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 Dipl-Dok; Sophia Rodopoulou; Maciej Strak; Kees de Hoogh; Zorana J Andersen; Tom Bellander; Jørgen Brandt; Giulia Cesaroni; Daniela Fecht; Prof Francesco Forastiere; Prof John Gulliver; Ole Hertel; Barbara Hoffmann; Ulla Arthur Hvidtfeldt; Prof Klea Katsouyanni; Matthias Ketzel; Karin Leander; Petter Ljungman; Patrik K E Magnusson; Göran Pershagen; Debora Rizzuto; Evangelia Samoli; Gianluca Severi; Massimo Stafoggia; Prof Anne Tjønneland; Roel Vermeulen; Annette Peters; Kathrin Wolf; Prof Ole Raaschou-Nielsen; Bert Brunekreef; Gerard Hoek; Emanuel Zitt; Prof Gabriele Nage

doi:10.1016/j.envres.2024.118942

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

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 (NO 2), black carbon (BC), ozone (O 3), particulate matter ≤2.5μm (PM 2.5) and several elemental constituents of PM 2.5. 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 PM 2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03-1.66) per 5μg/m 3, BC (1.26 (1.03-1.53) per 0.5×10 - 5/m), NO 2 (1.13 (0.93-1.38) per 10μg/m 3) and inverse for O 3 (0.71 (0.54-0.93) per 10μg/m 3). 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.

Original language	English
Article number	118942
Journal	Environmental Research
Volume	252
Issue number	Pt 3
Early online date	20 Apr 2024
DOIs	https://doi.org/10.1016/j.envres.2024.118942
Publication status	Published - 1 Jul 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Funding

the research described in this article was conducted under contract to the Health Effects Institute (HEI), an organisation jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers.

Funders	Funder number
U.S. Environmental Protection Agency	R-82811201
U.S. Environmental Protection Agency

Keywords

Air pollution
Chronic kidney disease
Long-term exposure
Mortality
PM
Particulate matter constituents

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Kadelbach, P., Weinmayr, G., Chen, J., Jaensch Dipl-Dok, A., Rodopoulou, S., Strak, M., de Hoogh, K., Andersen, Z. J., Bellander, T., Brandt, J., Cesaroni, G., Fecht, D., Forastiere, P. F., Gulliver, P. J., Hertel, O., Hoffmann, B., Hvidtfeldt, U. A., Katsouyanni, P. K., Ketzel, M., ... Nage, P. G. (2024). Long-term exposure to air pollution and chronic kidney disease-associated mortality - results from the pooled cohort of the European multicentre ELAPSE-study. Environmental Research, 252(Pt 3), Article 118942. https://doi.org/10.1016/j.envres.2024.118942

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title = "Long-term exposure to air pollution and chronic kidney disease-associated mortality - results from the pooled cohort of the European multicentre ELAPSE-study",

abstract = "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 (NO 2), black carbon (BC), ozone (O 3), particulate matter ≤2.5μm (PM 2.5) and several elemental constituents of PM 2.5. 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 PM 2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03-1.66) per 5μg/m 3, BC (1.26 (1.03-1.53) per 0.5×10 - 5/m), NO 2 (1.13 (0.93-1.38) per 10μg/m 3) and inverse for O 3 (0.71 (0.54-0.93) per 10μg/m 3). 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. ",

keywords = "Air pollution, Chronic kidney disease, Long-term exposure, Mortality, PM, Particulate matter constituents",

author = "Pauline Kadelbach and Gudrun Weinmayr and Jie Chen and {Jaensch Dipl-Dok}, Andrea and Sophia Rodopoulou and Maciej Strak and {de Hoogh}, Kees and Andersen, {Zorana J} and Tom Bellander and J{\o}rgen Brandt and Giulia Cesaroni and Daniela Fecht and Forastiere, {Prof Francesco} and Gulliver, {Prof John} and Ole Hertel and Barbara Hoffmann and Hvidtfeldt, {Ulla Arthur} and Katsouyanni, {Prof Klea} and Matthias Ketzel and Karin Leander and Petter Ljungman and Magnusson, {Patrik K E} and G{\"o}ran Pershagen and Debora Rizzuto and Evangelia Samoli and Gianluca Severi and Massimo Stafoggia and Tj{\o}nneland, {Prof Anne} and Roel Vermeulen and Annette Peters and Kathrin Wolf and Raaschou-Nielsen, {Prof Ole} and Bert Brunekreef and Gerard Hoek and Emanuel Zitt and Nage, {Prof Gabriele}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

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doi = "10.1016/j.envres.2024.118942",

language = "English",

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Kadelbach, P, Weinmayr, G, Chen, J, Jaensch Dipl-Dok, A, Rodopoulou, S, Strak, M, de Hoogh, K, Andersen, ZJ, Bellander, T, Brandt, J, Cesaroni, G, Fecht, D, Forastiere, PF, Gulliver, PJ, Hertel, O, Hoffmann, B, Hvidtfeldt, UA, Katsouyanni, PK, Ketzel, M, Leander, K, Ljungman, P, Magnusson, PKE, Pershagen, G, Rizzuto, D, Samoli, E, Severi, G, Stafoggia, M, Tjønneland, PA, Vermeulen, R, Peters, A, Wolf, K, Raaschou-Nielsen, PO, Brunekreef, B , Hoek, G, Zitt, E & Nage, PG 2024, 'Long-term exposure to air pollution and chronic kidney disease-associated mortality - results from the pooled cohort of the European multicentre ELAPSE-study', Environmental Research, vol. 252, no. Pt 3, 118942. https://doi.org/10.1016/j.envres.2024.118942

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 Dipl-Dok, 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, Prof Francesco

AU - Gulliver, Prof John

AU - Hertel, Ole

AU - Hoffmann, Barbara

AU - Hvidtfeldt, Ulla Arthur

AU - Katsouyanni, Prof 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, Prof Anne

AU - Vermeulen, Roel

AU - Peters, Annette

AU - Wolf, Kathrin

AU - Raaschou-Nielsen, Prof Ole

AU - Brunekreef, Bert

AU - Hoek, Gerard

AU - Zitt, Emanuel

AU - Nage, Prof Gabriele

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 (NO 2), black carbon (BC), ozone (O 3), particulate matter ≤2.5μm (PM 2.5) and several elemental constituents of PM 2.5. 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 PM 2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03-1.66) per 5μg/m 3, BC (1.26 (1.03-1.53) per 0.5×10 - 5/m), NO 2 (1.13 (0.93-1.38) per 10μg/m 3) and inverse for O 3 (0.71 (0.54-0.93) per 10μg/m 3). 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 (NO 2), black carbon (BC), ozone (O 3), particulate matter ≤2.5μm (PM 2.5) and several elemental constituents of PM 2.5. 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 PM 2.5 (hazard ratio (HR) with 95% confidence interval (CI) of 1.31 (1.03-1.66) per 5μg/m 3, BC (1.26 (1.03-1.53) per 0.5×10 - 5/m), NO 2 (1.13 (0.93-1.38) per 10μg/m 3) and inverse for O 3 (0.71 (0.54-0.93) per 10μg/m 3). 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

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U2 - 10.1016/j.envres.2024.118942

DO - 10.1016/j.envres.2024.118942

M3 - Article

C2 - 38649012

SN - 0013-9351

VL - 252

JO - Environmental Research

JF - Environmental Research

IS - Pt 3

M1 - 118942

ER -

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

Abstract

Bibliographical note

Funding

Keywords

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