Ambient particulate matter associates with asthma in high altitude region: A population-based study

ZhenZhen Xing; Ting Yang; Su Shi; Xia Meng; Renjie Chen; Huanyu Long; Yanlu Hu; Di Chai; WeiMing Liu; YaQi Tong; YuXia Wang; YaLi Ma; MingMing Pan; Jia Cui; TieYing Sun; YanFei Guo

doi:10.1016/j.waojou.2023.100774

Ambient particulate matter associates with asthma in high altitude region: A population-based study

World Allergy Organ J. 2023 May 5;16(5):100774. doi: 10.1016/j.waojou.2023.100774. eCollection 2023 May.

Authors

ZhenZhen Xing^{1

2}, Ting Yang^{3

4

5

6}, Su Shi⁷, Xia Meng⁷, Renjie Chen⁷, Huanyu Long^{1

2}, Yanlu Hu^{1

2}, Di Chai^{1

2}, WeiMing Liu⁸, YaQi Tong^{1

2}, YuXia Wang^{1

2}, YaLi Ma^{1

2}, MingMing Pan^{1

2}, Jia Cui^{1

2}, TieYing Sun^{1

2}, YanFei Guo^{1

2}

Affiliations

¹ Peking University Fifth School of Clinical Medicine, Beijing, China.
² Department of Respiratory and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
³ Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, China.
⁴ National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, China.
⁵ Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, China.
⁶ Department of Respiratory Medicine, Capital Medical University, Beijing, China.
⁷ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
⁸ Department of Intensive Care Medicine, Beijing Boai Hospital, Rehabilitation Research Center, Beijing, China.

Abstract

Background: Exposure to particulate matter (PM) has been a major public health threat, but the potentially differential effects on asthma of PM remain largely unknown in high altitude settings. We evaluated the effects of ambient PM on asthma in high altitude settings.

Methods: The study recruited a representative sample from high altitude settings using a multistage stratified sampling procedure. Asthma was defined by a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. The annual mean PM_2.5 and PM₁₀ concentrations were calculated for each grid cell at 1-km spatial resolution based on the geographical coordinates.

Results: We analyzed data for participants (mean age 39.1 years, 51.4% female) and 183 (3.7%, 95% confidence interval (CI): 3.2-4.2) of the participants had asthma. Prevalence was higher in women (4.3%, 95% CI 3.5-5.1) than in men (3.1%, 2.4-3.8) and increasing with higher concentration of PM exposures. For an interquartile range (IQR) difference (8.77 μg/m³) in PM_2.5 exposure, the adjusted odds ratio (OR) was 1.64 (95% CI 1.46-1.83, P < 0.001) for risk of asthma. For PM₁₀, there was evidence for an association with risk of asthma (OR 2.34, 95% CI: 1.75-3.15, P < 0.001 per IQR of 43.26 μg/m³). Further analyses showed that household mold or damp exposure may aggravate PM exposure associated risks of asthma.

Conclusions: This study identified that PM exposure could be a dominate environmental risk factor for asthma but largely unconsidered in the high-altitude areas. The association between PM exposure and asthma should be of interest for planners of national policies and encourage programs for prevention of asthma in residents living at high altitudes.

Keywords: Air pollution; Asthma; High altitude; Low- and middle-income region; Particulate matter.