Ambient air pollution, lifestyle, and genetic predisposition on all-cause and cause-specific mortality: A prospective cohort study

Yiqun Zhu; Yao Wu; Jun Cheng; Huaying Liang; Qinyu Chang; Fengyu Lin; Dianwu Li; Xin Zhou; Xiang Chen; Pinhua Pan; Hong Liu; Yuming Guo; Yan Zhang

doi:10.1016/j.scitotenv.2024.173120

Ambient air pollution, lifestyle, and genetic predisposition on all-cause and cause-specific mortality: A prospective cohort study

Sci Total Environ. 2024 Jul 10:933:173120. doi: 10.1016/j.scitotenv.2024.173120. Epub 2024 May 14.

Authors

Yiqun Zhu¹, Yao Wu², Jun Cheng³, Huaying Liang¹, Qinyu Chang¹, Fengyu Lin¹, Dianwu Li¹, Xin Zhou⁴, Xiang Chen⁵, Pinhua Pan⁶, Hong Liu⁷, Yuming Guo², Yan Zhang⁸

Affiliations

¹ Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China; Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha 410008, Hunan, China.
² School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
⁴ Department of Dermatology, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China.
⁵ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Dermatology, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008, Hunan, China.
⁶ Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China; Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008, Hunan, China.
⁷ Department of Dermatology, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008, Hunan, China.
⁸ Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China; Center of Respiratory Medicine, Xiangya Hospital of Central South University, Changsha 410008, Hunan, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha 410008, Hunan, China. Electronic address: zhangy4290@csu.edu.cn.

PMID: 38750765
DOI: 10.1016/j.scitotenv.2024.173120

Abstract

Background: Although it is widely acknowledged that long-term exposure to ambient air pollution is closely related to the risk of mortality, there were inconsistencies in terms of cause-specific mortality and it is still unknown whether lifestyle and genetic susceptibility could modify the association.

Methods: This population-based prospective cohort study involved 461,112 participants from the UK Biobank. The land-use regression model was used to estimate the concentrations of particulate matter (PM_2.5, PM_coarse, PM₁₀), and nitrogen oxides (NO₂ and NO_x). The association between air pollution and mortality was evaluated using Cox proportional hazard models. Furthermore, a lifestyle score incorporated with smoking status, physical activity, alcohol consumption, and diet behaviors, and polygenic risk score using 12 genetic variants, were developed to assess the modifying effect of air pollution on mortality outcomes.

Results: During a median follow-up of 14.0 years, 33,903 deaths were recorded, including 17,083 (2835; 14,248), 6970, 2429, and 1287 deaths due to cancer (lung cancer, non-lung cancer), cardiovascular disease (CVD), respiratory and digestive disease, respectively. Each interquartile range (IQR) increase in PM_2.5, NO₂ and NO_x was associated with 7 %, 6 % and 5 % higher risk of all-cause mortality, respectively. Specifically, for cause-specific mortality, each IQR increase in PM_2.5, NO₂ and NO_x was also linked to mortality due to cancer (lung cancer and non-lung cancer), CVD, respiratory and digestive disease. Furthermore, additive and multiplicative interactions were identified between high ambient air pollution and unhealthy lifestyle on mortality. In addition, associations between air pollution and mortality were modified by lifestyle behaviors.

Conclusion: Long-term exposure to air pollutants increased the risk of all-cause and cause-specific mortality, which was modified by lifestyle behaviors. In addition, we also revealed a synergistically detrimental effect between air pollution and an unhealthy lifestyle, suggesting the significance of joint air pollution management and adherence to a healthy lifestyle on public health.

Keywords: Air pollution; Genetic factors; Lifestyle; Mortality.

MeSH terms

Adult
Aged
Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / statistics & numerical data
Cardiovascular Diseases / mortality
Cause of Death
Environmental Exposure / statistics & numerical data
Female
Genetic Predisposition to Disease*
Humans
Life Style*
Male
Middle Aged
Neoplasms / mortality
Nitrogen Oxides / analysis
Particulate Matter*
Prospective Studies
United Kingdom / epidemiology

Substances

Particulate Matter
Air Pollutants
Nitrogen Oxides