Rationale: Short-term exposure to air pollution has been associated with exacerbation of chronic obstructive pulmonary disease (COPD), whereas the role of long-term exposures on the development of COPD is not yet fully understood. Objectives: We assessed the effect of exposure to traffic-related air pollution over 35 years on the incidence of COPD in a prospective cohort study. Methods: We followed 57,053 participants in the Danish Diet, Cancer, and Health cohort in the Hospital Discharge Register for their first hospital admission for COPD between 1993 and 2006. We estimated the annual mean levels of nitrogen dioxide (NO₂) and nitrogen oxides (NO_x) at all residential addresses of the cohort participants since 1971 to an event or 2006 and used indicators of traffic near the residential address at recruitment. We assessed the association between exposure to air pollution and COPD incidence by Cox regression analyses for the full cohort, and for participants with and without comorbid conditions, including asthma, diabetes, or cardiovascular disease. Measurements and Main Results: A first hospital admission for COPD was recorded for 1,786 (3.4%) of 52,799 eligible subjects between recruitment (1993–1997) and 2006. COPD incidence was associated with the 35-year mean NO₂ level (hazard ratio, 1.08; 95% confidence interval, 1.02–1.14, per interquartile range of 5.8 μg/m³), with stronger associations in subjects with diabetes (1.29; 1.05–1.50) and asthma (1.19; 1.03–1.38). Conclusions: Long-term exposure to traffic-related air pollution may contribute to the development of COPD with possibly enhanced susceptibility in people with diabetes and asthma.

Empirical spatial air pollution models have been applied extensively to assess exposure in epidemiological studies with increasingly sophisticated and complex statistical algorithms beyond ordinary linear regression. However, different algorithms have rarely been compared in terms of their predictive ability. This study compared 16 algorithms to predict annual average fine particle (PM2.5) and nitrogen dioxide (NO2) concentrations across Europe. The evaluated algorithms included linear stepwise regression, regularization techniques and machine learning methods. Air pollution models were developed based on the 2010 routine monitoring data from the AIRBASE dataset maintained by the European Environmental Agency (543 sites for PM2.5 and 2399 sites for NO2), using satellite observations, dispersion model estimates and land use variables as predictors. We compared the models by performing five-fold cross-validation (CV) and by external validation (EV) using annual average concentrations measured at 416 (PM2.5) and 1396 sites (NO2) from the ESCAPE study. We further assessed the correlations between predictions by each pair of algorithms at the ESCAPE sites. For PM2.5, the models performed similarly across algorithms with a mean CV R2 of 0.59 and a mean EV R2 of 0.53. Generalized boosted machine, random forest and bagging performed best (CV R2~0.63; EV R2 0.58-0.61), while backward stepwise linear regression, support vector regression and artificial neural network performed less well (CV R2 0.48-0.57; EV R2 0.39-0.46). Most of the PM2.5 model predictions at ESCAPE sites were highly correlated (R2 > 0.85, with the exception of predictions from the artificial neural network). For NO2, the models performed even more similarly across different algorithms, with CV R2s ranging from 0.57 to 0.62, and EV R2s ranging from 0.49 to 0.51. The predicted concentrations from all algorithms at ESCAPE sites were highly correlated (R2 > 0.9). For both pollutants, biases were low for all models except the artificial neural network. Dispersion model estimates and satellite observations were two of the most important predictors for PM2.5 models whilst dispersion model estimates and traffic variables were most important for NO2 models in all algorithms that allow assessment of the importance of variables. Different statistical algorithms performed similarly when modelling spatial variation in annual average air pollution concentrations using a large number of training sites.

This review provides a community's perspective on air quality research focusing mainly on developments over the past decade. The article provides perspectives on current and future challenges as well as research needs for selected key topics. While this paper is not an exhaustive review of all research areas in the field of air quality, we have selected key topics that we feel are important from air quality research and policy perspectives. After providing a short historical overview, this review focuses on improvements in characterizing sources and emissions of air pollution, new air quality observations and instrumentation, advances in air quality prediction and forecasting, understanding interactions of air quality with meteorology and climate, exposure and health assessment, and air quality management and policy. In conducting the review, specific objectives were (i) to address current developments that push the boundaries of air quality research forward, (ii) to highlight the emerging prominent gaps of knowledge in air quality research, and (iii) to make recommendations to guide the direction for future research within the wider community. This review also identifies areas of particular importance for air quality policy. The original concept of this review was borne at the International Conference on Air Quality 2020 (held online due to the COVID 19 restrictions during 18–26 May 2020), but the article incorporates a wider landscape of research literature within the field of air quality science. On air pollution emissions the review highlights, in particular, the need to reduce uncertainties in emissions from diffuse sources, particulate matter chemical components, shipping emissions, and the importance of considering both indoor and outdoor sources. There is a growing need to have integrated air pollution and related observations from both ground-based and remote sensing instruments, including in particular those on satellites. The research should also capitalize on the growing area of low-cost sensors, while ensuring a quality of the measurements which are regulated by guidelines. Connecting various physical scales in air quality modelling is still a continual issue, with cities being affected by air pollution gradients at local scales and by long-range transport. At the same time, one should allow for the impacts from climate change on a longer timescale. Earth system modelling offers considerable potential by providing a consistent framework for treating scales and processes, especially where there are significant feedbacks, such as those related to aerosols, chemistry, and meteorology. Assessment of exposure to air pollution should consider the impacts of both indoor and outdoor emissions, as well as application of more sophisticated, dynamic modelling approaches to predict concentrations of air pollutants in both environments. With particulate matter being one of the most important pollutants for health, research is indicating the urgent need to understand, in particular, the role of particle number and chemical components in terms of health impact, which in turn requires improved emission inventories and models for predicting high-resolution distributions of these metrics over cities. The review also examines how air pollution management needs to adapt to the above-mentioned new challenges and briefly considers the implications from the COVID-19 pandemic for air quality. Finally, we provide recommendations for air quality research and support for policy.