Associations between long-term exposure to low-level air pollution and risk of chronic kidney disease—findings from the Malmö Diet and Cancer cohort

• Background: Associations between air pollution and chronic kidney disease (CKD) have been reported, but studies at low exposure levels and relevant exposure time windows are still warranted. This study investigated clinical CKD at low air pollution levels in the Swedish Malmö Diet and Cancer Cohort in different exposure time windows. Methods: This study included 30,396 individuals, aged 45–74 at enrollment 1991–1996. Individual annual average residential outdoor PM2.5, PM10, nitrogen oxides (NOx), and black carbon (BC) were assigned using dispersion models from enrollment to 2016. Diagnoses of incident CKD were retrieved from national registries. Cox proportional hazards models were used to obtain hazard ratios (HRs) for CKD in relation to three time-dependent exposure time windows: exposure at concurrent year (lag 0), mean exposure in the 1–5 or 6–10 preceding years (lag 1–5 and lag 6–10), and baseline exposure. Results: During the study period, the average annual residential exposures were 16 μg/m3 for PM10, 11 μg/m3 for PM2.5, 26 μg/m3 for NOx, and 0.97 μg/m3 for BC. For lag 1–5 and lag 6–10 exposure, significantly elevated HRs for incident CKD were found for total PM10:1.13 (95% CI: 1.01–1.26) and 1.22 (1.06–1.41); NOx: 1.19 (1.07–1.33) and 1.13 (1.02–1.25) and BC: 1.12 (1.03–1.22) and 1.11 (1.02–1.21) per interquartile range increase in exposure. For total PM2.5 the positive associations of 1.12 (0.97–1.31) and 1.16 (0.98–1.36) were not significant. For baseline or lag 0 exposure there were significant associations only for NOx and BC, not for PM. Conclusion: Residential exposure to outdoor air pollution was associated with increased risk of incident CKD at relatively low exposure levels. Average long-term exposure was more clearly associated with CKD than current exposure or exposure at recruitment. Our findings imply that the health effects of low-level air pollution on CKD are considerable. © 2022

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

Nyckelord

Air pollution

Chronic kidney disease

Hazard ratio

Diagnosis

Diseases

Hazards

Housing

Land use

Black carbon

Exposure level

Exposure-time

Long term exposure

PM 10

PM 2.5

Pollution level

Time windows

Nitrogen oxides

nitrogen oxide

atmospheric pollution

cancer

cohort analysis

concentration (composition)

health risk

particulate matter

pollution exposure

adult

aged

alcohol consumption

Article

chronic kidney failure

controlled study

correlation analysis

diabetes mellitus

disease registry

dispersion

environmental exposure

female

human

hypertension

major clinical study

male

middle aged

morbidity

particulate matter 10

particulate matter 2.5

physical activity

pollutant

proportional hazards model

risk factor

smoking

Sweden

time factor

Air pollution

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)