Air pollution and human health: a phenome-wide association study

BMJ Open. 2024 Feb 29;14(2):e081351. doi: 10.1136/bmjopen-2023-081351.

Abstract

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 (PM2.5) and nitrogen dioxide (NO2) 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, PM2.5 and NO2 were strongest positively associated with chronic obstructive pulmonary disease (PM2.5: HR 1.06 (95% CI 1.05 to 1.07) per 1 IQR increase in exposure level; NO2: 1.14 (95% CI 1.12 to 1.15)), type 2 diabetes (PM2.5: 1.06 (95% CI 1.05 to 1.06); NO2: 1.12 (95% CI 1.10 to 1.13)) and ischaemic heart disease (PM2.5: 1.05 (95% CI 1.04 to 1.05); NO2: 1.11 (95% CI 1.09 to 1.12)). Furthermore, PM2.5 and NO2 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.

Keywords: EPIDEMIOLOGY; Observational Study; PUBLIC HEALTH; REGISTRIES.

MeSH terms

  • Air Pollutants* / adverse effects
  • Air Pollutants* / analysis
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Diabetes Mellitus, Type 2*
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Humans
  • Nitrogen Dioxide / adverse effects
  • Nitrogen Dioxide / analysis
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Prospective Studies

Substances

  • Air Pollutants
  • Nitrogen Dioxide
  • Particulate Matter