TY - JOUR

T1 - Air pollution and human health

T2 - a phenome-wide association study

AU - Hegelund, Emilie Rune

AU - Mehta, Amar J

AU - Andersen, Zorana J

AU - Lim, Youn-Hee

AU - Loft, Steffen

AU - Brunekreef, Bert

AU - Hoek, Gerard

AU - de Hoogh, Kees

AU - Mortensen, Laust Hvas

N1 - © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2024

Y1 - 2024

N2 - OBJECTIVES: To explore the associations of long-term exposure to air pollution with onset of all human health conditions.DESIGN: Prospective phenome-wide association study.SETTING: Denmark.PARTICIPANTS: All Danish residents aged ≥30 years on 1 January 2000 were included (N=3 323 612). After exclusion of individuals with missing geocoded residential addresses, 3 111 988 participants were available for the statistical analyses.MAIN OUTCOME MEASURE: First registered diagnosis of every health condition according to the International Classification of Diseases, 10th revision, from 2000 to 2017.RESULTS: Long-term exposure to fine particulate matter (PM 2.5) and nitrogen dioxide (NO 2) were both positively associated with the onset of more than 700 health conditions (ie, >80% of the registered health conditions) after correction for multiple testing, while the remaining associations were inverse or insignificant. As regards the most common health conditions, PM 2.5 and NO 2 were strongest positively associated with chronic obstructive pulmonary disease (PM 2.5: HR 1.06 (95% CI 1.05 to 1.07) per 1 IQR increase in exposure level; NO 2: 1.14 (95% CI 1.12 to 1.15)), type 2 diabetes (PM 2.5: 1.06 (95% CI 1.05 to 1.06); NO 2: 1.12 (95% CI 1.10 to 1.13)) and ischaemic heart disease (PM 2.5: 1.05 (95% CI 1.04 to 1.05); NO 2: 1.11 (95% CI 1.09 to 1.12)). Furthermore, PM 2.5 and NO 2 were both positively associated with so far unexplored, but highly prevalent outcomes relevant to public health, including senile cataract, hearing loss and urinary tract infection. CONCLUSIONS: The findings of this study suggest that air pollution has a more extensive impact on human health than previously known. However, as this study is the first of its kind to investigate the associations of long-term exposure to air pollution with onset of all human health conditions, further research is needed to replicate the study findings.

AB - OBJECTIVES: To explore the associations of long-term exposure to air pollution with onset of all human health conditions.DESIGN: Prospective phenome-wide association study.SETTING: Denmark.PARTICIPANTS: All Danish residents aged ≥30 years on 1 January 2000 were included (N=3 323 612). After exclusion of individuals with missing geocoded residential addresses, 3 111 988 participants were available for the statistical analyses.MAIN OUTCOME MEASURE: First registered diagnosis of every health condition according to the International Classification of Diseases, 10th revision, from 2000 to 2017.RESULTS: Long-term exposure to fine particulate matter (PM 2.5) and nitrogen dioxide (NO 2) were both positively associated with the onset of more than 700 health conditions (ie, >80% of the registered health conditions) after correction for multiple testing, while the remaining associations were inverse or insignificant. As regards the most common health conditions, PM 2.5 and NO 2 were strongest positively associated with chronic obstructive pulmonary disease (PM 2.5: HR 1.06 (95% CI 1.05 to 1.07) per 1 IQR increase in exposure level; NO 2: 1.14 (95% CI 1.12 to 1.15)), type 2 diabetes (PM 2.5: 1.06 (95% CI 1.05 to 1.06); NO 2: 1.12 (95% CI 1.10 to 1.13)) and ischaemic heart disease (PM 2.5: 1.05 (95% CI 1.04 to 1.05); NO 2: 1.11 (95% CI 1.09 to 1.12)). Furthermore, PM 2.5 and NO 2 were both positively associated with so far unexplored, but highly prevalent outcomes relevant to public health, including senile cataract, hearing loss and urinary tract infection. CONCLUSIONS: The findings of this study suggest that air pollution has a more extensive impact on human health than previously known. However, as this study is the first of its kind to investigate the associations of long-term exposure to air pollution with onset of all human health conditions, further research is needed to replicate the study findings.

KW - Humans

KW - Air Pollutants/adverse effects

KW - Prospective Studies

KW - Diabetes Mellitus, Type 2

KW - Nitrogen Dioxide/adverse effects

KW - Environmental Exposure/adverse effects

KW - Air Pollution/adverse effects

KW - Particulate Matter/adverse effects

U2 - 10.1136/bmjopen-2023-081351

DO - 10.1136/bmjopen-2023-081351

M3 - Journal article

C2 - 38423777

VL - 14

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 2

M1 - e081351

ER -