Quality of life in relation to the traffic pollution indicators NO2 and NOx: results from the Swedish GA2LEN survey

BMJ Open Resp Res 2014;1:e000039 doi:10.1136/bmjresp-2014-000039

1. Johan Nilsson Sommar1, 
2. Alexandra Ek2, 
3. Roelinde Middelveld3,4, 
4. Anders Bjerg5,
5. Sven-Erik Dahlén2, 
6. Christer Janson6 and 
7. Bertil Forsberg1

+Author Affiliations

1. ¹Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
2. ²Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3. ³The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
4. ⁴The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
5. ⁵Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Krefting Research Centre, University of Gothenburg, Göteborg, Sweden
6. ⁶Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden

1. Correspondence toDr Johan Nilsson Sommar; johan.n.sommar@envmed.umu.se

Abstract

Background Asthma is a chronic disease that may affect daily activities and quality of life. Asthmatics have higher incidence of chronic rhinosinusitis (CRS) and asthma is associated with sinonasal inflammation and nasal symptoms, that all impair quality of life. Worsening of asthma has been found associated with levels of nitrogen dioxide as traffic indicator.

Aims The aim of the study was to evaluate the impact of traffic pollution indicated by nitrogen oxides (NO₂ and NO_x) on quality of life in asthmatic persons, individuals with CRS and controls.

Methods Within the Swedish Ga²len (Global Allergy and Asthma European Network), 605 asthmatics with and without CRS, 110 individuals with CRS only and 226 controls from four cities were surveyed. The mini Asthma Quality of life Questionnaire (mAQLQ) and the Euro Quality of Life (EQ-5D) health questionnaire were used. Air pollution concentrations at the home address were modelled using dispersion models.

Results Levels of NO₂ (geometric mean 10.1 μg/m³ (95% CI 9.80 to 10.5) and NO_x (12.1 μg/m³, 11.7 to 12.6) were similar among conditions (controls, asthmatics, individuals with CRS and asthmatics with CRS). The mAQLQ overall score was not found associated with levels of NO₂ or NO_x, with or without adjustments, and neither was scores within each of the four domains of mAQLQ: symptoms, activity limitations, emotional functions and effects of environmental stimuli. The mean EQ-5D index value, based on the five dimensions mobility, self-care, usual activities, pain/discomfort and anxiety depression, was also found unrelated to NO₂ and NO_x.

Conclusions At moderate exposure levels traffic pollution appears not to affect quality of life.

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