Does residential exposure to air pollutants influence mortality and cardiovascular morbidity of older people from primary care?

Diseases affecting the cardiovascular system are the most common cause of death worldwide. In addition to classical risk factors of atherosclerosis, long-term exposure to particulate matter with particles of size up to 10 µm (PM10) in the atmosphere has become an increasing focus of scientific atten...

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Bibliographic Details
Published in:	BMC public health Vol. 23; no. 1; p. 1281
Main Authors:	D'Acquisto, Maurizio Pietro, Krause, Dietmar, Klaassen-Mielke, Renate, Trampisch, Matthias, Trampisch, Hans Joachim, Trampisch, Ulrike, Rudolf, Henrik
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 03-07-2023 BioMed Central BMC
Subjects:	Aged Aged patients Air Pollutants - adverse effects Air Pollutants - analysis Air pollution Air Pollution - adverse effects Air Pollution - analysis Cardiovascular Diseases Care and treatment Environmental aspects Environmental Exposure - adverse effects Environmental Exposure - analysis Health aspects Humans Mortality Nitrogen dioxide Nitrogen Dioxide - adverse effects Nitrogen Dioxide - analysis Older people Particulate matter Particulate Matter - adverse effects Particulate Matter - analysis Peripheral artery disease Prevention Primary Health Care Prospective Studies Risk factors Services Germany Peripheral artery disease Air pollution Nitrogen dioxide Mortality Older people Particulate matter
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Summary:	Diseases affecting the cardiovascular system are the most common cause of death worldwide. In addition to classical risk factors of atherosclerosis, long-term exposure to particulate matter with particles of size up to 10 µm (PM10) in the atmosphere has become an increasing focus of scientific attention in recent decades. This study analyses the associations of residential-associated air pollutants exposure with all-cause mortality and cardiovascular morbidity of older patients in a primary care setting. The "German Epidemiological Trial on Ankle Brachial Index" (getABI) is a prospective cohort study that started in 2001 and included 6,880 primary care patients with a follow-up of 7 years. The PM10 and nitrogen dioxide (NO ) concentrations in the atmosphere are interpolated values from the study "Mapping of background air pollution at a fine spatial scale across the European Union". The primary outcome in this analysis is death of any cause, a secondary outcome is onset of PAD. Cox proportional hazards regression was used in a two-step modelling, the first step with basic adjustment only for age, sex, and one or more air pollutants, the second with additional risk factors. A total of 6,819 getABI patients were included in this analysis. 1,243 of them died during the study period. The hazard ratio (HR) (1.218, 95%-confidence-interval (CI) 0.949-1.562) for the risk of death from any cause was elevated by 22% per 10 µg/m increase of PM10 in the fully adjusted model, although not statistically significant. Increased PM10 exposure in combination with the presence of PAD had a significantly increased risk (HR = 1.560, 95%-CI: 1.059-2.298) for this endpoint in the basic adjustment, but not in the fully adjusted model. 736 patients developed peripheral artery disease (PAD) during the course of the study. There was no association of air pollutants and the onset of PAD. Our analysis renders some hints for the impact of air pollutants (PM10, NO , and proximity to major road) on mortality. Interaction of PAD with PM10 was found. There was no association of air pollutants and the onset of PAD. German Clinical Trials Register: DRKS00029733 (19/09/2022).
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1471-2458 1471-2458
DOI:	10.1186/s12889-023-16166-w