Ambient Air Pollutants and Incident Microvascular Disease: A Cohort Study

Abstract

Little is known about the links between long-term exposure to air pollution and risk of incident microvascular disease (retinopathy, peripheral neuropathy, and chronic kidney disease). This study included 396 014 UK residents free of microvascular disease and macrovascular disease at baseline. Annual means of PM 2.5 , PM 2.5−10 , PM 10 , NO 2 , and NO x were assessed by land use regression models for each participant. A weighted air pollution score was generated from PM 10 and NO x . Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 11.7 years, 14 327 composite microvascular disease occurred. While none of the air pollutants showed any statistically significant association with the risk of retinopathy, all the air pollutants were linked to the risk of peripheral neuropathy and chronic kidney disease. The adjusted-HRs (95% CIs) for each interquartile range increase in air pollution score were 1.07 (1.05, 1.09), 1.01 (0.94, 1.07), 1.13 (1.08, 1.19), and 1.07 (1.05, 1.10) for overall microvascular disease, retinopathy, peripheral neuropathy, and chronic kidney disease, respectively. In conclusion, long-term exposure to overall air pollution was associated with higher risks of peripheral neuropathy and chronic kidney disease among the general UK population.

Genetic susceptibility and lifestyle modify the association of long-term air pollution exposure on major depressive disorder: a prospective study in UK Biobank

“…Air pollution levels in England have been relatively stable over these years [ 39 , 40 ]. As the fluctuation of the temporal trend of most air pollution was generally stable during the study period, the average values of air pollution could be used as a surrogate measure of long-term exposure [ 41 ]. The use of the average air pollution levels as the mean estimates in our sensitivity analysis further demonstrated the robustness of this approach.…”

Air Pollution and Allergic Rhinitis: Findings from a Prospective Cohort Study

“…According to previous literature studies, potential confounders that might influence air pollution or AR were selected as covariates, including demographic characteristics (age, sex, ethnicity, and education level), lifestyle and health status factors (smoking, alcohol drinking status, physical activity, body mass index [BMI], and healthy diet score), and household characteristics (average total before-tax household income and residence location distance to the coast). ,− Briefly, age was calculated as a continuous variable using the birth date and baseline assessment date. Self-reported sex at baseline was categorized as female or male.…”

Neuropathy in prediabetes

“…Novel studies suggest that novel risk factors such as air and noise pollution may not only increase the incidence of type 2 diabetes but also of DSPN, [115][116][117] so that ubiquitous environmental determinants also merit further investigation in this context. Clinical trials and additional modelling studies are needed to better decipher the optimal frequency of screening and the age at which to start and stop screening.…”

“…More data are also needed on the effects of lifestyle interventions and medical treatments for screen‐detected prediabetes and diabetes on health outcomes over a longer follow‐up period, particularly in populations reflective of the prevalence of diabetes and on how best to increase the uptake of lifestyle interventions, especially among populations at highest risk of progression to diabetes and adverse health outcomes. Novel studies suggest that novel risk factors such as air and noise pollution may not only increase the incidence of type 2 diabetes but also of DSPN, 115–117 so that ubiquitous environmental determinants also merit further investigation in this context. Clinical trials and additional modelling studies are needed to better decipher the optimal frequency of screening and the age at which to start and stop screening.…”