Search

Background: Air pollution is a known risk factor for cardiovascular and respiratory diseases and mortality. Less is known about how air pollution acts to increase cardiovascular risk. Many intermediate clinical conditions, such as chronic inflammation, Type 2 Diabetes Mellitus (T2DM), and anaemia are known to increase cardiovascular risk. I investigate whether air pollution is associated with these intermediate conditions. Methods: I used liner, logistic and Poisson regression models to evaluate associations between ambient air pollution (particulate matter and nitrogen dioxide) and Chronic Obstructive Pulmonary Disease (COPD), Type 2 Diabetes Mellitus (T2DM), anaemia and systemic inflammation and Cardiovascular Disease (CVD) risk in older Chinese. The associations for the outcomes in Chinese adults were examined using data sourced from World Health Organization (WHO) Study on global AGEing and adult health (SAGE) China. The average community exposure to ambient air pollutants (PM with an aerodynamic diameter of 10 μm or less (PM10), 2.5 μm or less (PM2.5), 1 μm or less (PM1) and nitrogen dioxide (NO2)) for each participant was estimated using a satellite-based spatial statistical model. Statistical models were adjusted for several demographics, socioeconomic, behavioural and health variables. For the review chapter, we qualitatively analysed the existing studies reporting long-term associations of particulate matter with important inflammation and markers (TNF-α, IL-6, IL-8). We reviewed relevant studies published up to November 2019. Results: I observed increased exposure to air pollution to be significantly associated with increased prevalence of COPD and reduction in lung functions measures. Elevated particulate matter and nitrogen dioxide exposures were also found to be associated with increased prevalence of T2DM, anaemia, and risk of CVD as well as increased glycosylated haemoglobin, C reactive protein and decreased haemoglobin levels. Conclusions: Air pollution was found to be significantly associated with increased rates of COPD, T2DM, systemic inflammation and anaemia in older Chinese. If causal, long term air pollution exposure may increase cardiovascular risk partially by increasing the risk of these clinical intermediate conditions.