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BEDREHELSE-Bedre helse og livskvalitet

Lifespan and inter-generational respiratory effects of exposures to greenness and air pollution: the Life-GAP project

Alternative title: Effekter av luftforurensing og grønne områder på lungehelse gjennom livsløpet: Life-GAP prosjektet

Awarded: NOK 11.5 mill.

The Life-GAP project will study how air pollution and greenness affect respiratory health over the lifespan and across generations. Life-GAP is based on the large Respiratory Health in Northern Europe study (RHINE), a questionnaire survey with >20 000 participants from Norway, Denmark, Sweden, Iceland and Estonia. The participants were in the age range 20 to 44 years old when they first participated in 1990, they have answered follow-up questionnaires in 2000 and in 2010 ? and we are currently conducting a 30-year follow-up survey. In 2015, their adult offspring (> 8000 persons, the RHINESSA study) also completed a large questionnaire. In the Life-GAP database, the questionnaire information on all the participants will be combined with information from national registries and information on their exposures to air pollution and greenness throughout their lifespan. Using the Life-GAP database, we will investigate if also lower pollution levels may harm health if the exposure lasts for a long period, and if greenness may have a beneficial effect. We will investigate a large range of outcomes, from milder respiratory symptoms through medication use and hospitalisations, to mortality. Our results will be presented in scientific papers and on scientific conferences. The first scientific paper in the Life-GAP project was published in August 2020 (Nordeide IN et al, Int J Environ Res Public Health 2020). This is one of twelve planned scientific papers from this project, and is more closely described in the progress report from 2020. The year 2021 is allocated to RHINE IV data collection, and because of this no scientific papers were planned for this year. We have established a Life-GAP project website where we will be posting news and results from the project. We are also working on a communication plan to make sure we reach a wider population with our findings. The project website is located here: https://www.uib.no/en/rg/gap/148378/life-gap-project

The Life-GAP project will study how air pollution affects respiratory health over time and across generations, with particular focus on low exposure levels. We will also investigate potential beneficial effects of greenness: an exposure that has been suggested to improve certain aspects of health but where little so far is known regarding respiratory effects. Life-GAP will focus on numerous outcomes of lung health: symptoms, diseases, medication use, hospitalisations - as well as factors at birth affecting lung health later in life (birth weight, pre-term birth), and the end-stage outcome: mortality. We will investigate both associations and population attributable risks, to be able to assess how much of the lung outcomes could be avoided if pollution exposures were removed. Life-GAP is based on the Respiratory Health in Northern Europe study (RHINE), a large population-based questionnaire cohort study of parents and offspring, with a 30-year follow-up of the parents being conducted in 2020. We will enrich these data with unique data from national registries (cause of death, birth-, prescription- and hospital data), and with environmental exposure data (greenness, NO2, PM2.5, PM10, O3 and black carbon) assigned to each participant far back in time based on residential address history. The lifespan cohort includes 21659 participants aged 20-44 years at baseline, and the generation study includes 8260 offspring with one parent from the lifespan cohort. Life-GAP has international research cooperation of supreme quality, and active user involvement from the Norwegian Asthma and Allergy Association. We will in the beginning of the project establish an end-user panel inviting also representatives for health professionals, city planners and policy makers in addition to our existing patient representative, to ensure that we focus our research where it has the best potential impact, and having the users' "lived experience" to guide us along the way.

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BEDREHELSE-Bedre helse og livskvalitet