Zorana Jovanovic Andersen

• PhD
• Professor at University of Copenhagen

The evidence linking air pollution with dementia has been fast growing over the last decade, but who is most susceptible remains rarely explored. Therefore, we aimed to examine the association between long-term exposure air pollution and incidence of dementia and identify the most susceptible groups by age, sex, socioeconomic status (SES), and como...

Background Transportation noise has been linked with cardiometabolic outcomes, yet whether it is a risk factor for atrial fibrillation (AF) remains inconclusive. We aimed to assess whether transportation noise was associated with AF in a large, pooled Nordic cohort. Methods We pooled data from 11 Nordic cohorts, totaling 161,115 participants. Base...

Objectives: We evaluated studies that used the World Health Organization's (WHO) AirQ and AirQ+ tools for air pollution (AP) health risk assessment (HRA) and provided best practice suggestions for future assessments. Methods: We performed a comprehensive review of studies using WHO's AirQ and AirQ+ tools, searching several databases for relevant...

Background and Aims Air pollution has been shown to be associated with cause-specific mortality. However, mortality due to chronic kidney disease (CKD) is understudied in this context, with no European data available so far. We investigated the relation between long-term exposure to air pollution and CKD-associated mortality in the Effects of Low-L...

Objectives: To explore the associations of long-term exposure to air pollution with onset of all human health conditions. Design: Prospective phenome-wide association study. Setting: Denmark. Participants: All Danish residents aged ≥30 years on 1 January 2000 were included (N=3 323 612). After exclusion of individuals with missing geocoded r...

Air pollution has been shown to significantly impact human health including cancer. Gastric and upper aerodigestive tract (UADT) cancers are common and increased risk has been associated with smoking and occupational exposures. However, the association with air pollution remains unclear. We pooled European subcohorts (N = 287,576 participants for g...

Ultrafine particles (UFPs) are airborne particles with a diameter of less than 100 nm. They are emitted from various sources, such as traffic, combustion, and industrial processes, and can have adverse effects on human health. Long-term mean ambient average particle size (APS) in the UFP range varies over space within cities, with locations near UF...

Background: Studies across the globe generally reported increased mortality risks associated with particulate matter with aerodynamic diameter ≤2.5μm (PM2.5) exposure with large heterogeneity in the magnitude of reported associations and the shape of concentration-response functions (CRFs). We aimed to evaluate the impact of key study design facto...

Ultrafine particles (UFP; particulate matter <0.1 μm in diameter) may be more harmful to human health than larger particles, but epidemiological evidence on their health effects is still limited. In this study, we examined the association between short-term exposure to UFP and mortality and hospital admissions in Copenhagen, Denmark. Daily concentr...

Background: Risk factors for malignant tumours of the central nervous system (CNS) are largely unknown. Methods: We pooled six European cohorts (N = 302,493) and assessed the association between residential exposure to nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), ozone (O3) and eight elemental components of PM2.5 (copper, i...

Background: Environmental noise is an important environmental exposure that can affect health. An association between transportation noise and breast cancer incidence has been suggested, although current evidence is limited. We investigated the pooled association between long-term exposure to transportation noise and breast cancer incidence. Method...

Abstract Background Long-term exposure to air pollution and noise is detrimental to health; but studies that evaluated both remain limited. This study explores associations with natural and cause-specific mortality for a range of air pollutants and transportation noise. Methods Over 4 million adults in Switzerland were followed from 2000 to 2014. E...

Most studies investigating the health effects of long-term exposure to air pollution used traditional regression models, although causal inference approaches have been proposed as alternative. However, few studies have applied causal models and comparisons with traditional methods are sparse. We therefore compared the associations between natural-c...

Background: Fine particulate matter (PM2.5) is a well-recognized risk factor for premature death. However, evidence on which PM2.5 components are most relevant is unclear. Methods: We evaluated the associations between mortality and long-term exposure to eight PM2.5 elemental components [copper (Cu), iron (Fe), zinc (Zn), sulfur (S), nickel (Ni)...

Background: Transportation noise may induce cardiovascular disease, but the public health implications are unclear. Objectives: The study aimed to assess exposure-response relationships for different transportation noise sources and ischemic heart disease (IHD), including subtypes. Methods: Pooled analyses were performed of nine cohorts from D...

Background The link between exposure to ambient air pollution and mortality from cardiorespiratory diseases is well established, while evidence on neurodegenerative disorders including Parkinson’s Disease (PD) remains limited. Objective We examined the association between long-term exposure to ambient air pollution and PD mortality in seven Europe...

Particulate matter with aerodynamic diameter less than 2.5 µm (PM2.5) is a multi-million human silent killer worldwide and contains numerous trace elements (TEs). Understanding TEs relative toxicity is largely limited by lack of data. Here, we used ensembles of machine learning models to generate ~163 billion predictions estimating annual means of...

Background: Particulate matter (PM) is classified as a group 1 human carcinogen. Previous experimental studies suggest that particles in diesel exhaust induce oxidative stress, inflammation and DNA damage in kidney cells, but the evidence from population studies linking air pollution to kidney cancer is limited. Methods: We pooled six European coho...

Particulate matter with aerodynamic diameter less than 2.5 µm (PM2.5) is a multi-million human silent killer worldwide, and contains many trace elements (TEs). Understanding the relative toxicity is largely limited by lack of data. Ensembles of machine learning models were used to generate ~163 billion predictions estimating annual mean PM2.5 TEs,...

Particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) increases mortality and morbidity. PM2.5 is composed of a mixture of chemical components that vary across space and time. Due to limited hyperlocal data availability, less is known about health risks of PM2.5 components, their US-wide exposure disparities, or which species are dr...

Burning candles at home emit small particles and gases that pollute indoor air. Exposure to fine particles in outdoor air has been convincingly linked to cardiovascular and respiratory events, while the associations with fine and ultrafine particles from candle burning remain unexplored. We examined the association between the use of candles and in...

We assessed mortality risks associated with source-specific fine particles (PM2.5) in a pooled European cohort of 323,782 participants. Cox proportional hazard models were applied to estimate mortality hazard ratios (HRs) for source-specific PM2.5 identified through a source apportionment analysis. Exposure to 2010 annual average concentrations of...

Particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) increases mortality and morbidity.1,2 PM2.5 is composed of a mixture of chemical components that vary across space and time.3 Due to limited hyperlocal data availability, less is known about health risks of PM2.5 components, their US-wide exposure disparities, or which species ar...

Particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) increases mortality and morbidity.1,2 PM2.5 is composed of a mixture of chemical components that vary across space and time.3 Due to limited hyperlocal data availability, less is known about health risks of PM2.5 components, their US-wide exposure disparities, or which species ar...

Background The majority of studies has shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort. Methods Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1...

Background The association between long-term exposure to air pollution and mortality from cardiorespiratory diseases is well established, yet the evidence for other diseases remains limited. Objectives To examine the associations of long-term exposure to air pollution with mortality from diabetes, dementia, psychiatric disorders, chronic kidney di...

Rationale: Ambient air pollution exposure has been linked to mortality from chronic cardiorespiratory diseases, while evidence on respiratory infections remains more limited. Objectives: We examined the association between long-term exposure to air pollution and pneumonia related mortality in adults in a pool of eight European cohorts. Methods:...

Background: The evidence linking ambient air pollution to bladder cancer is limited and mixed. Methods: We assessed the associations of bladder cancer incidence with residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC), warm season ozone (O3) and eight PM2.5 elemental components (copper, iron, potassium, nick...

Objective: Globally, dementia disproportionally affects women, which is not fully explained by higher female longevity. Oophorectomy at any age leads to the permanent loss of ovarian sex steroids, potentially increasing the risk of dementia. We aimed to investigate the association between oophorectomy and dementia and whether this was conditional...

Objective: Depression is a leading cause of disability globally and affects more women than men. Ovarian sex steroids are thought to modify depression risk in women and interventions such as bilateral oophorectomy that permanently change the sex steroid milieu may increase the risk of depression. This study aimed to investigate the associations be...

Background Long-term exposure to ambient air pollution has been associated with premature mortality, but associations at concentrations lower than current annual limit values are uncertain. We analysed associations between low-level air pollution and mortality within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPS...

Background: Road traffic noise has been linked to increased risk of ischemic heart disease, yet evidence on stroke shows mixed results. We examine the association between long-term exposure to road traffic noise and incidence of stroke, overall and by subtype (ischemic or hemorrhagic), after adjustment for air pollution. Methods: Twenty-five tho...

Objectives: Bilateral oophorectomy permanently reduces endogenous estrogen exposure and may increase cardiovascular mortality in women. This study aimed to investigate the association between bilateral oophorectomy and cardiovascular mortality and whether this association was conditional on hysterectomy or on the use of hormone therapy at the time...

Background We examined the association of long‐term exposure to air pollution and road traffic noise with incident heart failure (HF). Methods And Results Using data on female nurses from the Danish Nurse Cohort (aged >44 years), we investigated associations between 3‐year mean exposures to air pollution and road traffic noise and incident HF usin...

Background: Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse. Objective: We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population. Methods: We harmonized and pooled data from nine...

Background Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we in...

Objective To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. Design Pooled analysis of eight cohorts. Setting Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six Euro...

Background Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by a...

BACKGROUND AND AIM: The COVID-19 response policies had a major impact on air quality (AQ) worldwide. However, limited data availability, diverse political responses, and multiple-factor interactions made the analysis challenging. We aimed to quantify the effect of various COVID-19 response policies on concentration of ambient nitrogen dioxide (NO2)...

Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the “Effects of low‐level air pollution: A study in Europe” (ELAPSE) project, and...

The potential role of air pollution in the worsening of health impacts of COVID-19, and the influence of the pandemic on air pollution levels in Europe is explored. This editorial outlines the major lessons learned to chart a healthy post-pandemic course. https://bit.ly/3hmbaya

BACKGROUND: Associations between long-term exposure to air pollution and road traffic noise have been established for ischemic heart disease, but findings have been mixed for atrial fibrillation (AF). OBJECTIVES: The goal of the study was to examine associations of long-term exposure to road traffic noise and air pollution with AF. METHODS: Time-...

Background Ambient air pollution is likely a risk factor for asthma, and recent evidence suggests the possible relevance of road traffic noise. Objectives We examined the associations of long-term exposure to air pollution and road traffic noise with adult-asthma incidence. Methods We followed 28,731 female nurses (age > 44 years) from the Danish...

Background While air pollution has been linked to the development of chronic obstructive pulmonary disease (COPD), evidence on the role of environmental noise is just emerging. We examined the associations of long-term exposure to air pollution and road traffic noise with COPD incidence. Methods We defined COPD incidence for 24 538 female nurses f...

Background: Evidence of nonauditory health effects of road traffic noise exposure is growing. This prospective cohort study aimed to estimate the association between long-term exposure to road traffic noise above a threshold and incident myocardial infarction (MI) in Denmark. Methods: In the Danish Nurse Cohort study, we used data of 22,378 wome...

Background: Inconsistent associations between long-term exposure to particles with an aerodynamic diameter ≤2.5 μm [fine particulate matter (PM2.5)] components and mortality have been reported, partly related to challenges in exposure assessment. Objectives: We investigated the associations between long-term exposure to PM2.5 elemental component...

Background We evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). M...

Background/aim Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods The “Effects of Low-level...

Background Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE)...

Introduction To characterize air pollution exposure at a fine spatial scale, different exposure assessment methods have been applied. Comparison of associations with health from different exposure methods are scarce. The aim of this study was to evaluate associations of air pollution based on hybrid, land-use regression (LUR) and dispersion models...

Background Knowledge of the role of melatonin, xenograft experiments, and epidemiological studies suggests that exposure to light at night (LAN) may disturb circadian rhythms, possibly increasing the risk of developing breast cancer. Objectives We examined the association between residential outdoor LAN and the incidence of breast cancer: overall...

Aim The Lolland-Falster Health Study (LOFUS) is an ongoing prospective cohort study at Lolland-Falster, one of the most socio-economically disadvantaged areas of Denmark. The aim of this study was to examine the participation rates and socio-economic determinants of participation in LOFUS, approximately halfway through the data collection. Subject...

We developed Europe-wide models of long-term exposure to eight elements (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) in particulate matter with diameter <2.5 μm (PM 2.5) using standardized measurements for one-year periods between October 2008 and April 2011 in 19 study areas across Europe, with supervised linear regressio...

Background The association between air pollution and mortality is well established, yet some uncertainties remain: there are few studies that account for road traffic noise exposure or that consider in detail the shape of the exposure–response function for cause-specific mortality outcomes, especially at low-levels of exposure. Objectives We exami...

Outdoor air pollution is a major contributor to the burden of disease worldwide. Most of the global population resides in places where air pollution levels, because of emissions from industry, power generation, transportation, and domestic burning, considerably exceed the World Health Organization's health‐based air‐quality guidelines. Outdoor air...

PurposeHormone replacement therapy (HRT) is used to reduce climacteric symptoms of menopause and prevent osteoporosis; however, it increases risk of breast cancer. Mammographic density (MD) is also a strong risk factor for breast cancer. We conducted this review to investigate the association between HRT use and MD and to assess the effect of diffe...

Introduction: A few studies suggest that working night and rotating shifts increase the risk of dementia. We examined the association between shift work and the incidence of dementia in a cohort of female Danish nurses. Methods: We linked Danish Nurse Cohort participants, who reported work schedules (day, evening, night, rotating shifts) in 1993...

Ambient air pollution has been linked to stroke, but few studies have examined in detail stroke subtypes and confounding by road traffic noise, which was recently associated with stroke. Here we examined the association between long-term exposure to air pollution and incidence of stroke (overall, ischemic, hemorrhagic), adjusting for road traffic n...

Background: Air pollution exposure has been linked to coronary heart disease, although evidence on PM 2.5 and myocardial infarction (MI) incidence is mixed. Objectives: This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise. Methods: We...

The European Health Interview Survey (EHIS) is run every 5 years to examine how people experience and rank their health, how they care about their health, and to what extent they use the healthcare services. We identified the sub-population of special interest, i.e., cardiovascular disease (CVD) patients older than 65 years, in this cross-sectional...

Course about : Air Pollution – a Global Threat to our Health an online non-credit course authorized by University of Copenhagen and offered through Coursera

Air pollution epidemiology is a part of a larger field of environmental epidemiology, which is the study of health consequences of exposures that occur in the general environment. Air pollution is one of the most important and the most studied environmental exposures, due to its ubiquitous nature and since it affects multiple diseases, posing a hug...

Background: Attention in the 2000s on the importance of mammographic density led us to study screening sensitivity, breast cancer incidence, and associations with risk factors by mammographic density in Danish breast cancer screening programs. Here, we summarise our approaches and findings. Methods: Dichotomized density codes: fatty, equal to BI...