TY - JOUR
T1 - Long-term exposure to air pollution and chronic kidney disease-associated mortality–Results from the pooled cohort of the European multicentre ELAPSE-study
AU - Kadelbach, Pauline
AU - Weinmayr, Gudrun
AU - Chen, Jie
AU - Jaensch, Andrea
AU - Rodopoulou, Sophia
AU - Strak, Maciej
AU - de Hoogh, Kees
AU - Andersen, Zorana J.
AU - Bellander, Tom
AU - Brandt, Jørgen
AU - Cesaroni, Giulia
AU - Fecht, Daniela
AU - Forastiere, Francesco
AU - Gulliver, John
AU - Hertel, Ole
AU - Hoffmann, Barbara
AU - Hvidtfeldt, Ulla Arthur
AU - Katsouyanni, Klea
AU - Ketzel, Matthias
AU - Leander, Karin
AU - Ljungman, Petter
AU - Magnusson, Patrik K.E.
AU - Pershagen, Göran
AU - Rizzuto, Debora
AU - Samoli, Evangelia
AU - Severi, Gianluca
AU - Stafoggia, Massimo
AU - Tjønneland, Anne
AU - Vermeulen, Roel
AU - Peters, Annette
AU - Wolf, Kathrin
AU - Raaschou-Nielsen, Ole
AU - Brunekreef, Bert
AU - Hoek, Gerard
AU - Zitt, Emanuel
AU - Nagel, Gabriele
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/7/1
Y1 - 2024/7/1
N2 - Despite the known link between air pollution and cause-specific mortality, its relation to chronic kidney disease (CKD)-associated mortality is understudied. Therefore, we investigated the association between long-term exposure to air pollution and CKD-related mortality in a large multicentre population-based European cohort. Cohort data were linked to local mortality registry data. CKD-death was defined as ICD10 codes N18–N19 or corresponding ICD9 codes. Mean annual exposure at participant's home address was determined with fine spatial resolution exposure models for nitrogen dioxide (NO2), black carbon (BC), ozone (O3), particulate matter ≤2.5 μm (PM2.5) and several elemental constituents of PM2.5. Cox regression models were adjusted for age, sex, cohort, calendar year of recruitment, smoking status, marital status, employment status and neighbourhood mean income. Over a mean follow-up time of 20.4 years, 313 of 289,564 persons died from CKD. Associations were positive for PM2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03–1.66) per 5 μg/m3, BC (1.26 (1.03–1.53) per 0.5 × 10− 5/m), NO2 (1.13 (0.93–1.38) per 10 μg/m3) and inverse for O3 (0.71 (0.54–0.93) per 10 μg/m3). Results were robust to further covariate adjustment. Exclusion of the largest sub-cohort contributing 226 cases, led to null associations. Among the elemental constituents, Cu, Fe, K, Ni, S and Zn, representing different sources including traffic, biomass and oil burning and secondary pollutants, were associated with CKD-related mortality. In conclusion, our results suggest an association between air pollution from different sources and CKD-related mortality.
AB - Despite the known link between air pollution and cause-specific mortality, its relation to chronic kidney disease (CKD)-associated mortality is understudied. Therefore, we investigated the association between long-term exposure to air pollution and CKD-related mortality in a large multicentre population-based European cohort. Cohort data were linked to local mortality registry data. CKD-death was defined as ICD10 codes N18–N19 or corresponding ICD9 codes. Mean annual exposure at participant's home address was determined with fine spatial resolution exposure models for nitrogen dioxide (NO2), black carbon (BC), ozone (O3), particulate matter ≤2.5 μm (PM2.5) and several elemental constituents of PM2.5. Cox regression models were adjusted for age, sex, cohort, calendar year of recruitment, smoking status, marital status, employment status and neighbourhood mean income. Over a mean follow-up time of 20.4 years, 313 of 289,564 persons died from CKD. Associations were positive for PM2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03–1.66) per 5 μg/m3, BC (1.26 (1.03–1.53) per 0.5 × 10− 5/m), NO2 (1.13 (0.93–1.38) per 10 μg/m3) and inverse for O3 (0.71 (0.54–0.93) per 10 μg/m3). Results were robust to further covariate adjustment. Exclusion of the largest sub-cohort contributing 226 cases, led to null associations. Among the elemental constituents, Cu, Fe, K, Ni, S and Zn, representing different sources including traffic, biomass and oil burning and secondary pollutants, were associated with CKD-related mortality. In conclusion, our results suggest an association between air pollution from different sources and CKD-related mortality.
KW - Air pollution
KW - Chronic kidney disease
KW - Long-term exposure
KW - Mortality
KW - PM
KW - Particulate matter constituents
UR - http://www.scopus.com/inward/record.url?scp=85192278468&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2024.118942
DO - 10.1016/j.envres.2024.118942
M3 - Article
C2 - 38649012
AN - SCOPUS:85192278468
SN - 0013-9351
VL - 252
JO - Environmental Research
JF - Environmental Research
M1 - 118942
ER -