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      Associations between Long-Term Air Pollutant Exposures and Blood Pressure in Elderly Residents of Taipei City: A Cross-Sectional Study

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          Abstract

          Background

          Limited information is available regarding long-term effects of air pollution on blood pressure (BP) and hypertension.

          Objective

          We studied whether 1-year exposures to particulate matter (PM) and nitrogen oxides (NO x) were correlated with BP and hypertension in the elderly.

          Methods

          We analyzed cross-sectional data from 27,752 Taipei City residents > 65 years of age who participated in a health examination program in 2009. Land-use regression models were used to estimate participants’ 1-year exposures to particulate matter with aerodynamic diameter ≤ 10 μm (PM 10), coarse particles (PM 2.5–10), fine particles (≤ 2.5 μm; PM 2.5), PM 2.5 absorbance, NO x, and nitrogen dioxide (NO 2). Generalized linear regressions and logistic regressions were used to examine the association between air pollution and BP and hypertension, respectively.

          Results

          Diastolic BP was associated with 1-year exposures to air pollution, with estimates of 0.73 [95% confidence interval (CI): 0.44, 1.03], 0.46 (95% CI: 0.30, 0.63), 0.62 (95% CI: 0.24, 0.99), 0.34 (95% CI: 0.19, 0.50), and 0.65 (95% CI: 0.44, 0.85) mmHg for PM 10 (10 μg/m 3), PM 2.5–10 (5 μg/m 3), PM 2.5 absorbance (10 –5/m), NO x (20 μg/m 3), and NO 2 (10 μg/m 3), respectively. PM 2.5 was not associated with diastolic BP, and none of the air pollutants was associated with systolic BP. Associations of diastolic BP with PM 10 and PM 2.5 absorbance were stronger among participants with hypertension, diabetes, or a body mass index ≥ 25 kg/m 2 than among participants without these conditions. One-year air pollution exposures were not associated with hypertension.

          Conclusions

          One-year exposures to PM 10, PM 2.5–10, PM 2.5 absorbance, and NO x were associated with higher diastolic BP in elderly residents of Taipei.

          Citation

          Chen SY, Wu CF, Lee JH, Hoffmann B, Peters A, Brunekreef B, Chu DC, Chan CC. 2015. Associations between long-term air pollutant exposures and blood pressure in elderly residents of Taipei City: a cross-sectional study. Environ Health Perspect 123:779–784; http://dx.doi.org/10.1289/ehp.1408771

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          Development of Land Use Regression models for PM(2.5), PM(2.5) absorbance, PM(10) and PM(coarse) in 20 European study areas; results of the ESCAPE project.

          Marloes Eeftens, Rob Beelen, Kees de Hoogh … (2012)
          Land Use Regression (LUR) models have been used increasingly for modeling small-scale spatial variation in air pollution concentrations and estimating individual exposure for participants of cohort studies. Within the ESCAPE project, concentrations of PM(2.5), PM(2.5) absorbance, PM(10), and PM(coarse) were measured in 20 European study areas at 20 sites per area. GIS-derived predictor variables (e.g., traffic intensity, population, and land-use) were evaluated to model spatial variation of annual average concentrations for each study area. The median model explained variance (R(2)) was 71% for PM(2.5) (range across study areas 35-94%). Model R(2) was higher for PM(2.5) absorbance (median 89%, range 56-97%) and lower for PM(coarse) (median 68%, range 32- 81%). Models included between two and five predictor variables, with various traffic indicators as the most common predictors. Lower R(2) was related to small concentration variability or limited availability of predictor variables, especially traffic intensity. Cross validation R(2) results were on average 8-11% lower than model R(2). Careful selection of monitoring sites, examination of influential observations and skewed variable distributions were essential for developing stable LUR models. The final LUR models are used to estimate air pollution concentrations at the home addresses of participants in the health studies involved in ESCAPE.
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            Diabetes, Obesity, and Hypertension May Enhance Associations between Air Pollution and Markers of Systemic Inflammation

            Sara D. Dubowsky, Helen Suh, Joel Schwartz … (2006)
            Airborne particulate matter (PM) may lead to increased cardiac risk through an inflammatory pathway. Therefore, we investigated associations between ambient PM and markers of systemic inflammation among repeated measures from 44 senior citizens (≥ 60 years of age) and examined susceptibility by conditions linked to chronic inflammation. Mixed models were used to identify associations between concentrations of fine PM [aerodynamic diameter ≤ 2.5 μm (PM2.5)] averaged over 1–7 days and measures of C-reactive protein (CRP), interleukin-6 (IL-6), and white blood cells (WBCs). Effect modification was investigated for diabetes, obesity, hypertension, and elevated mean inflammatory markers. We found positive associations between longer moving averages of PM2.5 and WBCs across all participants, with a 5.5% [95% confidence interval (CI), 0.10 to 11%] increase per interquartile increase (5.4 μg/m3) of PM2.5 averaged over the previous week. PM2.5 and CRP also exhibited positive associations among all individuals for averages longer than 1 day, with the largest associations for persons with diabetes, obesity, and hypertension. For example, an interquartile increase in the 5-day mean PM2.5 (6.1 μg/m3) was associated with a 14% increase in CRP (95% CI, −5.4 to 37%) for all individuals and an 81% (95% CI, 21 to 172%) increase for persons with diabetes, obesity, and hypertension. Persons with diabetes, obesity, and hypertension also exhibited positive associations between PM2.5 and IL-6. Individuals with elevated mean inflammatory markers exhibited enhanced associations with CRP, IL-6, and WBCs. We found modest positive associations between PM2.5 and indicators of systemic inflammation, with larger associations suggested for individuals with diabetes, obesity, hypertension, and elevated mean inflammatory markers.
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              Long-term air pollution exposure and risk factors for cardiovascular diseases among the elderly in Taiwan.

              Jen-Hsiang Chuang, Yuan Yan, Shu-Jun Chiu … (2010)
              To investigate changes in blood pressure, blood lipids, blood sugar and haematological markers of inflammation associated with changes in long-term exposure to ambient air pollutants. We conducted secondary analyses of data on blood pressure and blood biochemistry markers from the Social Environment and Biomarkers of Aging Study in Taiwan and air pollution data from the Taiwan Environmental Protection Administration in 2000. Associations of 1-year averaged criteria air pollutants (particulate matter with aerodynamic diameters <10 μm (PM(10)) and <2.5 μm (PM(2.5)), ozone (O(3)), nitrogen dioxide (NO(2)), sulfur dioxide and carbon monoxide) with systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, high-density lipoprotein cholesterol, fasting glucose, haemoglobin A1c (HbA1c), interleukin 6 (IL-6) and neutrophils were explored by applying generalised additive models. After controlling for potential confounders, we observed that increased 1-year averaged particulate air pollutants (PM(10) and PM(2.5)) and NO(2) were associated with elevated blood pressure, total cholesterol, fasting glucose, HbA1c, IL-6 and neutrophils. Associations of increased 1-year averaged O(3) with elevated blood pressure, total cholesterol, fasting glucose, HbA1c and neutrophils were also observed. In particular, our two-pollutant models showed that PM(2.5) was more significantly associated with end-point variables than two gaseous pollutants, O(3) and NO(2). Changes in blood pressure, blood lipids, blood sugar and haematological markers of inflammation are associated with long-term exposure to ambient air pollutants. This might provide a link between air pollution and atherosclerotic cardiovascular diseases.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Environ Health Perspect
                Journal ID (iso-abbrev): Environ. Health Perspect
                Journal ID (publisher-id): EHP
                Title: Environmental Health Perspectives
                Publisher: NLM-Export
                ISSN (Print): 0091-6765
                ISSN (Electronic): 1552-9924
                Publication date (Electronic): 20 March 2015
                Publication date (Print): August 2015
                Volume: 123
                Issue: 8
                Pages: 779-784
                Affiliations
                [1 ]Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
                [2 ]Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, Kaohsiung, Taiwan
                [3 ]IUF-Leibniz Research Institute for Environmental Medicine and Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
                [4 ]Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
                [5 ]Institute for Risk Assessment Sciences, University of Utrecht, Utrecht, the Netherlands
                [6 ]Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
                Author notes
                Address correspondence to C.-C. Chan, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Rm. 722, No. 17, Xu-Zhou Rd., Taipei, 10020 Taiwan. Telephone: 886-2-3366-8082. E-mail: ccchan@ 123456ntu.edu.tw
                Article
                Publisher ID: ehp.1408771
                DOI: 10.1289/ehp.1408771
                PMC ID: 4529013
                PubMed ID: 25793646
                SO-VID: d5bc3cc5-43f4-4dab-acd8-1065f4559524
                License:

                Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, “Reproduced with permission from Environmental Health Perspectives”); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright.

                History
                Date received : 03 June 2014
                Date accepted : 17 March 2015
                Date: 20 March 2015
                Date: 01 August 2015
                Categories
                Subject: Research

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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