An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe

David Ruttens; Stijn E. Verleden; Esmee M. Bijnens; Ellen Winckelmans; Jens Gottlieb; Gregor Warnecke; Federica Meloni; Monica Morosini; Wim van der Bij; Erik A. Verschuuren; Urte Sommerwerck; Gerhard Weinreich; Markus Kamler; Antonio Roman; Susana Gomez-Olles; Cristina Berastegui; Christian Benden; AreMartin Holm; Martin Iversen; Hans Henrik Schultz; Bart Luijk; Erik-Jan Oudijk; Johanna M. Kwakkel-van Erp; Peter Jaksch; Walter Klepetko; Nikolaus Kneidinger; Claus Neurohr; Paul. A. Corris; Andrew J. Fisher; James Lordan; Gerard Meachery; Davide Piloni; Elly Vandermeulen; Hannelore Bellon; Barbara Hoffmann; Danielle Vienneau; Gerard Hoek; Kees de Hoogh; Benoit Nemery; Geert M. Verleden; Robin Vos; Tims. Nawrot; Bart M. Vanaudenaerde

doi:10.1183/13993003.00484-2016

An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe

David Ruttens, Stijn E. Verleden, Esmee M. Bijnens, Ellen Winckelmans, Jens Gottlieb, Gregor Warnecke, Federica Meloni, Monica Morosini, Wim van der Bij, Erik A. Verschuuren, Urte Sommerwerck, Gerhard Weinreich, Markus Kamler, Antonio Roman, Susana Gomez-Olles, Cristina Berastegui, Christian Benden, AreMartin Holm, Martin Iversen, Hans Henrik SchultzBart Luijk, Erik-Jan Oudijk, Johanna M. Kwakkel-van Erp, Peter Jaksch, Walter Klepetko, Nikolaus Kneidinger, Claus Neurohr, Paul. A. Corris, Andrew J. Fisher, James Lordan, Gerard Meachery, Davide Piloni, Elly Vandermeulen, Hannelore Bellon, Barbara Hoffmann, Danielle Vienneau, Gerard Hoek, Kees de Hoogh, Benoit Nemery, Geert M. Verleden, Robin Vos, Tims. Nawrot, Bart M. Vanaudenaerde^*

^*Corresponding author for this work

Groningen Institute for Organ Transplantation (GIOT)

Research output: Contribution to journal › Article › Academic › peer-review

47 Citations (Scopus)

Abstract

Air pollution from road traffic is a serious health risk, especially for susceptible individuals. Single-centre studies showed an association with chronic lung allograft dysfunction (CLAD) and survival after lung transplantation, but there are no large studies.

13 lung transplant centres in 10 European countries created a cohort of 5707 patients. For each patient, we quantified residential particulate matter with aerodynamic diameter. 10 mu m (PM10) by land use regression models, and the traffic exposure by quantifying total road length within buffer zones around the home addresses of patients and distance to a major road or freeway.

After correction for macrolide use, we found associations between air pollution variables and CLAD/ mortality. Given the important interaction with macrolides, we stratified according to macrolide use. No associations were observed in 2151 patients taking macrolides. However, in 3556 patients not taking macrolides, mortality was associated with PM10 (hazard ratio 1.081, 95% CI 1.000-1.167); similarly, CLAD and mortality were associated with road lengths in buffers of 200-1000 and 100-500 m, respectively (hazard ratio 1.0851.130). Sensitivity analyses for various possible confounders confirmed the robustness of these associations.

Long-term residential air pollution and traffic exposure were associated with CLAD and survival after lung transplantation, but only in patients not taking macrolides.

Original language	English
Number of pages	9
Journal	European Respiratory Journal
Volume	49
Issue number	1
DOIs	https://doi.org/10.1183/13993003.00484-2016
Publication status	Published - 2017

Keywords

BRONCHIOLITIS OBLITERANS SYNDROME
RANDOMIZED CONTROLLED-TRIAL
PLACEBO-CONTROLLED TRIAL
USE REGRESSION-MODELS
ALLOGRAFT DYSFUNCTION
DOUBLE-BLIND
AZITHROMYCIN
EXACERBATIONS
PREVENTION
NO2

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An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe
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Ruttens, D., Verleden, S. E., Bijnens, E. M., Winckelmans, E., Gottlieb, J., Warnecke, G., Meloni, F., Morosini, M., van der Bij, W., Verschuuren, E. A., Sommerwerck, U., Weinreich, G., Kamler, M., Roman, A., Gomez-Olles, S., Berastegui, C., Benden, C., Holm, A., Iversen, M., ... Vanaudenaerde, B. M. (2017). An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe. European Respiratory Journal, 49(1). https://doi.org/10.1183/13993003.00484-2016

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title = "An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe",

abstract = "Air pollution from road traffic is a serious health risk, especially for susceptible individuals. Single-centre studies showed an association with chronic lung allograft dysfunction (CLAD) and survival after lung transplantation, but there are no large studies.13 lung transplant centres in 10 European countries created a cohort of 5707 patients. For each patient, we quantified residential particulate matter with aerodynamic diameter. 10 mu m (PM10) by land use regression models, and the traffic exposure by quantifying total road length within buffer zones around the home addresses of patients and distance to a major road or freeway.After correction for macrolide use, we found associations between air pollution variables and CLAD/ mortality. Given the important interaction with macrolides, we stratified according to macrolide use. No associations were observed in 2151 patients taking macrolides. However, in 3556 patients not taking macrolides, mortality was associated with PM10 (hazard ratio 1.081, 95% CI 1.000-1.167); similarly, CLAD and mortality were associated with road lengths in buffers of 200-1000 and 100-500 m, respectively (hazard ratio 1.0851.130). Sensitivity analyses for various possible confounders confirmed the robustness of these associations.Long-term residential air pollution and traffic exposure were associated with CLAD and survival after lung transplantation, but only in patients not taking macrolides.",

keywords = "BRONCHIOLITIS OBLITERANS SYNDROME, RANDOMIZED CONTROLLED-TRIAL, PLACEBO-CONTROLLED TRIAL, USE REGRESSION-MODELS, ALLOGRAFT DYSFUNCTION, DOUBLE-BLIND, AZITHROMYCIN, EXACERBATIONS, PREVENTION, NO2",

author = "David Ruttens and Verleden, {Stijn E.} and Bijnens, {Esmee M.} and Ellen Winckelmans and Jens Gottlieb and Gregor Warnecke and Federica Meloni and Monica Morosini and {van der Bij}, Wim and Verschuuren, {Erik A.} and Urte Sommerwerck and Gerhard Weinreich and Markus Kamler and Antonio Roman and Susana Gomez-Olles and Cristina Berastegui and Christian Benden and AreMartin Holm and Martin Iversen and Schultz, {Hans Henrik} and Bart Luijk and Erik-Jan Oudijk and Erp, {Johanna M. Kwakkel-van} and Peter Jaksch and Walter Klepetko and Nikolaus Kneidinger and Claus Neurohr and Corris, {Paul. A.} and Fisher, {Andrew J.} and James Lordan and Gerard Meachery and Davide Piloni and Elly Vandermeulen and Hannelore Bellon and Barbara Hoffmann and Danielle Vienneau and Gerard Hoek and {de Hoogh}, Kees and Benoit Nemery and Verleden, {Geert M.} and Robin Vos and Tims. Nawrot and Vanaudenaerde, {Bart M.}",

year = "2017",

doi = "10.1183/13993003.00484-2016",

language = "English",

volume = "49",

journal = "European Respiratory Journal",

issn = "0903-1936",

publisher = "EUROPEAN RESPIRATORY SOC JOURNALS LTD",

number = "1",

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Ruttens, D, Verleden, SE, Bijnens, EM, Winckelmans, E, Gottlieb, J, Warnecke, G, Meloni, F, Morosini, M, van der Bij, W , Verschuuren, EA, Sommerwerck, U, Weinreich, G, Kamler, M, Roman, A, Gomez-Olles, S, Berastegui, C, Benden, C, Holm, A, Iversen, M, Schultz, HH, Luijk, B, Oudijk, E-J, Erp, JMK, Jaksch, P, Klepetko, W, Kneidinger, N, Neurohr, C, Corris, PA, Fisher, AJ, Lordan, J, Meachery, G, Piloni, D, Vandermeulen, E, Bellon, H, Hoffmann, B, Vienneau, D, Hoek, G, de Hoogh, K, Nemery, B, Verleden, GM, Vos, R, Nawrot, T & Vanaudenaerde, BM 2017, 'An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe', European Respiratory Journal, vol. 49, no. 1. https://doi.org/10.1183/13993003.00484-2016

TY - JOUR

T1 - An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe

AU - Ruttens, David

AU - Verleden, Stijn E.

AU - Bijnens, Esmee M.

AU - Winckelmans, Ellen

AU - Gottlieb, Jens

AU - Warnecke, Gregor

AU - Meloni, Federica

AU - Morosini, Monica

AU - van der Bij, Wim

AU - Verschuuren, Erik A.

AU - Sommerwerck, Urte

AU - Weinreich, Gerhard

AU - Kamler, Markus

AU - Roman, Antonio

AU - Gomez-Olles, Susana

AU - Berastegui, Cristina

AU - Benden, Christian

AU - Holm, AreMartin

AU - Iversen, Martin

AU - Schultz, Hans Henrik

AU - Luijk, Bart

AU - Oudijk, Erik-Jan

AU - Erp, Johanna M. Kwakkel-van

AU - Jaksch, Peter

AU - Klepetko, Walter

AU - Kneidinger, Nikolaus

AU - Neurohr, Claus

AU - Corris, Paul. A.

AU - Fisher, Andrew J.

AU - Lordan, James

AU - Meachery, Gerard

AU - Piloni, Davide

AU - Vandermeulen, Elly

AU - Bellon, Hannelore

AU - Hoffmann, Barbara

AU - Vienneau, Danielle

AU - Hoek, Gerard

AU - de Hoogh, Kees

AU - Nemery, Benoit

AU - Verleden, Geert M.

AU - Vos, Robin

AU - Nawrot, Tims.

AU - Vanaudenaerde, Bart M.

PY - 2017

Y1 - 2017

N2 - Air pollution from road traffic is a serious health risk, especially for susceptible individuals. Single-centre studies showed an association with chronic lung allograft dysfunction (CLAD) and survival after lung transplantation, but there are no large studies.13 lung transplant centres in 10 European countries created a cohort of 5707 patients. For each patient, we quantified residential particulate matter with aerodynamic diameter. 10 mu m (PM10) by land use regression models, and the traffic exposure by quantifying total road length within buffer zones around the home addresses of patients and distance to a major road or freeway.After correction for macrolide use, we found associations between air pollution variables and CLAD/ mortality. Given the important interaction with macrolides, we stratified according to macrolide use. No associations were observed in 2151 patients taking macrolides. However, in 3556 patients not taking macrolides, mortality was associated with PM10 (hazard ratio 1.081, 95% CI 1.000-1.167); similarly, CLAD and mortality were associated with road lengths in buffers of 200-1000 and 100-500 m, respectively (hazard ratio 1.0851.130). Sensitivity analyses for various possible confounders confirmed the robustness of these associations.Long-term residential air pollution and traffic exposure were associated with CLAD and survival after lung transplantation, but only in patients not taking macrolides.

AB - Air pollution from road traffic is a serious health risk, especially for susceptible individuals. Single-centre studies showed an association with chronic lung allograft dysfunction (CLAD) and survival after lung transplantation, but there are no large studies.13 lung transplant centres in 10 European countries created a cohort of 5707 patients. For each patient, we quantified residential particulate matter with aerodynamic diameter. 10 mu m (PM10) by land use regression models, and the traffic exposure by quantifying total road length within buffer zones around the home addresses of patients and distance to a major road or freeway.After correction for macrolide use, we found associations between air pollution variables and CLAD/ mortality. Given the important interaction with macrolides, we stratified according to macrolide use. No associations were observed in 2151 patients taking macrolides. However, in 3556 patients not taking macrolides, mortality was associated with PM10 (hazard ratio 1.081, 95% CI 1.000-1.167); similarly, CLAD and mortality were associated with road lengths in buffers of 200-1000 and 100-500 m, respectively (hazard ratio 1.0851.130). Sensitivity analyses for various possible confounders confirmed the robustness of these associations.Long-term residential air pollution and traffic exposure were associated with CLAD and survival after lung transplantation, but only in patients not taking macrolides.

KW - BRONCHIOLITIS OBLITERANS SYNDROME

KW - RANDOMIZED CONTROLLED-TRIAL

KW - PLACEBO-CONTROLLED TRIAL

KW - USE REGRESSION-MODELS

KW - ALLOGRAFT DYSFUNCTION

KW - DOUBLE-BLIND

KW - AZITHROMYCIN

KW - EXACERBATIONS

KW - PREVENTION

KW - NO2

U2 - 10.1183/13993003.00484-2016

DO - 10.1183/13993003.00484-2016

M3 - Article

SN - 0903-1936

VL - 49

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 1

ER -

An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe

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Keywords

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