, Lal, Dharmesh Kumar, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lam, Jennifer O, Langan, Sinead M, Lansingh, Van C, Larsson, Anders, Laryea, Dennis Odai, Latif, Asma Abdul, Lawrynowicz, Alicia Elena Beatriz, Leigh, James, Levi, Miriam, Li, Yongmei, Lindsay, M Patrice, Lipshultz, Steven E, Liu, Patrick Y, Liu, Shiwei, Liu, Yang, Lo, Loon-Tzian, Logroscino, Giancarlo, Lotufo, Paulo A, Lucas, Robyn M, Lunevicius, Raimundas, Lyons, Ronan A, Ma, Stefan, Machado, Vasco Manuel Pedro, Mackay, Mark T, MacLachlan, Jennifer H, Razek, Hassan Magdy Abd El, Magdy, Mohammed, Razek, Abd El, Majdan, Marek, Majeed, Azeem, Malekzadeh, Reza, Manamo, Wondimu Ayele Ayele, Mandisarisa, John, Mangalam, Srikanth, Mapoma, Chabila C, Marcenes, Wagner, Margolis, David Joel, Martin, Gerard Robert, Martinez-Raga, Jose, Marzan, Melvin Barrientos, Masiye, Felix, Mason-Jones, Amanda J, Massano, João, Matzopoulos, Richard, Mayosi, Bongani M, McGarvey, Stephen Theodore, McGrath, John J, McKee, Martin, McMahon, Brian J, Meaney, Peter A, Mehari, Alem, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Alemayehu B, Melaku, Yohannes Adama, Memiah, Peter, Memish, Ziad A, Mendoza, Walter, Meretoja, Atte, Meretoja, Tuomo J, Mhimbira, Francis Apolinary, Micha, Renata, Millear, Anoushka, Miller, Ted R, Mirarefin, Mojde, Misganaw, Awoke, Mock, Charles N, Mohammad, Karzan Abdulmuhsin, Mohammadi, Alireza, Mohammed, Shafiu, Mohan, Viswanathan, Mola, Glen Liddell D, Monasta, Lorenzo, Hernandez, Julio Cesar Montañez, Montero, Pablo, Montico, Marcella, Montine, Thomas J, Moradi-Lakeh, Maziar, Morawska, Lidia, Morgan, Katherine, Mori, Rintaro, Mozaffarian, Dariush, Mueller, Ulrich O, Murthy, Gudlavalleti Venkata Satyanarayana, Murthy, Srinivas, Musa, Kamarul Imran, Nachega, Jean B, Nagel, Gabriele, Naidoo, Kovin S, Naik, Nitish, Naldi, Luigi, Nangia, Vinay, Nash, Denis, Nejjari, Chakib, Neupane, Subas, Newton, Charles R, Newton, John N, Ng, Marie, Ngalesoni, Frida Namnyak, de Dieu Ngirabega, Jean, Nguyen, Quyen Le, Nisar, Muhammad Imran, Pete, Patrick Martial Nkamedjie, Nomura, Marika, Norheim, Ole F, Norman, Paul E, Norrving, Bo, Nyakarahuka, Luke, Ogbo, Felix Akpojene, Ohkubo, Takayoshi, Ojelabi, Foluke Adetola, Olivares, Pedro R, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Opio, John Nelson, Oren, Eyal, Ortiz, Alberto, Osman, Majdi, Ota, Erika, Ozdemir, Raziye, PA, Mahesh, Pain, Amanda, Pandian, Jeyaraj D, Pant, Puspa Raj, Papachristou, Christina, Park, Eun-Kee, Park, Jae-Hyun, Parry, Charles D, Parsaeian, Mahboubeh, Caicedo, Angel J Paternina, Patten, Scott B, Patton, George C, Paul, Vinod K, Pearce, Neil, Pedro, João Mário, Stokic, Ljiljana Pejin, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Phillips, Michael Robert, Piel, Frédéric B, Pillay, Julian David, Plass, Dietrich, Platts-Mills, James A, Polinder, Suzanne, Pope, C Arden, Popova, Svetlana, Poulton, Richie G, Pourmalek, Farshad, Prabhakaran, Dorairaj, Qorbani, Mostafa, Quame-Amaglo, Justice, Quistberg, D Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Sajjad Ur, Rai, Rajesh Kumar, Rajavi, Zhale, Rajsic, Sasa, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Ranabhat, Chhabi L, Rangaswamy, Thara, Rao, Puja, Rao, Sowmya R, Refaat, Amany H, Rehm, Jürgen, Reitsma, Marissa B, Remuzzi, Giuseppe, Resnikoff, Serge, Ribeiro, Antonio L, Ricci, Stefano, Blancas, Maria Jesus Rios, Roberts, Bayard, Roca, Anna, Rojas-Rueda, David, Ronfani, Luca, Roshandel, Gholamreza, Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nawal K, Ruhago, George Mugambage, Sagar, Rajesh, Saha, Sukanta, Sahathevan, Ramesh, Saleh, Muhammad Muhammad, Sanabria, Juan R, Sanchez-Niño, Maria Dolores, Sanchez-Riera, Lidia, Santos, Itamar S, Sarmiento-Suarez, Rodrigo, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Schaub, Michael P, Schmidt, Maria Inês, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta E, Schwebel, David C, Seedat, Soraya, Sepanlou, Sadaf G, Servan-Mori, Edson E, Shackelford, Katya A, Shaddick, Gavin, Shaheen, Amira, Shahraz, Saeid, Shaikh, Masood Ali, Shakh-Nazarova, Marina, Sharma, Rajesh, She, Jun, Sheikhbahaei, Sara, Shen, Jiabin, Shen, Ziyan, Shepard, Donald S, Sheth, Kevin N, Shetty, Balakrishna P, Shi, Peilin, Shibuya, Kenji, Shin, Min-Jeong, Shiri, Rahman, Shiue, Ivy, Shrime, Mark G, Sigfusdottir, Inga Dora, Silberberg, Donald H, Silva, Diego Augusto Santos, Silveira, Dayane Gabriele Alves, Silverberg, Jonathan I, Simard, Edgar P, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Singh, Om Prakash, Singh, Prashant Kumar, Singh, Virendra, Soneji, Samir, Søreide, Kjetil, Soriano, Joan B, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stathopoulou, Vasiliki, Stein, Dan J, Stein, Murray B, Stranges, Saverio, Stroumpoulis, Konstantinos, Sunguya, Bruno F, Sur, Patrick, Swaminathan, Soumya, Sykes, Bryan L, Szoeke, Cassandra E I, Tabarés-Seisdedos, Rafael, Tabb, Karen M, Takahashi, Ken, Takala, Jukka S, Talongwa, Roberto Tchio, Tandon, Nikhil, Tavakkoli, Mohammad, Taye, Bineyam, Taylor, Hugh R, Ao, Braden J Te, Tedla, Bemnet Amare, Tefera, Worku Mekonnen, Have, Margreet Ten, Terkawi, Abdullah Sulieman, Tesfay, Fisaha Haile, Tessema, Gizachew Assefa, Thomson, Alan J, Thorne-Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tirschwell, David L, Tonelli, Marcello, Topor-Madry, Roman, Topouzis, Fotis, Towbin, Jeffrey Allen, Traebert, Jefferson, Tran, Bach Xuan, Truelsen, Thomas, Trujillo, Ulises, Tura, Abera Kenay, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Undurraga, Eduardo A, Uthman, Olalekan A, Dingenen, Rita Van, van Donkelaar, Aaron, Vasankari, Tommi, Vasconcelos, Ana Maria Nogales, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Wagner, Joseph A, Wagner, Gregory R, Wallin, Mitchell T, Wang, Linhong, Watkins, David A, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Westerman, Ronny, White, Richard A, Wijeratne, Tissa, Wilkinson, James D, Williams, Hywel C, Wiysonge, Charles Shey, Woldeyohannes, Solomon Meseret, Wolfe, Charles D A, Won, Sungho, Wong, John Q, Woolf, Anthony D, Xavier, Denis, Xiao, Qingyang, Xu, Gelin, Yakob, Bereket, Yalew, Ayalnesh Zemene, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Ye, Pengpeng, Yebyo, Henock Gebremedhin, Yip, Paul, Yirsaw, Biruck Desalegn, Yonemoto, Naohiro, Yonga, Gerald, Younis, Mustafa Z, Yu, Shicheng, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zannad, Faiez, Zavala, Diego E, Zeeb, Hajo, Zeleke, Berihun M, Zhang, Hao, Zodpey, Sanjay, Zonies, David, Zuhlke, Liesl Joanna, Vos, Theo, Lopez, Alan D, and Murray, Christopher J L

Published
2016
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16. Title. Availability, Accessibility, and Use of Green Spaces and Cognitive Development in Primary School Children

Author

Fernandes, Amanda, primary, Krog, Norun Hjertager, additional, Mceachan, Rosie, additional, Nieuwenhuijsen, Mark, additional, Julvez, Jordi, additional, Marquez, Sandra, additional, De Castro, Montserrat, additional, Urquiza, Jose, additional, Heude, Barbara, additional, Vafeiadi, Marina, additional, Gražulevičienė, Regina, additional, Slama, Rémy, additional, Dedele, Audrius, additional, Aasvang, Gunn Marit, additional, Evandt, Jorunn, additional, Andrusaityte, Sandra, additional, Kampouri, Mariza, additional, and Virjheid, Martine, additional

Published
2023
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18. Exposure to traffic noise and markers of obesity

Author

Pyko, Andrei, Eriksson, Charlotte, Oftedal, Bente, Hilding, Agneta, Östenson, Claes-Göran, Krog, Norun Hjertager, Julin, Bettina, Aasvang, Gunn Marit, and Pershagen, Göran

Published
2015

19. Mortality and Morbidity Effects of Long-Term Exposure to Low-Level PM, BC, NO, and O: An Analysis of European Cohorts in the ELAPSE Project

Author

Bert, Brunekreef, Maciej, Strak, Jie, Chen, Zorana, J Andersen, Richard, Atkinson, Mariska, Bauwelinck, Tom, Bellander, Marie-Christine, Boutron, Jørgen, Brandt, Iain, Carey, Giulia, Cesaroni, Francesco, Forastiere, Daniela, Fecht, John, Gulliver, Ole, Hertel, Barbara, Hoffmann, Kees, de Hoogh, Danny, Houthuijs, Ulla, Hvidtfeldt, Nicole, Janssen, Jeanette, Jørgensen, Klea, Katsouyanni, Matthias, Ketzel, Jochem, Klompmaker, Norun, Hjertager Krog, Shuo, Liu, Petter, Ljungman, Amar, Mehta, Gabriele, Nagel, Bente, Oftedal, Göran, Pershagen, Annette, Peters, Ole, Raaschou-Nielsen, Matteo, Renzi, Sophia, Rodopoulou, Evi, Samoli, Per, Schwarze, Torben, Sigsgaard, Massimo, Stafoggia, Danielle, Vienneau, Gudrun, Weinmayr, Kathrin, Wolf, and Gerard, Hoek

Abstract

Epidemiological cohort studies have consistently found associations between long-term exposure to outdoor air pollution and a range of morbidity and mortality endpoints. Recent evaluations by the World Health Organization and the Global Burden of Disease study have suggested that these associations may be nonlinear and may persist at very low concentrations. Studies conducted in North America in particular have suggested that associations with mortality persisted at concentrations of particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5) well below current air quality standards and guidelines. The uncertainty about the shape of the concentration-response function at the low end of the concentration distribution, related to the scarcity of observations in the lowest range, was the basis of the current project. Previous studies have focused on PM2.5, but increasingly associations with nitrogen dioxide (NO2) are being reported, particularly in studies that accounted for the fine spatial scale variation of NO2. Very few studies have evaluated the effects of long-term exposure to low concentrations of ozone (O3). Health effects of black carbon (BC), representing primary combustion particles, have not been studied in most large cohort studies of PM2.5. Cohort studies assessing health effects of particle composition, including elements from nontailpipe traffic emissions (iron, copper, and zinc) and secondary aerosol (sulfur) have been few in number and reported inconsistent results.

Published
2022

20. Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort

Author

Bereziartua, Ainhoa, Chen, Jie, de Hoogh, Kees, Rodopoulou, Sophia, Andersen, Zorana J., Bellander, Tom, Brandt, Jorgen, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Verschuren, W. M. Monique, Joeckel, Karl-Heinz, Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Krog, Norun Hjertager, Brynedal, Boel, Leander, Karin, Liu, Shuo, Ljungman, Petter, Faure, Elodie, Magnusson, Patrik K. E., Nagel, Gabriele, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Severi, Gianluca, Stafoggia, Massimo, Strak, Maciej, Sorensen, Mette, Tjonneland, Anne, Weinmayr, Gudrun, Wolf, Kathrin, Zitt, Emanuel, Brunekreef, Bert, Hoek, Gerard, Bereziartua, Ainhoa, Chen, Jie, de Hoogh, Kees, Rodopoulou, Sophia, Andersen, Zorana J., Bellander, Tom, Brandt, Jorgen, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Verschuren, W. M. Monique, Joeckel, Karl-Heinz, Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Krog, Norun Hjertager, Brynedal, Boel, Leander, Karin, Liu, Shuo, Ljungman, Petter, Faure, Elodie, Magnusson, Patrik K. E., Nagel, Gabriele, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Severi, Gianluca, Stafoggia, Massimo, Strak, Maciej, Sorensen, Mette, Tjonneland, Anne, Weinmayr, Gudrun, Wolf, Kathrin, Zitt, Emanuel, Brunekreef, Bert, and Hoek, Gerard

Abstract

Background: The majority of studies have shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort.Methods: Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1-km radius were assigned to participants' baseline home addresses as a measure of surrounding greenness exposure. We used Cox proportional hazards models to estimate the association of NDVI exposure with natural-cause and cause-specific mortality, adjusting for a number of potential confounders including socioeconomic status and lifestyle factors at individual and area-levels. We further assessed the associations between greenness exposure and mortality after adjusting for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and road traffic noise.Results: The pooled study population comprised 327,388 individuals who experienced 47,179 natural-cause deaths during 6,374,370 person-years of follow-up. The mean NDVI in the pooled cohort was 0.33 (SD 0.1) and 0.34 (SD 0.1) in the 300-m grid and 1-km buffer. In the main fully adjusted model, 0.1 unit increment of NDVI inside 300-m grid was associated with 5% lower risk of natural-cause mortality (Hazard Ratio (HR) 0.95 (95% CI: 0.94, 0.96)). The associations attenuated after adjustment for air pollution [HR (95% CI): 0.97 (0.96, 0.98) adjusted for PM2.5; 0.98 (0.96, 0.99) adjusted for NO2]. Additional adjustment for traffic noise hardly affected the associations. Consistent results were observed for NDVI within 1-km buffer. After adjustment for air pollution, NDVI was inversely associated with diabetes, respiratory and lung cancer mortality, yet with wider 95% confidence intervals. No association with cardiovascular mortality was found.Conclusions: We found a significant inverse association between surrounding greenness and natural-cause mortality, w

Published
2022

22. Influence of the Urban Exposome on Birth Weight

Author

Nieuwenhuijsen, Mark J., Agier, Lydiane, Basagana, Xavier, Urquiza, Jose, Tamayo-Uria, Ibon, Giorgis-Allemand, Lise, Robinson, Oliver, Siroux, Valerie, Maitre, Lea, de Castro, Montserrat, Valentin, Antonia, Donaire, David, Dadvand, Payam, Aasvang, Gunn Marit, Krog, Norun Hjertager, Schwarze, Per E., Chatzi, Leda, Grazuleviciene, Regina, Andrusaityte, Sandra, Dedele, Audrius, McEachan, Rosie, Wright, John, West, Jane, Ibarluzea, Jesus, Ballester, Ferran, Vrijheid, Martine, and Slama, Remy

Subjects
Weather -- Health aspects, Air pollution -- Health aspects, Environmental toxicology -- Health aspects, Type 2 diabetes -- Health aspects, Pregnant women -- Health aspects, Algorithms, Traffic engineering, Pollution, Health, Environmental issues, Health, European Union -- Evaluation
Abstract

Background: The exposome is defined as the totality of environmental exposures from conception onwards. It calls for providing a holistic view of environmental exposures and their effects on human health by evaluating multiple environmental exposures simultaneously during critical periods of life. Objective: We evaluated the association of the urban exposome with birth weight. Methods: We estimated exposure to the urban exposome, including the built environment, air pollution, road traffic noise, meteorology, natural space, and road traffic (corresponding to 24 environmental indicators and 60 exposures) for nearly 32,000 pregnant women from six European birth cohorts. To evaluate associations with either continuous birth weight or term low birth weight (TLBW) risk, we primarily relied on the DeletionSubstitution-Addition (DSA) algorithm, which is an extension of the stepwise variable selection method. Second, we used an exposure- byexposure exposome-wide association studies (ExWAS) method accounting for multiple hypotheses testing to report associations not adjusted for co exposures. Results: The most consistent statistically significant associations were observed between increasing green space exposure estimated as Normalized Difference Vegetation Index (NDVI) and increased birth weight and decreased TLBW risk. Furthermore, we observed statistically significant associations among presence of public bus line, land use Shannon's Evenness Index, and traffic density and birth weight in our DSA analysis. Conclusion: This investigation is the first large urban exposome study of birth weight that tests many environmental urban exposures. It confirmed previously reported associations for NDVI and generated new hypotheses for a number of built-environment exposures. https://doi.org/10.1289/EHP3971, Introduction The exposome is defined as the totality of environmental exposures from conception onwards (Wild 2005, 2012). This definition aims to provide a holistic view of environmental exposures and their [...]

Published
2019
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24. Green CURIOCITY: a study protocol for a European birth cohort study analysing childhood heat-related health impacts and protective effects of urban natural environments

Author

Matilda van den Bosch, Xavier Basagaña, Pierpaolo Mudu, Vladimir Kendrovski, Léa Maitre, Norun Hjertager Krog, Gunn Marit Aasvang, Regina Grazuleviciene, Rosemary McEachan, Martine Vrijheid, and Mark J Nieuwenhuijsen

Subjects
Hot Temperature, Epidemiology, Parks, Recreational, public health, General Medicine, preventive medicine, Cohort Studies, Pregnancy, Air Pollution, Child, Preschool, Medicine, Humans, Birth Cohort, Female, Cities, Child, community child health
Abstract

Introduction: The European climate is getting warmer and the impact on childhood health and development is insufficiently understood. Equally, how heat-related health risks can be reduced through nature-based solutions, such as exposure to urban natural environments, is unknown. Green CURe In Outdoor CITY spaces (Green CURIOCITY) will analyse how heat exposure during pregnancy affects birth outcomes and how long-term heat exposure may influence children's neurodevelopment. We will also investigate if adverse effects can be mitigated by urban natural environments. A final goal is to visualise intraurban patterns of heat vulnerability and assist planning towards healthier cities. Methods and analysis: We will use existing data from the Human Early-Life Exposure cohort, which includes information on birth outcomes and neurodevelopment from six European birth cohorts. The cohort is linked to data on prenatal heat exposure and impact on birth outcomes will be analysed with logistic regression models, adjusting for air pollution and noise and sociobehavioural covariates. Similarly, impact of cumulative and immediate heat exposure on neurodevelopmental outcomes at age 5 will be assessed. For both analyses, the potentially moderating impact of natural environments will be quantified. For visualisation, Geographical information systems data will be combined to develop vulnerability maps, demonstrating urban 'hot spots' where the risk of negative impacts of heat is aggravated due to sociodemographic and land use patterns. Finally, geospatial and meteorological data will be used for informing GreenUr, an existing software prototype developed by the WHO Regional Office for Europe to quantify health impacts and augment policy tools for urban green space planning. Ethics and dissemination: The protocol was approved by the Comité Ético de Investigación Clínica Parc de Salut MAR, Spain. Findings will be published in peer-reviewed journals and presented at policy events. Through stakeholder engagement, the results will also reach user groups and practitioners. This work is supported by the European Commission through a Horizon 2020 Marie Skłodowska-Curie Grant, Reference number 891 538.LM is funded by a Juan de la Cierva-Incorporación fellowship (IJC2018-035394-I) awarded by the Spanish Ministerio de Economía, Industria y Competitividad.

Published
2022

27. Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015–2016)

Author

Oddgeir Friborg, Laila Arnesdatter Hopstock, Christopher Sivert Nielsen, Magnar Johnsen, Ólöf Anna Steingrímsdóttir, Jannike Heyerdahl-Larsen Ausland, Norun Hjertager Krog, Bo Engdahl, Anne Elise Eggen, Jan H. Rosenvinge, and Bente Oftedal

Subjects
Questionnaires, Male, Adult population, Information Theory, Social Sciences, Otology, Comorbidity, Audiology, Logistic regression, Directed Acyclic Graphs, Tinnitus, Sociology, Medicine and Health Sciences, Prevalence, Psychology, Hearing Disorders, Aged, 80 and over, Multidisciplinary, VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801, Directed Graphs, Norway, Incidence, Chronic pain, Middle Aged, Neurology, Research Design, Physical Sciences, Medicine, Population study, Body region, Sensory Perception, Female, medicine.symptom, Chronic Pain, Research Article, Adult, medicine.medical_specialty, Computer and Information Sciences, Science, Immunology, Pain, Population based, Research and Analysis Methods, Education, Signs and Symptoms, medicine, otorhinolaryngologic diseases, Hypersensitivity, Humans, Educational Attainment, Aged, Survey Research, business.industry, Cognitive Psychology, Biology and Life Sciences, medicine.disease, Otorhinolaryngology, Age Groups, Graph Theory, People and Places, Cognitive Science, Population Groupings, Clinical Immunology, Perception, VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801, Clinical Medicine, business, Mathematics, Neuroscience
Abstract

Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, and tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in tinnitus patients to provide a more comprehensive treatment of tinnitus.

Published
2021

28. Prenatal and childhood exposure to air pollution and traffic and the risk of liver injury in European children

Author

Nerea Varo, Sandra Andrusaityte, Rob McConnell, Rosemary R. C. McEachan, Norun Hjertager Krog, Gunn Marit Aasvang, Barbara Heude, Martine Vrijheid, Serena Fossati, Mark J. Nieuwenhuijsen, Nikos Stratakis, John Wright, Jose Urquiza, Miriam B. Vos, L. Chatzi, David V. Conti, Rémy Slama, Kiros Berhane, Xavier Basagaña, Theano Roumeliotaki, Montserrat de Castro, Damaskini Valvi, Erika Garcia, Gerard Hoek, Marina Vafeiadi, Regina Grazuleviciene, Léa Maitre, and Maribel Casas

Subjects
Liver injury, Global and Planetary Change, Pregnancy, Exposome, Epidemiology, business.industry, Health, Toxicology and Mutagenesis, Confounding, Public Health, Environmental and Occupational Health, Air pollution, Overweight, medicine.disease, Chronic liver disease, Pollution, Environmental health, Nonalcoholic fatty liver disease, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, medicine, Population study, Original Research Article, medicine.symptom, business
Abstract

Supplemental Digital Content is available in the text., Background: Nonalcoholic fatty liver disease is the most prevalent pediatric chronic liver disease. Experimental studies suggest effects of air pollution and traffic exposure on liver injury. We present the first large-scale human study to evaluate associations of prenatal and childhood air pollution and traffic exposure with liver injury. Methods: Study population included 1,102 children from the Human Early Life Exposome project. Established liver injury biomarkers, including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and cytokeratin-18, were measured in serum between ages 6–10 years. Air pollutant exposures included nitrogen dioxide, particulate matter

Published
2021

29. Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Author

Klea Katsouyanni, Jochem O. Klompmaker, Per E. Schwarze, Göran Pershagen, Massimo Stafoggia, Alois Lang, Carla H. van Gils, Richard Atkinson, Sophia Rodopoulou, Giulia Cesaroni, Danielle Vienneau, Kathrin Wolf, Ulla Arthur Hvidtfeldt, Torben Sigsgaard, Gabriele Nagel, Bert Brunekreef, Francesco Forastiere, Amar Mehta, Mette Kildevæld Simonsen, Annette Peters, Gudrun Weinmayr, Mariska Bauwelinck, Tom Bellander, Matthias Ketzel, Jørgen Brandt, Norun Hjertager Krog, Evangelia Samoli, John S. Gulliver, Matteo Renzi, Karl-Heinz Jöckel, Ole Hertel, Jeanette Therming Jørgensen, Hans Concin, Petter Ljungman, Daniela Fecht, Nicole Janssen, Kees de Hoogh, Gianluca Severi, Karin Leander, Ole Raaschou-Nielsen, Barbara Hoffmann, Debora Rizzuto, Zorana Jovanovic Andersen, Patrik K. E. Magnusson, Maciek Strak, Shuo Liu, Jie Chen, Gerard Hoek, Marie-Christine Boutron-Ruault, Raphael Simon Peter, Bente Oftedal, Interface Demography, Faculty of Economic and Social Sciences and Solvay Business School, and Sociology

Subjects
Lung Neoplasms, 010504 meteorology & atmospheric sciences, Air pollution, Medizin, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Environmental Science(all), Environmental health, Medicine, Humans, Lung cancer, Air quality index, lcsh:Environmental sciences, 0105 earth and related environmental sciences, General Environmental Science, lcsh:GE1-350, Air Pollutants, business.industry, Proportional hazards model, Incidence (epidemiology), Air Pollution, Dose Response Relationship, Lung Cancer Incidence, Particulate Matter, Environmental exposure, Environmental Exposure, medicine.disease, Europe, Dose response relationship, Cohort, Lung cancer incidence, business, Particulate matter, Body mass index, Environmental Sciences
Abstract

Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods: The “Effects of Low-level Air Pollution: a Study in Europe” (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O3) to assign exposure to cohort participants’ residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O3 (warm season) were 24.2 µg/m3 (19.5, 29.7), 15.4 µg/m3 (12.8, 17.3), 1.6 10−5m−1 (1.3, 1.8), and 86.6 µg/m3 (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 µg/m3). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset of subjects with exposure below the EU limit value of 25 µg/m3. We did not observe associations between NO2, BC or O3 and lung cancer incidence. Conclusions: Long-term ambient PM2.5 exposure is associated with lung cancer incidence even at concentrations below current EU limit values and possibly WHO Air Quality Guidelines.

Published
2021

30. Long-term low-level ambient air pollution exposure and risk of lung cancer - A pooled analysis of 7 European cohorts

Author

Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Jovanovic Andersen, Zorana, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl-Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L. S., Magnusson, Patrik K. E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Fecht, Daniela, Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Jovanovic Andersen, Zorana, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl-Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L. S., Magnusson, Patrik K. E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, and Fecht, Daniela

Abstract

Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods: The Effects of Low-level Air Pollution: a Study in Europe (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O-3) to assign exposure to cohort participants' residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socioeconomic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O-3 (warm season) were 24.2 mu g/m(3) (19.5, 29.7), 15.4 mu g/m(3) (12.8, 17.3), 1.6 10(-5)m(-1) (1.3, 1.8), and 86.6 mu g/m(3) (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 mu g/m(3)). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset o

Published
2021
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32. Prenatal and childhood exposure to air pollution and traffic and the risk of liver injury in European children

Author

Garcia, Erika, primary, Stratakis, Nikos, additional, Valvi, Damaskini, additional, Maitre, Léa, additional, Varo, Nerea, additional, Aasvang, Gunn Marit, additional, Andrusaityte, Sandra, additional, Basagana, Xavier, additional, Casas, Maribel, additional, de Castro, Montserrat, additional, Fossati, Serena, additional, Grazuleviciene, Regina, additional, Heude, Barbara, additional, Hoek, Gerard, additional, Krog, Norun Hjertager, additional, McEachan, Rosemary, additional, Nieuwenhuijsen, Mark, additional, Roumeliotaki, Theano, additional, Slama, Rémy, additional, Urquiza, Jose, additional, Vafeiadi, Marina, additional, Vos, Miriam B., additional, Wright, John, additional, Conti, David V., additional, Berhane, Kiros, additional, Vrijheid, Martine, additional, McConnell, Rob, additional, and Chatzi, Lida, additional

Published
2021
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33. A Longitudinal Study of Road Traffic Noise and Body Mass Index Trajectories from Birth to 8 Years

Author

Gunn Marit Aasvang, Per Magnus, Simon Øverland, Norun Hjertager Krog, Bente Oftedal, Kjell Vegard Fjeldheim Weyde, Stephen Stansfeld, and Richard Aubrey White

Subjects
Male, Pediatric Obesity, Longitudinal study, Epidemiology, Norwegian Mother and Child Cohort Study, 010501 environmental sciences, Overweight, 01 natural sciences, Body Mass Index, BMI, 03 medical and health sciences, Child Development, 0302 clinical medicine, Pregnancy, Surveys and Questionnaires, medicine, Humans, Perinatal Epidemiology, Longitudinal Studies, 030212 general & internal medicine, Road traffic noise, Health risk, Child, Children, Road traffic, 0105 earth and related environmental sciences, 2. Zero hunger, Norway, Infant, Newborn, Infant, nutritional and metabolic diseases, Child development, 3. Good health, Noise, Noise, Transportation, Child, Preschool, Prenatal Exposure Delayed Effects, Female, medicine.symptom, Psychology, Body mass index, Demography
Abstract

Background: Being overweight constitutes a health risk, and the proportion of overweight and obese children is increasing. It has been argued that road traffic noise could be linked to adiposity through its influence on sleep and stress. Few studies, to our knowledge, have investigated whether noise and adiposity are associated. Most of them were on adults, and we are not aware of any longitudinal study using repeated measures. Objectives: The present longitudinal study investigated whether road traffic noise exposures in pregnancy (N = 6,963; obs = 22,975) or childhood (N = 6,403; obs = 14,585) were associated with body mass index (BMI) trajectories in children. Methods: We obtained information on BMI and covariates from questionnaires used in the Norwegian Mother and Child Cohort Study, Statistics Norway, and Medical Birth Registry of Norway. We modeled road traffic noise for the most exposed façade of children’s present and historical addresses at 6 time points from pregnancy to age 8. We investigated effects on BMI trajectories using repeated measures and linear mixed models. Results: The results indicated that BMI curves depended on road traffic noise exposure during pregnancy, but not on exposure during childhood. Children in the highest decile of traffic noise exposure had increased BMI, with 0.35 kg/m2 more than children in the lowest decile, from birth to age 8 years. Conclusions: The results indicate that exposure to road traffic noise during pregnancy may be associated with children’s BMI trajectories. Future studies should investigate this further, using anthropometric measures such as waist-hip ratio and skinfold thickness, in addition to BMI.

Published
2018

34. Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Author

Hvidtfeldt, Ulla Arthur, primary, Severi, Gianluca, additional, Andersen, Zorana Jovanovic, additional, Atkinson, Richard, additional, Bauwelinck, Mariska, additional, Bellander, Tom, additional, Boutron-Ruault, Marie-Christine, additional, Brandt, Jørgen, additional, Brunekreef, Bert, additional, Cesaroni, Giulia, additional, Chen, Jie, additional, Concin, Hans, additional, Forastiere, Francesco, additional, van Gils, Carla H., additional, Gulliver, John, additional, Hertel, Ole, additional, Hoek, Gerard, additional, Hoffmann, Barbara, additional, de Hoogh, Kees, additional, Janssen, Nicole, additional, Jöckel, Karl-Heinz, additional, Jørgensen, Jeanette Therming, additional, Katsouyanni, Klea, additional, Ketzel, Matthias, additional, Klompmaker, Jochem O., additional, Krog, Norun Hjertager, additional, Lang, Alois, additional, Leander, Karin, additional, Liu, Shuo, additional, Ljungman, Petter L.S., additional, Magnusson, Patrik K.E., additional, Mehta, Amar Jayant, additional, Nagel, Gabriele, additional, Oftedal, Bente, additional, Pershagen, Göran, additional, Peter, Raphael Simon, additional, Peters, Annette, additional, Renzi, Matteo, additional, Rizzuto, Debora, additional, Rodopoulou, Sophia, additional, Samoli, Evangelia, additional, Schwarze, Per Everhard, additional, Sigsgaard, Torben, additional, Simonsen, Mette Kildevæld, additional, Stafoggia, Massimo, additional, Strak, Maciek, additional, Vienneau, Danielle, additional, Weinmayr, Gudrun, additional, Wolf, Kathrin, additional, Raaschou-Nielsen, Ole, additional, and Fecht, Daniela, additional

Published
2021
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36. Outdoor air pollution and risk for kidney parenchyma cancer in 14 European cohorts

Author

Johan Nilsson Sommar, Anne Tjønneland, Petra H.M. Peeters, Paolo Vineis, Nancy L. Pedersen, Ingeborg M. Kooter, Marloes Eeftens, Carlotta Sacerdote, Alessandro Marcon, Marie Pedersen, Claudia Galassi, Massimo Stafoggia, Andrea Jaensch, Enrica Migliore, Kirsten Thorup Eriksen, Andrei Pyko, Rob Beelen, Laura Fratiglioni, Ranjeet S. Sokhi, Bertil Forsberg, Gerard Hoek, Ming-Yi Tsai, Fulvio Ricceri, Miren Dorronsoro, Gunn Marit Aasvang, H. Bas Bueno-de-Mesquita, Meng Wang, Bernhard Föger, Zorana Jovanovic Andersen, Ulf de Faire, Kees de Hoogh, Gudrun Weinmayr, Sara Grioni, Mette Sørensen, Claes-Göran Östenson, Roel Vermeulen, Pilar Amiano, Ibon Tamayo, Michelle Plusquin, Norun Hjertager Krog, Göran Pershagen, Timothy J. Key, David Olsson, Gabriele Nagel, Bert Brunekreef, Ole Raaschou-Nielsen, Michal Korek, Vittorio Krogh, and Bente Oftedal

Subjects
Pollutant, Cancer Research, business.industry, Air pollution, Cancer, Environmental exposure, 010501 environmental sciences, Particulates, medicine.disease, medicine.disease_cause, complex mixtures, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Environmental health, Parenchyma, medicine, business, Risk assessment, Kidney cancer, 0105 earth and related environmental sciences
Abstract

Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutant ...

Published
2017

37. The early-life exposome: Description and patterns in six European countries

Author

Marina Vafeiadi, Inga Petraviciene, Sandra Andrusaityte, Norun Hjertager Krog, Gunn Marit Aasvang, Dagmar Waiblinger, Audrius Dedele, Mark J. Nieuwenhuijsen, Lydiane Agier, Line Småstuen Haug, Jose Urquiza, Xavier Basagaña, Oliver Robinson, John Wright, Martine Vrijheid, Rosemary R. C. McEachan, Cathrine Thomsen, Kristine B. Gutzkow, Rémy Slama, Montserrat de Castro, Charline Warembourg, Dan Mason, Valérie Siroux, Barbara Heude, Amrit Kaur Sakhi, Ibon Tamayo-Uria, Helle Margrete Meltzer, Leda Chatzi, Regina Grazuleviciene, Léa Maitre, Maribel Casas, Theano Roumeliotaki, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), CIBER de Epidemiología y Salud Pública (CIBERESP), Harvard University Statistics Department, Harvard University [Cambridge], Norwegian Institute of Public Health [Oslo] (NIPH), University of Southern California (USC), Université Grenoble Alpes (UGA), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Vytautas Magnus University - Vytauto Didziojo Universitetas (VDU), Equipe 6 : ORCHAD - Origines précoces de la santé du développement de l'enfant (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Bradford Teaching Hospitals NHS Foundation Trust [Bradford, UK] (BTHFT), Imperial College London, University of Crete [Heraklion] (UOC), European Project: 308333,EC:FP7:ENV,FP7-ENV-2012-two-stage,HELIX(2013), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Siroux, Valérie, The Human Early-Life Exposome – novel tools for integrating early-life environmental exposures and child health across Europe - HELIX - - EC:FP7:ENV2013-01-01 - 2017-06-30 - 308333 - VALID, Harvard University, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK (BIHR), and Medical Research Council (MRC)

Subjects
[SDE] Environmental Sciences, 010504 meteorology & atmospheric sciences, 010501 environmental sciences, 01 natural sciences, Cohort Studies, MESH: Pregnancy, Pregnancy, MESH: Child, MESH: Water Purification, Medicine, Child, Children, MESH: Cohort Studies, lcsh:Environmental sciences, General Environmental Science, lcsh:GE1-350, Confounding, Early life, MESH: Mothers, 3. Good health, Europe, Exposome, Cohort, [SDE]Environmental Sciences, Female, Birth cohort, Multiple exposure, MESH: Air Pollution, MESH: Environmental Exposure, Mothers, Article, Water Purification, Exposure group, Environmental health, Air Pollution, MD Multidisciplinary, Humans, 0105 earth and related environmental sciences, MESH: Humans, business.industry, MESH: Chronic Disease, Environmental exposures, Environmental Exposure, medicine.disease, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Chronic Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, business, MESH: Female, Environmental Sciences
Abstract

Characterization of the "exposome", the set of all environmental factors that one is exposed to from conception onwards, has been advocated to better understand the role of environmental factors on chronic diseases. Here, we aimed to describe the early-life exposome. Specifically, we focused on the correlations between multiple environmental exposures, their patterns and their variability across European regions and across time (pregnancy and childhood periods). We relied on the Human Early-Life Exposome (HELIX) project, in which 87 environmental exposures during pregnancy and 122 during the childhood period (grouped in 19 exposure groups) were assessed in 1301 pregnant mothers and their children at 6-11 years in 6 European birth cohorts. Some correlations between exposures in the same exposure group reached high values above 0.8. The median correlation within exposure groups was >0.3 for many exposure groups, reaching 0.69 for water disinfection by products in pregnancy and 0.67 for the meteorological group in childhood. Median correlations between different exposure groups rarely reached 0.3. Some correlations were driven by cohort-level associations (e.g. air pollution and chemicals). Ten principal components explained 45% and 39% of the total variance in the pregnancy and childhood exposome, respectively, while 65 and 90 components were required to explain 95% of the exposome variability. Correlations between maternal (pregnancy) and childhood exposures were high (>0.6) for most exposures modeled at the residential address (e.g. air pollution), but were much lower and even close to zero for some chemical exposures. In conclusion, the early life exposome was high dimensional, meaning that it cannot easily be measured by or reduced to fewer components. Correlations between exposures from different exposure groups were much lower than within exposure groups, which have important implications for co-exposure confounding in multiple exposure studies. Also, we observed the early life exposome to be variable over time and to vary by cohort, so measurements at one time point or one place will not capture its complexities. This work was supported by the European Commission Seventh Framework Programme (FP7/2007–2013) [grant number: 308333–the HELIX project]. INMA data collections were supported by grants from the Instituto de Salud Carlos III, CIBERESP, and the Generalitat de Catalunya-CIRIT. KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research, NIH/NIEHS (contract no N01-ES-75558), NIH/NINDS (grant no.1 UO1 NS 047537-01 and grant no.2 UO1 NS 047537-06A1). The Rhea project was financially supported by European projects (EU FP6-2003-Food-3-NewGeneris, EU FP6. STREP Hiwate, EU FP7 ENV.2007.1.2.2.2. Project No 211250 Escape, EU FP7-2008-ENV-1.2.1.4 Envirogenomarkers, EU FP7-HEALTH-2009-single stage CHICOS, EU FP7 ENV.2008.1.2.1.6. Proposal No 226285 ENRIECO, EUFP7-HEALTH-2012 Proposal No 308333 HELIX, FP7 European Union project, No. 264357 MeDALL), and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011–2014; “Rhea Plus”: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012–15).

Published
2019

38. Agreement between self-reported and registry-based use of sleep medications and tranquilizers

Author

Bente Oftedal, Gunn Marit Aasvang, Norun Hjertager Krog, Svetlana Skurtveit, Eva Skovlund, Per Nafstad, Jorunn Evandt, and Per E. Schwarze

Subjects
Adult, Male, medicine.medical_specialty, Prescription Drugs, Epidemiology, Population, Drug Prescriptions, Sensitivity and Specificity, 030226 pharmacology & pharmacy, Prescription data, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Tranquilizing Agents, Pharmacology (medical), Registries, 030212 general & internal medicine, Medical prescription, education, education.field_of_study, Norway, business.industry, Pharmacoepidemiology, Confidence interval, Cross-Sectional Studies, Sleep Aids, Pharmaceutical, Female, Self Report, Sleep (system call), business, Kappa
Abstract

Purpose The purpose of the present study was to assess the agreement between self-reported use of sleep medications and tranquilizers and dispensed hypnotics and anxiolytics. Methods Self-reported medication use was obtained from the population-based survey Health and Environment in Oslo (HELMILO) (2009-2010) (n = 13 019). Data on dispensed hypnotics and anxiolytics were obtained from the Norwegian Prescription Database (NorPD). As measures of validity, we calculated sensitivity and specificity using both self-reports and prescription records as the reference standard. Furthermore, we calculated Cohen's kappa. Current self-reported medication use was compared with prescription data in time windows of both 100 and 200 days preceding questionnaire completion. Results The highest sensitivity was observed for current sleep medication use in the 100-day time window (sensitivity = 0.76, 95% confidence interval [CI]: 0.74, 0.79) when using prescription records as the reference standard. Sensitivity was generally lower for tranquilizers compared with sleep medications. Cohen's kappa showed the highest agreement for the 200-day time window with substantial agreement for sleep medications (kappa = 0.64; 95% CI: 0.62, 0.67) and moderate agreement for tranquilizers (kappa = 0.45; 95% CI: 0.41, 0.48). Conclusions The present study suggests moderate to substantial agreement between self-reported use of sleep medications and tranquilizers and dispensed drugs in a general adult population. The magnitude of agreement varied according to drug category and time window. Since self-reported and registry-based use of these drug classes does not match each other accurately, limitations of each data source should be considered when such medications are applied as the exposure or outcome in epidemiologic studies.

Published
2019

39. Influence of the Urban Exposome on Birth Weight

Author

Per E. Schwarze, Audrius Dedele, Léa Maitre, Payam Dadvand, Rosie McEachan, Valérie Siroux, Ibon Tamayo-Uria, Lise Giorgis-Allemand, Oliver Robinson, Martine Vrijheid, Norun Hjertager Krog, Jose Urquiza, Leda Chatzi, Antonia Valentin, Gunn Marit Aasvang, Sandra Andrusaityte, Xavier Basagaña, David Donaire, Rémy Slama, John Wright, Mark J. Nieuwenhuijsen, Ferran Ballester, Jane West, Lydiane Agier, Montserrat de Castro, Jesús Ibarluzea, Regina Grazuleviciene, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), CIBER de Epidemiología y Salud Pública (CIBERESP), Department of Statistics, Faculty of Arts and Sciences, Harvard University, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T9405), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Gustave Eiffel, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norwegian Institute of Public Health [Oslo] (NIPH), Vytautas Magnus University - Vytauto Didziojo Universitetas (VDU), Bradford Institute for Health Research Bradford, Universitat Pompeu Fabra [Barcelona] (UPF), Complexe Genetica, RS: NUTRIM - R3 - Respiratory & Age-related Health, Cadic, Ifsttar, Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), and Medical Research Council (MRC)

Subjects
Health, Toxicology and Mutagenesis, 05 Environmental Sciences, 010501 environmental sciences, Toxicology, 01 natural sciences, Cohort Studies, 0302 clinical medicine, USE REGRESSION-MODELS, Pregnancy, 11. Sustainability, SANTE, WIDE ASSOCIATION, Birth Weight, Research article, 030212 general & internal medicine, reproductive and urinary physiology, 11 Medical and Health Sciences, media_common, Europe, Geography, Female, HEALTH, medicine.symptom, Cohort study, Pollution, Exposome, PRETERM BIRTH, Birth weight, media_common.quotation_subject, 03 medical and health sciences, POLLUTION, Environmental health, medicine, Humans, RESIDENTIAL GREENNESS, Cities, 0105 earth and related environmental sciences, Land use, LAND-USE, Research, EXPOSOME, Public Health, Environmental and Occupational Health, Infant, Newborn, Environmental Exposure, AMBIENT AIR-POLLUTION, CHILD COHORT, 13. Climate action, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, COHORT PROFILE, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, VEGETATION, Vegetation (pathology)
Abstract

Background: The exposome is defined as the totality of environmental exposures from conception onwards. It calls for providing a holistic view of environmental exposures and their effects on human health by evaluating multiple environmental exposures simultaneously during critical periods of life. Objective: We evaluated the association of the urban exposome with birth weight. Methods: We estimated exposure to the urban exposome, including the built environment, air pollution, road traffic noise, meteorology, natural space, and road traffic (corresponding to 24 environmental indicators and 60 exposures) for nearly 32,000 pregnant women from six European birth cohorts. To evaluate associations with either continuous birth weight or term low birth weight (TLBW) risk, we primarily relied on the Deletion-Substitution-Addition (DSA) algorithm, which is an extension of the stepwise variable selection method. Second, we used an exposure-by-exposure exposome-wide association studies (ExWAS) method accounting for multiple hypotheses testing to report associations not adjusted for coexposures. Results: The most consistent statistically significant associations were observed between increasing green space exposure estimated as Normalized Difference Vegetation Index (NDVI) and increased birth weight and decreased TLBW risk. Furthermore, we observed statistically significant associations among presence of public bus line, land use Shannon's Evenness Index, and traffic density and birth weight in our DSA analysis. Conclusion: This investigation is the first large urban exposome study of birth weight that tests many environmental urban exposures. It confirmed previously reported associations for NDVI and generated new hypotheses for a number of built-environment exposures. The study has received funding from the European Community’s Seventh Framework Programme (FP7/2007–2013) under Grant Agreement No. 308333—the HELIX project—for data collection and analyses. The HELIX program built on six existing cohorts that received previous funding, including the major cohorts listed here. INMA data collections were supported by grants from the Instituto de Salud Carlos III, CIBERESP, the Conselleria de Sanitat, Generalitat Valenciana, Department of Health of the Basque Government; the Provincial Government of Gipuzkoa, and the Generalitat de Catalunya-CIRIT. KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). MoBa (Norwegian Mother and Child Cohort Study) is supported by the Norwegian Ministry of Health and the Ministry of Education and Research, NIH/NIEHS (Contract No. N01-ES-75558), and the U.S. National Institutes of Health (NIH) National Institute of Environmental Health Sciences (NIEHS; Contract No. N01-ES-75558), and National Institute of Neurological Disorders and Stroke (Grant No. 1 UO1 NS 047537-01 and Grant No. 2 UO1 NS 047537-06A1). The Rhea project was financially supported by European projects (EU FP6–2003-Food-3-NewGeneris, EU FP6.STREP Hiwate, EU FP7 ENV.2007·1.2.2.2, Project No. 211250 Escape, EU FP7–2008-ENV-1·2.1·4 Envirogenomarkers, EU FP7-HEALTH-2009-single stage CHICOS, EU FP7 ENV.2008.1.2.1.6, Proposal No. 226285 ENRIECO, EUFP7-HEALTH-2012 Proposal No. 308333 HELIX, FP7 European Union Project No. 264357 MeDALL), and the Greek Ministry of Health (Program of Prevention of Obesity and Neurodevelopmental Disorders in Preschool Children, in Heraklion district, Crete, Greece: 2011–2014; “Rhea Plus”: Primary Prevention Program of Environmental Risk Factors for Reproductive Health, and Child Health: 2012–15). L.C. received additional funding from the Southern California Environmental Health Sciences Center (Grant No. P30ES007048) funded by NIEHS. We acknowledge the support of the program for international scientific collaborations of Région Rhône-Alpes-Auvergne.

Published
2019

40. Linking green infrastructure to urban heat and human health risk mitigation in Oslo, Norway

Author

Norun Hjertager Krog, Zander S. Venter, and David N. Barton

Subjects
Environmental Engineering, Hot Temperature, 010504 meteorology & atmospheric sciences, Climate, Population, 010501 environmental sciences, 01 natural sciences, Ecosystem services, Environmental Chemistry, Humans, Urban heat island, Cities, education, Waste Management and Disposal, Ecosystem, Heat-associated illness, 0105 earth and related environmental sciences, Tree canopy, education.field_of_study, Norway, Global warming, Vegetation, Remote sensing, Pollution, Surface temperature, Environmental science, Physical geography, Urban ecosystem, Green infrastructure, Landsat, Samfunnsvitenskap: 200::Økonomi: 210 [VDP]
Abstract

The predicted extreme temperatures of global warming are magnified in cities due to the urban heat island effect. Even if the target for average temperature increase in the Paris Climate Agreement is met, temperatures during the hottest month in a northern city like Oslo are predicted to rise by over 5 °C by 2050. We hypothesised that heat-related diagnoses for heat-sensitive citizens (75+) in Oslo are correlated to monthly air temperatures, and that green infrastructure such as tree canopy cover reduces extreme land surface temperatures and thus reduces health risk from heat exposure. Monthly air temperatures were significantly correlated to the number of skin-related diagnoses at the city level, but were unrelated to diagnoses under circulatory, nervous system, or general categories. Satellite-derived spatially-explicit measures revealed that on one of the hottest days during the summer of 2018, landscape units composed of paved, midrise or lowrise buildings gave off the most heat (39 °C), whereas units composed of complete tree canopy cover, or mixed (i.e. tree and grass) vegetation maintained temperatures of between 29 and 32 °C. Land surface temperatures were negatively correlated to tree canopy cover (R2 = 0.45) and vegetation greenness (R2 = 0.41). In a scenario in which each city tree was replaced by the most common non-tree cover in its neighbourhood, the area of Oslo exceeding a 30 °C health risk threshold during the summer would increase from 23 to 29%. Combining modelling results with population at risk at census tract level, we estimated that each tree in the city currently mitigates additional heat exposure of one heat-sensitive person by one day. Our results indicate that maintaining and restoring tree cover provides an ecosystem service of urban heat reduction. Our findings have particular relevance for health benefit estimation in urban ecosystem accounting and municipal policy decisions regarding ecosystem-based climate adaptation.

Published
2019

41. Early-Life Environmental Exposures and Blood Pressure in Children

Author

J. R. Gonzalez, Marianna Karachaliou, Cathrine Thomsen, Marina Vafeiadi, Line Småstuen Haug, Mark J. Nieuwenhuijsen, Rosemary R. C. McEachan, Serena Fossati, Charline Warembourg, Enrique Cequier, Sandra Andrusaityte, Norun Hjertager Krog, Martine Vrijheid, Joane Quentin, Jane West, Theano Roumeliotaki, Carles Hernandez-Ferrer, Gunn Marit Aasvang, Xavier Basagaña, Jose Urquiza, Regina Gražulevičienė, Rémy Slama, Inga Petraviciene, Oliver Robinson, Léa Maitre, Amrit Kaur Sakhi, Maribel Casas, Ibon Tamayo-Uria, John Wright, Audrius Dedele, Leda Chatzi, Barbara Heude, Complexe Genetica, RS: NUTRIM - R3 - Respiratory & Age-related Health, and Medical Research Council (MRC)

Subjects
Male, Insecticides, Meteorological Concepts, CHILDHOOD, Physiology, CARDIOMETABOLIC TRAITS, Blood Pressure, 030204 cardiovascular system & hematology, chemistry.chemical_compound, 0302 clinical medicine, Pregnancy, ADOLESCENTS, PERSISTENT ORGANIC POLLUTANTS, 030212 general & internal medicine, Built Environment, Child, 1102 Cardiorespiratory Medicine and Haematology, Phthalate, cohort, ASSOCIATION, Polychlorinated Biphenyls, MOTHER, Europe, Dichlorodiphenyldichloroethylene, OBESITY, Prenatal Exposure Delayed Effects, Cohort, Hypertension, epidemiology, Environmental Pollutants, Female, Cardiology and Cardiovascular Medicine, environment, Dichlorodiphenyl Dichloroethylene, chemicals, IN-UTERO, Holistic Health, 1117 Public Health and Health Services, 03 medical and health sciences, children, medicine, Humans, business.industry, EXPOSOME, Blood Pressure Determination, Hexachlorobenzene, Environmental Exposure, medicine.disease, Confidence interval, BISPHENOL-A, Blood pressure, chemistry, Cardiovascular System & Hematology, Cotinine, business
Abstract

BACKGROUND Growing evidence exists about the fetal and environmental origins of hypertension, but mainly limited to single-exposure studies. The exposome has been proposed as a more holistic approach by studying many exposures simultaneously.OBJECTIVES This study aims to evaluate the association between a wide range of prenatal and postnatal exposures and blood pressure (BP) in children.METHODS Systolic and diastolic BP were measured among 1,277 children from the European HELIX (Human Early-Life Exposome) cohort aged 6 to 11 years. Prenatal (n = 89) and postnatal (n = 128) exposures include air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals, and lifestyles. Two methods adjusted for confounders were applied: an exposome-wide association study considering the exposures independently, and the deletion-substitution-addition algorithm considering all the exposures simultaneously.RESULTS Decreases in systolic BP were observed with facility density (beta change for an interquartile-range increase in exposure: -1.7 mm Hg [95% confidence interval (CI): -2.5 to -0.8 mm Hg]), maternal concentrations of polychlorinated biphenyl 118 (-1.4 mm Hg [95% CI: -2.6 to -0.2 mm Hg]) and child concentrations of dichlorodiphenyldichloroethylene (DDE: -1.6 mm Hg [95% CI: -2.4 to -0.7 mm Hg]), hexachlorobenzene (-1.5 mm Hg [95% CI: -2.4 to -0.6 mm Hg]), and mono -benzyl phthalate (-0.7 mm Hg [95% CI: -1.3 to -0.1 mm Hg]), whereas increases in systolic BP were observed with outdoor temperature during pregnancy (1.6 mm Hg [95% CI: 0.2 to 2.9 mm Hg]), high fish intake during pregnancy (2.0 mm Hg [95% CI: 0.4 to 3.5 mm Hg]), maternal cotinine concentrations (1.2 mm Hg [95% CI: -0.3 to 2.8 mm Hg]), and child perfluorooctanoate concentrations (0.9 mm Hg [95% CI: 0.1 to 1.6 mm Hg]). Decreases in diastolic BP were observed with outdoor temperature at examination (-1.4 mm Hg [95% CI: -2.3 to -0.5 mm Hg]) and child DDE concentrations (-1.1 mm Hg [95% CI: -1.9 to -0.3 mm Hg]), whereas increases in diastolic BP were observed with maternal bisphenol-A concentrations (0.7 mm Hg [95% CI: 0.1 to 1.4 mm Hg]), high fish intake during pregnancy (1.2 mm Hg [95% CI: -0.2 to 2.7 mm Hg]), and child copper concentrations (0.9 mm Hg [95% CI: 0.3 to 1.6 mm Hg]).CONCLUSIONS This study suggests that early-life exposure to several chemicals, as well as built environment and meteorological factors, may affect BP in children. (C) 2019 by the American College of Cardiology Foundation.

Published
2018

42. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015

Author

Haidong, Wang, Mohsen, Naghavi, Christine, Allen, Ryan M, Barber Zulfi, qar A, Bhutta, Austin, Carter, Daniel C, Casey Fiona, J Charlson, Alan Zian, Chen Matthew, M Coates, Megan, Coggeshall, Lalit, Dandona, Daniel J, Dicker Holly, E Erskine, Alize J, Ferrari, Christina, Fitzmaurice, Kyle, Foreman, Mohammad H, Forouzanfar Maya, S Fraser, Nancy, Fullman, Peter W, Gething Ellen, M Goldberg, Nicholas, Graetz, Juanita A, Haagsma Simon, I Hay, Chantal, Huynh, Catherine O, Johnson Nicholas, J Kassebaum, Yohannes, Kinfu, Xie Rachel, Kulikoff, Michael, Kutz, Hmwe H, Kyu Heidi, J Larson, Janni, Leung, Xiaofeng, Liang, Stephen S, Lim, Margaret, Lind, Rafael, Lozano, Neal, Marquez, George A, Mensah, Joe, Mikesell, Ali H, Mokdad Meghan, D Mooney, Grant, Nguyen, Elaine, Nsoesie, David M, Pigott, Christine, Pinho, Gregory A, Roth Joshua, A Salomon, Logan, Sandar, Naris, Silpakit, Amber, Sligar, Reed J, D Sorensen, Jeff rey, Stanaway, Caitlyn, Steiner, Stephanie, Teeple, Bernadette A, Thomas, Christopher, Troeger, Amelia, VanderZanden, Stein Emil, Vollset, Valentine, Wanga, Harvey A, Whiteford, Timothy, Wolock, Leo, Zoeckler, Kalkidan Hassen, Abate, Cristiana, Abbafati, Kaja M, Abbas, Foad, Abd-Allah, Semaw Ferede, Abera Daisy, M X, Abreu Laith, J Abu-Raddad, Gebre Yitayih, Abyu, Tom, Achoki, Ademola Lukman, Adelekan Zanfi, na Ademi, Arsène Kouablan, Adou José, C Adsuar, Kossivi Agbelenko, Afanvi, Ashkan, Afshin, Emilie Elisabet, Agardh, Arnav, Agarwal, Anurag, Agrawal, Aliasghar Ahmad, Kiadaliri Oluremi, N Ajala, Ali Shafqat, Akanda Rufus, Olusola Akinyemi, Tomi F, Akinyemiju, Nadia, Akseer, Faris Hasan, Al Lami, Samer, Alabed, Ziyad, Al-Aly, Khurshid, Alam, Noore K, M Alam, Deena, Alasfoor, Saleh Fahed, Aldhahri Robert, William Aldridge, Miguel Angel, Alegretti Alicia, V Aleman, Zewdie Aderaw, Alemu Lily, T Alexander, Samia, Alhabib, Raghib, Ali, Ala’a, Alkerwi, François, Alla, Peter, Allebeck, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid A, Altirkawi Elena, Alvarez Martin, Nelson, Alvis-Guzman, Azmeraw T, Amare Adeladza, Kofi Amegah, Emmanuel A, Ameh, Heresh, Amini, Walid, Ammar, Stephen Marc, Amrock Hjalte, H Andersen, Benjamin O, Anderson Gregory, M Anderson, Carl Abelardo, T Antonio, Atsede Fantahun, Aregay, Johan, Ärnlöv, Valentina S, Arsic Arsenijevic, Al, Artaman, Hamid, Asayesh, Rana Jawad, Asghar, Suleman, Atique, Euripide Frinel, G Arthur, Avokpaho, Ashish, Awasthi, Peter, Azzopardi, Umar, Bacha, Alaa, Badawi, Maria C, Bahit, Kalpana, Balakrishnan, Amitava, Banerjee, Aleksandra, Barac, Suzanne L, Barker-Collo, Till, Bärnighausen, Lars, Barregard, Lope H, Barrero, Arindam, Basu, Sanjay, Basu, Yibeltal Tebekaw, Bayou, Shahrzad, Bazargan-Hejazi, Justin, Beardsley, Neeraj, Bedi, Ettore, Beghi, Haileeyesus Adamu, Belay, Brent, Bell, Michelle L, Bell Aminu, K Bello, Derrick A, Bennett Isabela, M Bensenor, Adugnaw, Berhane, Eduardo, Bernabé, Balem Demtsu, Betsu Addisu, Shunu Beyene, Neeraj, Bhala, Ashish, Bhalla, Sibhatu, Biadgilign, Boris, Bikbov, Aref A, Bin Abdulhak, Brian J, Biroscak, Stan, Biryukov, Espen, Bjertness, Jed D, Blore Christopher, D Blosser, Megan A, Bohensky, Rohan, Borschmann, Dipan, Bose, Rupert R, A Bourne, Michael, Brainin, Carol E, G Brayne, Alexandra, Brazinova, Nicholas J, K Breitborde, Hermann, Brenner, Jerry D, Brewer, Alexandria, Brown, Jonathan, Brown, Traolach S, Brugha Geoff, rey Colin, Buckle Zahid, A Butt, Bianca, Calabria, Ismael Ricardo, Campos-Nonato Julio, Cesar Campuzano, Jonathan R, Carapetis, Rosario, Cárdenas, David O, Carpenter Juan, Jesus Carrero, Carlos A, Castañeda-Orjuela Jacqueline, Castillo Rivas, Ferrán, Catalá-López, Fiorella, Cavalleri, Kelly, Cercy, Jorge, Cerda, Wanqing, Chen, Adrienne, Chew, Peggy Pei-Chia, Chiang, Mirriam, Chibalabala, Chioma Ezinne, Chibueze, Odgerel, Chimed-Ochir, Vesper Hichilombwe, Chisumpa Jee-Young, Jasmine Choi, Rajiv, Chowdhury, Hanne, Christensen, Devasahayam Jesudas, Christopher Liliana, G Ciobanu, Cirillo Massimo, Aaron J, Cohen, Valentina, Colistro, Mercedes, Colomar, Samantha M, Colquhoun, Cyrus, Cooper, Leslie Trumbull, Cooper, Monica, Cortinovis, Benjamin C, Cowie John, A Crump, James, Damsere-Derry, Hadi, Danawi, Rakhi, Dandona, Farah, Daoud, Sarah C, Darby Paul, I Dargan, José das, Neves, Gail, Davey, Adrian C, Davis Dragos, V Davitoiu, E Filipa, de Castro, Pieter de, Jager Diego, De Leo, Louisa, Degenhardt, Robert P, Dellavalle, Kebede, Deribe, Amare, Deribew, Samath D, Dharmaratne Preet, K Dhillon, Cesar, Diaz-Torné, Eric L, Ding Kadine, Priscila Bender, dos Santos, Edem, Dossou, Tim R, Driscoll, Leilei, Duan, Manisha, Dubey, Bruce Bartholow, Duncan Richard, G Ellenbogen, Christian Lycke, Ellingsen, Iqbal, Elyazar, Aman Yesuf, Endries Sergey, Petrovich Ermakov, Babak, Eshrati, Alireza, Esteghamati, Kara, Estep, Imad D, A Faghmous, Saman, Fahimi, Emerito Jose, Aquino Faraon, Talha A, Farid Carla, Sofi a, e Sa, Farinha, André, Faro, Maryam S, Farvid, Farshad, Farzadfar, Valery L, Feigin, Seyed-Mohammad, Fereshtehnejad, Jeff erson, G Fernandes, Joao C, Fernandes, Florian, Fischer, Joseph R, A Fitchett, Abraham, Flaxman, Nataliya, Foigt, F Gerry, R Fowkes, Elisabeth Barboza, Franca Richard, C Franklin, Joseph, Friedman, Joseph, Frostad, Thomas, Fürst, Neal D, Futran Seana, L Gall, Ketevan, Gambashidze, Amiran, Gamkrelidze, Parthasarathi, Ganguly, Fortuné Gbètoho, Gankpé, Teshome, Gebre, Tsegaye Tsewelde, Gebrehiwot Amanuel, Tesfay Gebremedhin, Alemseged Aregay, Gebru Johanna, M Geleijnse, Bradford D, Gessner Aloke, Gopal Ghoshal, Katherine B, Gibney Richard, F Gillum, Stuart, Gilmour, Ababi Zergaw, Giref, Maurice, Giroud, Melkamu Dedefo, Gishu, Giorgia, Giussani, Elizabeth, Glaser, William W, Godwin, Hector, Gomez-Dantes, Philimon, Gona, Amador, Goodridge, Sameer Vali, Gopalani Richard, A Gosselin, Carolyn C, Gotay, Atsushi, Goto, Hebe N, Gouda, Felix, Greaves, Harish Chander, Gugnani, Rahul, Gupta, Rajeev, Gupta, Vipin, Gupta, Reyna A, Gutiérrez, Nima, Hafezi-Nejad, Demewoz, Haile, Alemayehu Desalegne, Hailu Gessessew, Bugssa Hailu, Yara A, Halasa Randah, Ribhi Hamadeh, Samer, Hamidi, Jamie, Hancock, Alexis J, Handal Graeme, J Hankey, Yuantao, Hao, Hilda L, Harb, Sivadasanpillai, Harikrishnan, Josep Maria, Haro, Rasmus, Havmoeller, Susan R, Heckbert Ileana, Beatriz Heredia-Pi, Pouria, Heydarpour, Henk B, M Hilderink, Hans W, Hoek Robert, S Hogg, Masako, Horino, Nobuyuki, Horita, H Dean, Hosgood Peter, J Hotez, Damian G, Hoy, Mohamed, Hsairi, Aung Soe, Htet Maung, Maung Than, Htike, Guoqing, Hu, Cheng, Huang, Hsiang, Huang, Laetitia, Huiart, Abdullatif, Husseini, Inge, Huybrechts, Grace, Huynh, Kim Moesgaard, Iburg, Kaire, Innos, Manami, Inoue, Veena J, Iyer Troy, A Jacobs, Kathryn H, Jacobsen, Nader, Jahanmehr, Mihajlo B, Jakovljevic, Peter, James, Mehdi, Javanbakht, Sudha P, Jayaraman Achala, Upendra Jayatilleke, Panniyammakal, Jeemon, Paul N, Jensen, Vivekanand, Jha, Guohong, Jiang, Ying, Jiang, Tariku, Jibat, Aida, Jimenez-Corona, Jost B, Jonas Tushar, Kant Joshi, Zubair, Kabir, Ritul, Kamal, Haidong, Kan, Surya, Kant, André, Karch, Corine Kakizi, Karema, Chante, Karimkhani, Dimitris, Karletsos, Ganesan, Karthikeyan, Amir, Kasaeian, Marzieh, Katibeh, Anil, Kaul, Norito, Kawakami, Jeanne Françoise, Kayibanda Peter, Njenga Keiyoro, Laura, Kemmer, Andrew Haddon, Kemp Andre, Pascal Kengne, Andre, Keren, Maia, Kereselidze, Chandrasekharan Nair, Kesavachandran Yousef, Saleh Khader, Ibrahim A, Khalil Abdur, Rahman Khan, Ejaz Ahmad, Khan, Young-Ho, Khang, Sahil, Khera, Tawfi k, Ahmed Muthafer, Khoja, Christian, Kieling, Daniel, Kim, Yun Jin, Kim Brett, M Kissela, Niranjan, Kissoon, Luke D, Knibbs Ann, Kristin Knudsen, Yoshihiro, Kokubo, Dhaval, Kolte, Jacek A, Kopec, Soewarta, Kosen, Parvaiz A, Koul, Ai, Koyanagi, Norun Hjertager, Krog Barthelemy, Kuate Defo, Burcu Kucuk, Bicer Andreas, A Kudom, Ernst J, Kuipers Veena, S Kulkarni, G Anil, Kumar Gene, F Kwan, Aparna, Lal, Dharmesh Kumar, Lal, Ratilal, Lalloo, Hilton, Lam, Jennifer O, Lam Sinead, M Langan, Van C, Lansingh, Anders, Larsson, Dennis Odai, Laryea Asma, Abdul Latif, Alicia Elena, Beatriz Lawrynowicz, James, Leigh, Miriam, Levi, Yongmei, Li, M Patrice, Lindsay Steven, E Lipshultz, Patrick Y, Liu, Shiwei, Liu, Yang, Liu, Loon-Tzian, Lo, Giancarlo, Logroscino, Paulo A, Lotufo Robyn, M Lucas, Raimundas, Lunevicius, Ronan A, Lyons, Stefan, Ma, Vasco Manuel, Pedro Machado, Mark T, Mackay Jennifer, H MacLachlan, Hassan Magdy, Abd El, Razek Mohammed, Magdy Abd, El Razek, Marek, Majdan, Azeem, Majeed, Reza, Malekzadeh, Wondimu Ayele, Ayele Manamo, John, Mandisarisa, Srikanth, Mangalam, Chabila C, Mapoma, Wagner, Marcenes, David Joel, Margolis Gerard, Robert Martin, Jose, Martinez-Raga, Melvin Barrientos, Marzan, Felix, Masiye, Amanda J, Mason-Jones, João, Massano, Richard, Matzopoulos, Bongani M, Mayosi Stephen, Theodore McGarvey, John J, McGrath, Martin, McKee, McMahon Peter, A Meaney, Alem, Mehari, Man Mohan, Mehndiratta, Fabiola, Mejia-Rodriguez, Alemayehu B, Mekonnen Yohannes, Adama Melaku, Peter, Memiah, Ziad A, Memish, Walter, Mendoza, Atte, Meretoja, Tuomo J, Meretoja Francis, Apolinary Mhimbira, Renata, Micha, Ted R, Miller Mojde, Mirarefi n, Awoke, Misganaw, Charles N, Mock Karzan, Abdulmuhsin Mohammad, Alireza, Mohammadi, Shafi u, Mohammed, Viswanathan, Mohan, Glen Liddell, D Mola, Lorenzo, Monasta, Julio Cesar, Montañez Hernandez, Pablo, Montero, Marcella, Montico, Thomas J, Montine, Maziar, Moradi-Lakeh, Lidia, Morawska, Katherine, Morgan, Rintaro, Mori, Dariush Mozaff, arian Ulrich, O Mueller, Gudlavalleti Venkata, Satyanarayana Murthy, Srinivas, Murthy, Kamarul Imran, Musa Jean, B Nachega, Gabriele, Nagel, Kovin S, Naidoo, Nitish, Naik, Luigi, Naldi, Vinay, Nangia, Denis, Nash, Chakib, Nejjari, Subas, Neupane, Charles R, Newton John, N Newton, Marie, Ng, Frida Namnyak, Ngalesoni Jean, de Dieu, Ngirabega Quyen, Le Nguyen, Muhammad Imran, Nisar Patrick, Martial Nkamedjie, Pete, Marika, Nomura, Ole F, Norheim Paul, E Norman, Bo, Norrving, Luke, Nyakarahuka, Felix Akpojene, Ogbo, Takayoshi, Ohkubo, Foluke Adetola, Ojelabi Pedro, R Olivares, Bolajoko Olubukunola, Olusanya Jacob, Olusegun Olusanya, John Nelson, Opio, Eyal, Oren, Alberto, Ortiz, Majdi, Osman, Erika, Ota, Raziye, Ozdemir, Mahesh, PA, Jeyaraj D, Pandian Puspa, Raj Pant, Christina, Papachristou, Eun-Kee, Park, Jae-Hyun, Park, Charles D, Parry, Mahboubeh, Parsaeian, Angel J, Paternina Caicedo, Scott B, Patten George, C Patton, Vinod K, Paul, Neil, Pearce, João Mário, Pedro Ljiljana, Pejin Stokic, Pereira, Norberto, Perico, Konrad, Pesudovs, Max, Petzold, Michael Robert, Phillips Frédéric, B Piel, Julian David, Pillay, Dietrich, Plass, James A, Platts-Mills, Suzanne, Polinder, C Arden, Pope, Svetlana, Popova, Richie G, Poulton, Farshad, Pourmalek, Dorairaj, Prabhakaran, Mostafa, Qorbani, Justice, Quame-Amaglo, D Alex, Quistberg, Anwar, Rafay, Kazem, Rahimi, Vafa, Rahimi-Movaghar, Mahfuzar, Rahman, Mohammad Hifz, Ur Rahman, Sajjad Ur, Rahman Rajesh, Kumar Rai, Zhale, Rajavi, Sasa, Rajsic, Murugesan, Raju, Ivo, Rakovac, Saleem M, Rana Chhabi, L Ranabhat, Thara, Rangaswamy, Puja, Rao, Sowmya R, Rao Amany, H Refaat, Jürgen, Rehm, Marissa B, Reitsma, Giuseppe, Remuzzi, Serge Resnikoff, Antonio L, Ribeiro, Stefano, Ricci, Maria Jesus, Rios Blancas, Bayard, Roberts, Anna, Roca, David, Rojas-Rueda, Luca, Ronfani, Gholamreza, Roshandel, Dietrich, Rothenbacher, Ambuj, Roy, Nawal K, Roy George, Mugambage Ruhago, Rajesh, Sagar, Sukanta, Saha, Ramesh, Sahathevan, Muhammad Muhammad, Saleh Juan, R Sanabria, Maria Dolores, Sanchez-Niño, Lidia, Sanchez-Riera, Itamar S, Santos, Rodrigo, Sarmiento-Suarez, Benn, Sartorius, Maheswar, Satpathy, Miloje, Savic, Monika, Sawhney, Michael P, Schaub Maria, Inês Schmidt, Ione J, C Schneider, Ben, Schöttker, Aletta E, Schutte David, C Schwebel, Soraya, Seedat, Sadaf G, Sepanlou Edson, E Servan-Mori, Katya A, Shackelford, Gavin, Shaddick, Amira, Shaheen, Saeid, Shahraz, Masood Ali, Shaikh, Marina, Shakh-Nazarova, Rajesh, Sharma, Jun, She, Sara, Sheikhbahaei, Jiabin, Shen, Ziyan, Shen, Donald S, Shepard Kevin, N Sheth, Balakrishna P, Shetty, Peilin, Shi, Kenji, Shibuya, Min-Jeong, Shin, Rahman, Shiri, Ivy, Shiue, Mark G, Shrime Inga, Dora Sigfusdottir, Donald H, Silberberg Diego, Augusto Santos, Silva Dayane, Gabriele Alves, Silveira Jonathan, I Silverberg, Edgar P, Simard, Abhishek, Singh, Gitanjali M, Singh Jasvinder, A Singh, Om Prakash, Singh Prashant, Kumar Singh, Virendra, Singh, Samir, Soneji, Kjetil, Søreide, Joan B, Soriano Luciano, A Sposato, Chandrashekhar T, Sreeramareddy, Vasiliki, Stathopoulou, Dan J, Stein Murray, B Stein, Saverio, Stranges, Konstantinos, Stroumpoulis, Bruno F, Sunguya, Patrick, Sur, Soumya, Swaminathan, Bryan L, Sykes Cassandra, E I, Szoeke, Rafael, Tabarés-Seisdedos, Karen M, Tabb, Ken, Takahashi, Jukka S, Takala Roberto, Tchio Talongwa, Nikhil, Tandon, Mohammad, Tavakkoli, Bineyam, Taye, Hugh R, Taylor Braden, J Te, Ao Bemnet, Amare Tedla, Worku Mekonnen, Tefera 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Subjects
VITAL-STATISTICS, INTEGRATED APPROACH, ECONOMIC-DEVELOPMENT, DEVELOPMENT ASSISTANCE, UNITED-STATES, Global Health, Communicable Disease, Communicable Diseases, cause of death, Medicine, General & Internal, Life Expectancy, General & Internal Medicine, Humans, Mortality, Medicine(all), Science & Technology, Mortality, Premature, Medicine (all), EPIDEMIOLOGIC TRANSITION, GBD 2015 Mortality and Causes of Death Collaborators, CIVIL REGISTRATION, Public Health, Global Health, Social Medicine and Epidemiology, Articles, 11 Medical And Health Sciences, ROAD TRAFFIC INJURIES, ALZHEIMERS-DISEASE, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, VERBAL AUTOPSY, Life Sciences & Biomedicine, Human
Abstract

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.

Published
2016

43. The Urban Exposome during Pregnancy and Its Socioeconomic Determinants

Author

Xavier Basagaña, Rosie McEachan, Johanna Lepeule, Jesús Ibarluzea, Valérie Siroux, Jose Urquiza, Mark J. Nieuwenhuijsen, Regina Gražuleviciene, Mariza Kampouri, Jordi Sunyer, Audrius Dėdelė, Léa Maitre, Oliver Robinson, Kjell Vegard Fjeldheim Weyde, Rémy Slama, Martine Vrijheid, David Donaire-Gonzalez, Marta Cirach, Montserrat de Castro, Ibon Tamayo, Norun Hjertager Krog, Antònia Valentín, Pippa Bird, Euripides G. Stephanou, Lise Giorgis-Allemand, Minas Iakovidis, Leda Chatzi, Bente Oftedal, Albert Ambros, Gunn Marit Aasvang, Ferran Ballester, John Wright, RS: NUTRIM - R3 - Respiratory & Age-related Health, Complexe Genetica, RS: NUTRIM - R4 - Gene-environment interaction, Medical Research Council (MRC), Imperial College London, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Norwegian Institute of Public Health [Oslo] (NIPH), Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana [Espagne] (FISABIO), Universitat Jaume I, Universitat de València (UV), Bradford Institute for Health Research [Bradford, UK], Bradford Teaching Hospitals NHS Foundation Trust [Bradford, UK] (BTHFT), University of Crete [Heraklion] (UOC), University of Southern California (USC), Maastricht University [Maastricht], Vytautas Magnus University - Vytauto Didziojo Universitetas (VDU), Biodonostia Institute [San Sebastian, Espagne], University of the Basque Country [Bizkaia] (UPV/EHU), Basque Government [San Sebastien, Spain], Université Grenoble Alpes (UGA), Siroux, Valérie, Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), and University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU)

Subjects
[SDE] Environmental Sciences, Urban Population, Health, Toxicology and Mutagenesis, 05 Environmental Sciences, NEIGHBORHOOD WALKABILITY, 010501 environmental sciences, Toxicology, 01 natural sciences, 0302 clinical medicine, USE REGRESSION-MODELS, 11. Sustainability, 030212 general & internal medicine, NITROGEN-DIOXIDE, 11 Medical And Health Sciences, 3. Good health, Europe, MESH: Urban Population, Geography, GREEN SPACES, MESH: Environmental Pollutants, MESH: Young Adult, [SDE]Environmental Sciences, ENVIRONMENTAL JUSTICE, Environmental Pollutants, Female, Adult, Exposome, medicine.medical_specialty, MESH: Socioeconomic Factors, Adolescent, MESH: Environmental Exposure, Young Adult, 03 medical and health sciences, Environmental health, medicine, MESH: Cities, Humans, Cities, Socioeconomic status, 0105 earth and related environmental sciences, Environmental justice, MESH: Adolescent, Pregnancy, MESH: Humans, Land use, LAND-USE, Research, Public health, Public Health, Environmental and Occupational Health, MESH: Adult, Environmental Exposure, medicine.disease, Child development, AMBIENT AIR-POLLUTION, ROAD TRAFFIC NOISE, RESIDENTIAL EXPOSURE, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 13. Climate action, COHORT PROFILE, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Europe, MESH: Female
Abstract

Background: The urban exposome is the set of environmental factors that are experienced in the outdoor urban environment and that may influence child development. Objective: The authors’ goal was to describe the urban exposome among European pregnant women and understand its socioeconomic determinants. Methods: Using geographic information systems, remote sensing and spatio-temporal modeling we estimated exposure during pregnancy to 28 environmental indicators in almost 30,000 women from six population-based birth cohorts, in nine urban areas from across Europe. Exposures included meteorological factors, air pollutants, traffic noise, traffic indicators, natural space, the built environment, public transport, facilities, and walkability. Socioeconomic position (SEP), assessed at both the area and individual level, was related to the exposome through an exposome-wide association study and principal component (PC) analysis. Results: Mean±standard deviation (SD) NO2 levels ranged from 13.6±5.1 μg/m3 (in Heraklion, Crete) to 43.2±11 μg/m3 (in Sabadell, Spain), mean±SD walkability score ranged from 0.22±0.04 (Kaunas, Lithuania) to 0.32±0.07 (Valencia, Spain) and mean±SD Normalized Difference Vegetation Index ranged from 0.21±0.05 in Heraklion to 0.51±0.1 in Oslo, Norway. Four PCs explained more than half of variation in the urban exposome. There was considerable heterogeneity in social patterning of the urban exposome across cities. For example, high-SEP (based on family education) women lived in greener, less noisy, and less polluted areas in Bradford, UK (0.39 higher PC1 score, 95% confidence interval (CI): 0.31, 0.47), but the reverse was observed in Oslo (−0.57 PC1 score, 95% CI: −0.73, −0.41). For most cities, effects were stronger when SEP was assessed at the area level: In Bradford, women living in high SEP areas had a 1.34 higher average PC1 score (95% CI: 1.21, 1.48). Conclusions: The urban exposome showed considerable variability across Europe. Pregnant women of low SEP were exposed to higher levels of environmental hazards in some cities, but not others, which may contribute to inequities in child health and development. The research leading to these results received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement no 308333 – the HELIX project.

Published
2018

45. Nocturnal Road Traffic Noise Exposure and Children’s Sleep Duration and Sleep Problems

Author

Simon Øverland, Bente Oftedal, Stephen Stansfeld, Charlotte Clark, Gunn Marit Aasvang, Jorunn Evandt, Norun Hjertager Krog, Per Magnus, and Kjell Vegard Fjeldheim Weyde

Subjects
Sleep Wake Disorders, Pediatrics, medicine.medical_specialty, Health, Toxicology and Mutagenesis, Population, 010501 environmental sciences, 01 natural sciences, Article, Cohort Studies, socioeconomic status, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, children, media_common.cataloged_instance, Medicine, road traffic noise, sleep duration, sleep problems, Humans, European union, education, Child, 0105 earth and related environmental sciences, media_common, education.field_of_study, business.industry, Noise pollution, Norway, Traffic noise, Public Health, Environmental and Occupational Health, Odds ratio, Environmental exposure, Environmental Exposure, Cross-Sectional Studies, Socioeconomic Factors, Noise, Transportation, Female, business, Sleep, 030217 neurology & neurosurgery, Demography, Cohort study
Abstract

Almost half of the European Union (EU)’s population is exposed to road traffic noise above levels that constitute a health risk. Associations between road traffic noise and impaired sleep in adults have consistently been reported. Less is known about effects of noise on children’s sleep. The aim of this study was to examine the association between nocturnal road traffic noise exposure and children’s parental-reported sleep duration and sleep problems. The present cross-sectional study used data from The Norwegian Mother and Child Cohort Study. Parental report of children’s sleep duration and sleep problems at age 7 was linked to modelled levels of residential night-time road traffic noise. The study population included 2665 children from Oslo, Norway. No association was found between road traffic noise and sleep duration in the total study population (odds ratio (OR): 1.05, 95% confidence interval (CI): [0.94, 1.17]), but a statistically significant association was observed in girls (OR: 1.21, 95% CI: [1.04, 1.41]). For sleep problems, the associations were similar (OR: 1.36, 95% CI: [0.85, 2.16]) in girls. The ORs are presented for an increase of 10 dB. The findings suggest there is an association between road traffic noise and sleep for girls, underlining the importance of protecting children against excessive noise levels. publishedVersion

Published
2017

47. Road traffic noise and registry based use of sleep medication

Author

Danny Houthuijs, Jorunn Evandt, Svetlana Skurtveit, Per Nafstad, Bente Oftedal, Gunn Marit Aasvang, Norun Hjertager Krog, Eva Skovlund, and Per E. Schwarze

Subjects
Male, Pediatrics, Health, Toxicology and Mutagenesis, Poison control, 010501 environmental sciences, 01 natural sciences, 0302 clinical medicine, Insomnia, Odds Ratio, 030212 general & internal medicine, Registries, Aged, 80 and over, education.field_of_study, Norway, lcsh:Public aspects of medicine, Traffic noise, Middle Aged, Noise, Transportation, Prescription registry, lcsh:Industrial medicine. Industrial hygiene, Female, Seasons, medicine.symptom, Environmental Monitoring, Adult, Sleep Wake Disorders, medicine.medical_specialty, Population, Drug Prescriptions, 03 medical and health sciences, lcsh:RC963-969, medicine, Humans, education, 0105 earth and related environmental sciences, Aged, Directed acyclic graph, Population-based study, business.industry, Research, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Odds ratio, Confidence interval, Noise, Sleep medication, business, Sleep, Hypnotics, Demography
Abstract

Background Road traffic noise has been associated with adverse health effects including sleep disturbances. Use of sleep medication as an indicator of sleeping problems has rarely been explored in studies of the effects of traffic noise. Furthermore, using registry data on sleep medications provides an opportunity to study the effects of noise on sleep where attribution of sleep problems to noise is not possible. Methods We used questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009–10) (n = 13,019). Individual data on sleep medications was obtained from the Norwegian Prescription Database (NorPD). Noise levels (L night) were modeled for the most exposed façade of the building at each participant’s home address. Logistic regression models adjusted for potential confounders were used to analyze the association between traffic noise and sleep medication use both for one whole year and for the summer season. The results were reported as changes in the effect estimate per 5 decibel (dB) increase in noise level. Results We observed no association between traffic noise and sleep medication use during one year [odds ratio (OR) = 1.00; 95% confidence interval (CI): 0.96, 1.04]. For sleep medication use in the summer season, there was a positive, however non-significant association (OR = 1.04; 95% CI: 0.99, 1.10). Among individuals sleeping with the bedroom window open, the association increased slightly and was borderline statistically significant (OR = 1.06; 95% CI: 1.00, 1.12). Conclusions We found no evidence of an association between traffic noise and sleep medication use during one year. However, for the summer season, there was some suggestive evidence of an association. These findings indicate that season may play a role in the association between traffic noise and sleep, possibly because indoor traffic noise levels are likely to be higher during summer due to more frequent window opening. More studies are, however, necessary in order to confirm this. © The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Published
2017

48. The Urban Exposome during Pregnancy and Its Socioeconomic Determinants

Author

Robinson, Oliver, Tamayo, Ibon, de Castro, Montserrat, Valentin, Antonia, Giorgis-Allemand, Lise, Krog, Norun Hjertager, Aasvang, Gunn Marit, Ambros, Albert, Ballester, Ferran, Bird, Pippa, Chatzi, Leda, Cirach, Marta, Dedele, Audrius, Donaire-Gonzalez, David, Grazuleviciene, Regina, Iakovidis, Minas, Ibarluzea, Jesus, Kampouri, Mariza, Lepeule, Johanna, Maitre, Lea, McEachan, Rosie, Oftedal, Bente, Siroux, Valerie, Slama, Remy, Stephanou, Euripides G., Sunyer, Jordi, Urquiza, Jose, Weyde, Kjell Vegard, Wright, John, Vrijheid, Martine, Nieuwenhuijsen, Mark, and Basagana, Xavier

Subjects
Genome-wide association studies -- Usage, Pregnant women -- Health aspects, Social class -- Influence, Environmental issues, Health
Abstract

BACKGROUND: The urban exposome is the set of environmental factors that are experienced in the outdoor urban environment and that may influence child development. OBJECTIVE: The authors' goal was to describe the urban exposome among European pregnant women and understand its socioeconomic determinants. METHODS: Using geographic information systems, remote sensing and spatio-temporal modeling we estimated exposure during pregnancy to 28 environmental indicators in almost 30,000 women from six population-based birth cohorts, in nine urban areas from across Europe. Exposures included meteorological factors, air pollutants, traffic noise, traffic indicators, natural space, the built environment, public transport, facilities, and walkability. Socioeconomic position (SEP), assessed at both the area and individual level, was related to the exposome through an exposome-wide association study and principal component (PC) analysis. RESULTS: Mean [+ or -] standard deviation (SD) N[O.sub.2] levels ranged from 13.6 [+ or -]5.1 [micro]g/[m.sup.3] (in Heraklion, Crete) to 43.2 [+ or -] 11 [micro]g/[m.sup.3] (in Sabadell, Spain), mean [+ or -] SD walkability score ranged from 0.22 [+ or -] 0.04 (Kaunas, Lithuania) to 0.32 [+ or -] 0.07 (Valencia, Spain) and mean [+ or -] SD Normalized Difference Vegetation Index ranged from 0.21 [+ or -] 0.05 in Heraklion to 0.51 [+ or -] 0.1 in Oslo, Norway. Four PCs explained more than half of variation in the urban exposome. There was considerable heterogeneity in social patterning of the urban exposome across cities. For example, high-SEP (based on family education) women lived in greener, less noisy, and less polluted areas in Bradford, UK (0.39 higher PC1 score, 95% confidence interval (CI): 0.31, 0.47), but the reverse was observed in Oslo (-0.57 PC1 score, 95% CI: -0.73, -0.41). For most cities, effects were stronger when SEP was assessed at the area level: In Bradford, women living in high SEP areas had a 1.34 higher average PC1 score (95% CI: 1.21, 1.48). CONCLUSIONS: The urban exposome showed considerable variability across Europe. Pregnant women of low SEP were exposed to higher levels of environmental hazards in some cities, but not others, which may contribute to inequities in child health and development., Introduction The majority of the European population now live in an urban environment, and although city living confers many benefits to health, such as increased economic opportunity and access to [...]

Published
2018
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49. The Outdoor Exposome during pregnancy and its Social Determinants

Author

Mark J. Nieuwenhuijsen, Rosie McEachan, Rémy Slama, Ibon Tamayo-Uria, Gunn Marit Aasvang, Xavier Basagaña, Montserrat de Castro, Martine Vrijheid, Antonia Valentin, Norun Hjertager Krog, John Wright, Regina Grazuleviciene, Leda Chatzi, Mariza Kampouri, Oliver Robinson, Lise Giorgis-Allemand, Audrius Dedele, and Minas Iakovidis

Subjects
Exposome, Pregnancy, Environmental equity, Environmental health, medicine, General Earth and Planetary Sciences, Social determinants of health, medicine.disease, Psychology, General Environmental Science
Abstract

Background: We define the 'Outdoor Exposome' as the complex mixture of environmental factors that individuals are exposed to in the outdoor environment, which may be determined by socio-demographic...

Published
2016

50. Effects of Changed Aircraft Noise Exposure on Experiential Qualities of Outdoor Recreational Areas

Author

Kristian Tambs, Bo Engdahl, and Norun Hjertager Krog

Subjects
Aircraft, Aircraft noise, Health, Toxicology and Mutagenesis, lcsh:Medicine, Annoyance, Article, experiential effects, Environmental health, Humans, area problems, panel study, telephone survey, Recreation, Sound (geography), annoyance, geography, geography.geographical_feature_category, Noise pollution, lcsh:R, Public Health, Environmental and Occupational Health, aircraft noise, Environmental Exposure, Environmental exposure, Crowding, Noise, outdoor recreation
Abstract

The literature indicates that sound and visual stimuli interact in the impression of landscapes. This paper examines the relationship between annoyance with sound from aircraft and annoyance with other area problems (e.g., careless bicycle riding, crowding, etc.), and how changes in noise exposure influence the perceived overall recreational quality of outdoor recreational areas. A panel study (telephone interviews) conducted before and after the relocation of Norway's main airport in 1998 examined effects of decreased or increased noise exposure in nearby recreational areas (n = 591/455). Sound from aircraft annoyed the largest proportion of recreationists, except near the old airport after the change. The decrease in annoyance with sound from aircraft was accompanied by significant decreases in annoyance with most of the other area problems. Near the new airport annoyance with most factors beside sound from aircraft increased slightly, but not significantly. A relationship between aircraft noise annoyance and perceived overall recreational quality of the areas was found.

Published
2010

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