Long-term exposure to air pollution and chronic kidney disease-associated mortality–Results from the pooled cohort of the European multicentre ELAPSE-study

Pauline Kadelbach, Gudrun Weinmayr, Jie Chen, Andrea Jaensch, Sophia Rodopoulou, Maciej Strak, Kees de Hoogh, Zorana J. Andersen, Tom Bellander, Jørgen Brandt, Giulia Cesaroni, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, Klea Katsouyanni, Matthias Ketzel, Karin LeanderPetter Ljungman, Patrik K.E. Magnusson, Göran Pershagen, Debora Rizzuto, Evangelia Samoli, Gianluca Severi, Massimo Stafoggia, Anne Tjønneland, Roel Vermeulen, Annette Peters, Kathrin Wolf, Ole Raaschou-Nielsen, Bert Brunekreef, Gerard Hoek, Emanuel Zitt, Gabriele Nagel

Résultats de recherche: Contribution à un journalArticleRevue par des pairs

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Résumé

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.

langue originaleAnglais
Numéro d'article118942
journalEnvironmental Research
Volume252
Les DOIs
étatPublié - 1 juil. 2024
Modification externeOui

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