External exposome and incident asthma across the life course in 14 European cohorts: a prospective analysis within the EXPANSE project

IF 13 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-07-01 DOI:10.1016/j.lanepe.2025.101314

Zhebin Yu , Sara Kress , Natalia Blay , Petr Gregor , Hanna-Maria Kukk , Miriam Leskien , Renata Majewska , Max J. Oosterwegel , Daniel Szabó , Margreet ten Have , Jana Klánová , Ondřej Mikeš , Anna Bergström , Alonso Bussalleu , Rafael de Cid , Andrea Dalecka , Payam Dadvand , Saskia van Dorsselaer , Krista Fischer , Kees de Hoogh , Erik Melén

{"title":"External exposome and incident asthma across the life course in 14 European cohorts: a prospective analysis within the EXPANSE project","authors":"Zhebin Yu , Sara Kress , Natalia Blay , Petr Gregor , Hanna-Maria Kukk , Miriam Leskien , Renata Majewska , Max J. Oosterwegel , Daniel Szabó , Margreet ten Have , Jana Klánová , Ondřej Mikeš , Anna Bergström , Alonso Bussalleu , Rafael de Cid , Andrea Dalecka , Payam Dadvand , Saskia van Dorsselaer , Krista Fischer , Kees de Hoogh , Erik Melén","doi":"10.1016/j.lanepe.2025.101314","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The joint impact of exposure to multiple urban environmental factors on asthma remains unclear.</div></div><div><h3>Methods</h3><div>We analysed data from 14 European cohorts to assess the impact of the urban exposome on asthma incidence across the life course. We linked three external exposome domains (air pollution, built environment, ambient temperature) to the participants’ home addresses at baseline. We performed k-means clustering within each domain and assessed associations of clusters with asthma adjusting for potentially relevant covariates in cohort-specific analyses, with subsequent separate meta-analyses for birth and adult cohorts. An environmental risk score using a coefficient-weighted sum approach was used to assess the impact of combining the three domains.</div></div><div><h3>Findings</h3><div>A total of 7428 incident asthma cases were identified among 349,037 participants (from birth up to age 70+). Overall, we observed higher risks of asthma for clusters characterized by high particulate matter and nitrogen dioxide exposure in adults (OR<sub>meta</sub> = 1.13, 95%CI:1.01–1.25), and clusters characterized by high built-up area and low levels of greenness in both children and adults (OR<sub>meta</sub> = 1.36, 95%CI: 1.14–1.64 for birth cohorts and OR<sub>meta</sub> = 1.15, 95%CI: 1.03–1.28 for adult cohorts, respectively). The joint exposure using the environment risk score combining the three domains was consistently associated with higher risks of incident asthma (OR<sub>meta</sub> = 1.13, 95%CI: 1.07–1.20 for birth cohorts, OR<sub>meta</sub> = 1.15, 95%CI: 1.10–1.20 for adult cohorts per 20% increase). On average 11.6% of the incident asthma cases could be attributed to environmental risk score above cohort-specific median levels.</div></div><div><h3>Interpretation</h3><div>Multiple environmental exposures jointly contribute to incident asthma risk across the life course. Urban planning accounting for these factors may help mitigate asthma development.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>European Union’s Horizon 2020</span> research and innovation program under agreement No <span><span>874627</span></span> (EXPANSE).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101314"},"PeriodicalIF":13.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Regional Health-Europe","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666776225001061","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The joint impact of exposure to multiple urban environmental factors on asthma remains unclear.

Methods

We analysed data from 14 European cohorts to assess the impact of the urban exposome on asthma incidence across the life course. We linked three external exposome domains (air pollution, built environment, ambient temperature) to the participants’ home addresses at baseline. We performed k-means clustering within each domain and assessed associations of clusters with asthma adjusting for potentially relevant covariates in cohort-specific analyses, with subsequent separate meta-analyses for birth and adult cohorts. An environmental risk score using a coefficient-weighted sum approach was used to assess the impact of combining the three domains.

Findings

A total of 7428 incident asthma cases were identified among 349,037 participants (from birth up to age 70+). Overall, we observed higher risks of asthma for clusters characterized by high particulate matter and nitrogen dioxide exposure in adults (OR_meta = 1.13, 95%CI:1.01–1.25), and clusters characterized by high built-up area and low levels of greenness in both children and adults (OR_meta = 1.36, 95%CI: 1.14–1.64 for birth cohorts and OR_meta = 1.15, 95%CI: 1.03–1.28 for adult cohorts, respectively). The joint exposure using the environment risk score combining the three domains was consistently associated with higher risks of incident asthma (OR_meta = 1.13, 95%CI: 1.07–1.20 for birth cohorts, OR_meta = 1.15, 95%CI: 1.10–1.20 for adult cohorts per 20% increase). On average 11.6% of the incident asthma cases could be attributed to environmental risk score above cohort-specific median levels.

Interpretation

Multiple environmental exposures jointly contribute to incident asthma risk across the life course. Urban planning accounting for these factors may help mitigate asthma development.

Funding

This study was funded by the European Union’s Horizon 2020 research and innovation program under agreement No 874627 (EXPANSE).

查看原文本刊更多论文

在14个欧洲队列的整个生命过程中，外部暴露和哮喘事件：在浩瀚项目中的前瞻性分析

暴露于多种城市环境因素对哮喘的共同影响尚不清楚。方法：我们分析了来自14个欧洲队列的数据，以评估城市暴露对整个生命过程中哮喘发病率的影响。我们将三个外部暴露域（空气污染、建筑环境、环境温度）与参与者的家庭住址联系起来。我们在每个区域内进行k均值聚类，并评估聚类与哮喘的关联，在队列特定分析中调整潜在相关协变量，随后对出生和成人队列进行单独的荟萃分析。使用系数加权和方法的环境风险评分用于评估结合三个领域的影响。在349,037名参与者（从出生到70岁以上）中，共发现7428例哮喘病例。总体而言，我们观察到以成人高颗粒物和二氧化氮暴露为特征的聚集（ORmeta = 1.13, 95%CI: 1.01-1.25），以及以儿童和成人高建筑面积和低绿化水平为特征的聚集（出生队列ORmeta = 1.36, 95%CI: 1.14-1.64，成人队列ORmeta = 1.15, 95%CI: 1.03-1.28）哮喘风险更高。结合三个领域使用环境风险评分的联合暴露始终与较高的哮喘发生风险相关（出生队列ORmeta = 1.13, 95%CI: 1.07-1.20，成人队列ORmeta = 1.15, 95%CI: 1.10-1.20）。平均11.6%的哮喘病例可归因于环境风险评分高于队列特定中位水平。多种环境暴露共同导致生命过程中哮喘风险的发生。考虑到这些因素的城市规划可能有助于减轻哮喘的发展。本研究由欧盟地平线2020研究与创新计划资助，协议编号874627 （ether）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.