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(average age 70 years) whose lung function was measured up to six times from 1995 to 2011, exposure to traffic-derived air pollution, determined for the home address, revealed that increased long-term exposure to black carbon correlated with an accelerated decline in both FEV 1 and FVC. 11 The European Study of Cohorts for Air Pollution Effects (ESCAPE) also studied the effect of outdoor air pollution on adult lung function decline. 12 Subjects in this study had to be at least 20 years old, with lung function data from two different time points approximately 10 years apart. While no association was found between either background or locally generated air pollution and lung function decline, cross-sectional analysis found that reduced FEV 1 was associated with increased long-term exposure to NO 2 and PM 10 . The researchers concluded that their findings were consistent with accelerated decline in lung function caused by air pollution. 4.1.4 Summary Long-term exposure to either background or locally generated air pollution impairs lung function growth in children. Reducing exposure to air pollution reverses this effect, thereby allowing more young people to achieve their maximum lung function growth potential. In adults, there is emerging evidence that air pollution accelerates the decline in lung function during ageing. © Royal College of Physicians 2016 55 4 Health effects of air pollution over our lifetime Fig 13. Association between FEV 1 (expressed as a percentage of the predicted value based on height and sex) and area of fossil fuel-derived particles in healthy children living in Leicester, UK. As the number of particles in macrophages increases, lung function decreases. Adapted with permission from Kulkarni et al, 7 © 2006 Massachusetts Medical Society. 0.00 0.25 0.50 0.75 1.00 1.25 0 75 85 95 105 115 125 FEV 1 (% of predicted) Median carbon area (µm 2 ) r 2 =0.13 p=0.004

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