Lung function-associated exposome profile in the era of climate change: Pooled analysis of 8 population-based European cohorts within the EXPANSE project.

Background: The independent and interrelated long-term effects of the exposome such as air pollution, greenness, and ambient temperature on lung function are not well understood, yet relevant in the light of climate change.

Methods: Pre-bronchodilation FEV1 from five mature birth cohorts (N = 4724) and three adult cohorts (N = 6052) from five European countries were used to assess cross-sectional associations with air pollution, greenness, and ambient temperature, assigned to their residential address. All two-way interactions and square terms were a priori included in building the final elastic net regression model. Elastic net regression results were put into the context of different environmental scenarios such as improvement of air quality, improvement of greenness, climate change, or their combinations.

Results: Elastic net regression of FEV1 z-scores identified non-zero coefficients for many interaction terms, indicating the importance of joint effects of exposure to air pollution, greenness, and temperature. The non-zero coefficients were bigger and more stable in adults than in children. Upon exploring lung function benefits for different environmental scenarios, an improvement of FEV1 was expected in the scenario of improving air quality or greenness. In contrast, negative changes in FEV1 z-scores were expected in the scenario of climate change, characterized by daily temperature increase in summer and decrease in winter. The beneficial FEV1 effects of improving air pollution or greenness were attenuated in the presence of climate change.

Conclusion: Complex exposome profiles of long-term exposure to air pollution, greenness, and temperature showed associations with FEV1 in European adults, and to less extent in children and adolescents. Climate change seems to have a negative impact on lung function and modifies the association of air pollution and greenspace with lung function.