Long-term Ambient Air Pollution Exposure and Cardio-respiratory Disease in China: Findings from a Prospective Cohort Study

Overview

Journal Environ Health

Publisher Biomed Central

Specialty Environmental Health

Date 2023 Mar 27

PMID 36973808

Authors

Neil Wright

Katherine Newell

Ka Hung Chan

Simon Gilbert

Alex Hacker

Yan Lu

Yu Guo

Pei Pei

Canqing Yu

Jun Lv

Junshi Chen

Liming Li

Om Kurmi

Zhengming Chen

Kin Bong Hubert Lam

Christiana Kartsonaki

Affiliations

Soon will be listed here.

Abstract

Background: Existing evidence on long-term ambient air pollution (AAP) exposure and risk of cardio-respiratory diseases in China is mainly on mortality, and based on area average concentrations from fixed-site monitors for individual exposures. Substantial uncertainty persists, therefore, about the shape and strength of the relationship when assessed using more personalised individual exposure data. We aimed to examine the relationships between AAP exposure and risk of cardio-respiratory diseases using predicted local levels of AAP.

Methods: A prospective study included 50,407 participants aged 30-79 years from Suzhou, China, with concentrations of nitrogen dioxide (NO), sulphur dioxide (SO), fine (PM), and inhalable (PM) particulate matter, ozone (O) and carbon monoxide (CO) and incident cases of cardiovascular disease (CVD) (n = 2,563) and respiratory disease (n = 1,764) recorded during 2013-2015. Cox regression models with time-dependent covariates were used to estimate adjusted hazard ratios (HRs) for diseases associated with local-level concentrations of AAP exposure, estimated using Bayesian spatio-temporal modelling.

Results: The study period of 2013-2015 included a total of 135,199 person-years of follow-up for CVD. There was a positive association of AAP, particularly SO and O, with risk of major cardiovascular and respiratory diseases. Each 10 µg/m increase in SO was associated with adjusted hazard ratios (HRs) of 1.07 (95% CI: 1.02, 1.12) for CVD, 1.25 (1.08, 1.44) for COPD and 1.12 (1.02, 1.23) for pneumonia. Similarly, each 10 µg/m increase in O was associated with adjusted HR of 1.02 (1.01, 1.03) for CVD, 1.03 (1.02, 1.05) for all stroke, and 1.04 (1.02, 1.06) for pneumonia.

Conclusions: Among adults in urban China, long-term exposure to ambient air pollution is associated with a higher risk of cardio-respiratory disease.

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