Does respiratory health contribute to the effects of long-term air pollution exposure on XXXX ?

@entity1 @entity73 @entity6836 @entity1576 @entity65
BACKGROUND: There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase @entity65 and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health. To what extent the association between @entity65 and air pollution is driven by the impact of air pollution on respiratory health is unknown. The aim of this study was to investigate whether respiratory health at baseline contributes to the effects of long-term exposure to high levels of air pollution on @entity65 in a cohort of elderly @entity1 . METHOD: We analyzed data from 4750 @entity1 , aged 55 at the baseline investigation in the years 1985-1994. 2593 of these @entity1 had their lung function tested by spirometry. @entity1576 and symptoms were asked by questionnaire. Ambient air pollution exposure was assessed by the concentrations of @entity6836 and total suspended particles at fixed monitoring sites and by the distance of residency to a major road. A mortality follow-up of these @entity1 was conducted between 2001 and 2003. For the statistical analysis, Cox' regression was used. RESULTS: @entity1 with @entity73 or pre-existing @entity1576 had a higher risk of dying from cardiovascular causes. The impact of @entity73 declined over time. The risk ratio (RR) of @entity1 with forced expiratory volume in one second (FEV1) of less than 80% predicted to die from cardiovascular causes was RR = 3.79 (95%CI: 1.64-8.74) at 5 years survival time and RR = 1.35 (95%CI: 0.66-2.77) at 12 years. The association between air pollution levels and @entity65 rate was strong and statistically significant. However, this association did only change marginally when including indicators of respiratory health into the regression analysis. Furthermore, no interaction between air pollution and respiratory health on @entity65 indicating a higher risk of those with impaired respiratory health could be detected. CONCLUSION: Respiratory health is a predictor for @entity65 . In @entity1 followed about 15 years after the baseline investigation at age 55 years long-term air pollution exposure and impaired respiratory health were independently associated with increased @entity65 .
