The mediating role of lung function on air pollution-induced cardiopulmonary mortality in elderly women: The SALIA cohort study with 22-year mortality follow-up

Dalecká, Andrea; Wigmann, Claudia; Kress, Sara; Altuğ, Hicran; Jiřík, Vítězslav; Heinrich, Joachim; Abramson, Michael J.; Schikowski, Tamara

doi:10.1016/j.ijheh.2021.113705

Cited by 7 publications

(11 citation statements)

References 35 publications

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“…For FEV 1 and FVC, this result was more prominent in never-smokers; for FEV 1 /FVC, the result was more prominent in ever-smokers. Our results in all participants are in broad agreement with a previous mediation analysis from the SALIA (Study on the influence of Air pollution on Lung function, Inflammation and Ageing) cohort of 2527 elderly women in Germany [ 10 ]. Although the outcome assessed in the SALIA study was cardiopulmonary mortality, the confidence intervals of the proportion of the associations of NO 2 with mortality and incident CVD mediated by FEV 1 in our analysis are consistent with the SALIA estimate (in SALIA, 16.5% of the NO 2 –cardiopulmonary mortality association was estimated to be mediated via FEV 1 ).…”

Section: Discussionsupporting

confidence: 90%

“…To the best of our knowledge, this is the largest mediation analysis exploring the role of FEV 1 in driving associations between air pollution, all-cause mortality and incident CVD, and includes a more diverse population (in terms of age and sex) than studied previously [ 10 ]. We were able to stratify by smoking status and control for smoking intensity in analyses of smokers.…”

Section: Discussionmentioning

confidence: 99%

“…We were able to stratify by smoking status and control for smoking intensity in analyses of smokers. The large sample size is likely to have helped detection of a potential mediating effect of FEV 1 on PM 2.5 –mortality and –CVD outcome associations; this more modest effect size for PM 2.5 may explain why it was not detected in a previous, smaller study [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Mendelian randomisation studies have suggested that confounding by smoking alone does not explain the relationship between lung function and mortality [ 8 , 9 ]. Few studies, however, have reported the potential mediating role of impaired lung function on the associations between air pollution and mortality or CVD outcomes [ 10 ], in particular in subgroups that differ by smoking status. Previous studies have shown that the effect of air pollution on lung function may differ by smoking status [ 2 ]; effects of air pollution in ever-smokers have been hypothesised as being harder to detect, since smoking may already impair lung function via similar pathways to air pollution.…”

Section: Introductionmentioning

confidence: 99%

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Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank

Guyatt,

Cai,

Doiron

et al. 2024

ERJ Open Res

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BackgroundAir pollution is associated with lower lung function, and both are associated with premature mortality and cardiovascular disease (CVD). Evidence remains scarce on the potential mediating effect of impaired lung function on the association between air pollution and mortality or CVD.MethodsWe used data from UK Biobank (N∼200 000) with 8-year follow-up to mortality and incident CVD. Exposures to PM10, PM2.5, and NO2were assessed by land-use regression modelling. Lung function [forced expiratory volume in 1-second (FEV1), Forced Vital Capacity (FVC), and their ratio] was measured between 2006–2010 and transformed to Global Lung Function Initiative z-scores. Adjusted Cox proportional hazards and causal proportional hazards mediation analysis models were fitted, stratified by smoking status.ResultsLower FEV1and FVC were associated with all-cause and CVD mortality, and incident CVD, with larger estimates in ever- than never-smokers: (all-cause mortality Hazard Ratio (HR) per decrease FEV1GLI z-score, ever-smokers: 1.29 [95%CI:1.24–1.34], never-smokers: HR 1.16 [95%CI:1.12–1.21]). Long-term exposure to PM2.5or NO2was associated with incident CVD, with similar effect sizes for ever and never-smokers. Mediated proportions of the air pollution—all-cause mortality estimates driven by FEV1were 18% [95%CI:2%-33%] for PM2.5, and 27% [95%CI:3%-51%] for NO2. Corresponding mediated proportions for incident CVD were 9% [95%CI:4%-13%] for PM2.5and 16% [95%CI:6%-25%] for NO2.ConclusionsLung function may mediate a modest proportion of associations between air pollution on mortality and CVD outcomes. Results likely reflect the extent of either shared mechanisms or direct effects relating to lower lung function caused by air pollution.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank

Guyatt,

Cai,

Doiron

et al. 2024

ERJ Open Res

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“…Asthma, pulmonary fibrosis, lung cancer and other respiratory diseases are also accompanied by decreased pulmonary function. A study also indicated that decreased pulmonary function is a mediator of cardiopulmonary death (16).…”

Section: Introductionmentioning

confidence: 99%

Association between long-term exposure to ambient particulate matter and pulmonary function among men and women in typical areas of South and North China

Liu

Pan

Yang

et al. 2023

Front. Public Health

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BackgroundStudies comparing the effects of different sizes and concentrations of ambient particulate matter (PM) on pulmonary function in different regions and sexes remain sparse.ObjectivesTo investigate the associations of different sizes and levels of long-term ambient PM exposure with pulmonary function among people of different sexes in typical areas of South and North China.MethodsIn 2021, a total of 1,592 participants aged 20–73 years were recruited to participate in the pulmonary function test from the baseline survey of the Diverse Life-Course Cohort (DLCC) in typical areas of Guangdong Province and Hebei Province. The three-year (2018–2020) average ambient PM concentrations were assessed from the ChinaHighPM1 dataset, ChinaHighPM2.5 dataset and ChinaHighPM10 dataset. Mean differences in pulmonary function were used in multilevel models for different regions and sexes.ResultsWe discovered significant associations of ambient PM exposure with reduced forced vital capacity (FVC) and increased forced expiratory volume in 1 s/forced vital capacity ratio (FEV1/FVC) among men and lower levels of FEV1 and FVC among women, such that a 5-μg/m3 concentration increase in PM1, PM2.5, and PM10 was associated with decreases in FVC of 122.1 ml (95% confidence interval (CI): 30.8, 213.4), 54.6 ml (95% CI: 15.8, 93.3) and 42.9 ml (95% CI: 12.7, 73.1) and increases in FEV1/FVC of 2.2% (95% CI: 0.6, 3.9), 1.1% (95% CI: 0.4, 1.9) and 0.9% (95% CI: 0.3, 1.5) among men and decreases in FEV1 of 51.1 ml (95% CI: 9.7, 92.4), 21.6 ml (95% CI: 4.3, 38.9) and 16.7 ml (95% CI: 3.3, 30.1) and in FVC of 77.8 ml (95% CI: 10.0, 145.6), 38.7 ml (95% CI: 9.0, 68.5) and 31.1 ml (95% CI: 8.1, 54.1) among women in Hebei Province. There was no association between ambient PM and pulmonary function in Guangdong Province.ConclusionLong-term exposure to different sizes and concentrations of ambient PM were associated with FEV1 and FVC among men and women differently. The impact of ambient PM on FVC should be of greater concerned.

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How air pollution inhibits economic development: empirical analysis and mechanism verification based on prefecture-level data in China

Hu,

Li,

Long

2024

Environ Dev Sustain

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The mediating role of lung function on air pollution-induced cardiopulmonary mortality in elderly women: The SALIA cohort study with 22-year mortality follow-up

Cited by 7 publications

References 35 publications

Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank

Air pollution, lung function and mortality: survival and mediation analyses in UK Biobank

Association between long-term exposure to ambient particulate matter and pulmonary function among men and women in typical areas of South and North China

How air pollution inhibits economic development: empirical analysis and mechanism verification based on prefecture-level data in China

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