• Sara H Downs, Christian Schindler, L-J Sally Liu, Dirk Keidel, Lucy Bayer-Oglesby, Martin H Brutsche, Margaret W Gerbase, Roland Keller, Nino Künzli, Philippe Leuenberger, Nicole M Probst-Hensch, Jean-Marie Tschopp, Jean-Pierre Zellweger, Thierry Rochat, Joel Schwartz, Ursula Ackermann-Liebrich, and SAPALDIA Team.
• Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland.
• N. Engl. J. Med. 2007 Dec 6;357(23):2338-47.

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

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