Associations of long-term exposure to ambient fine particulate matter and nitrogen dioxide with lung function: A cross-sectional study in China

Dongni Hou; Yihui Ge; Cuicui Chen; Qiang Tan; Renjie Chen; Yanjie Yang; Li Li; Jian Wang; Maosong Ye; Chun Li; Xia Meng; Haidong Kan; Jing Cai; Yuanlin Song

doi:10.1016/j.envint.2020.105977

Associations of long-term exposure to ambient fine particulate matter and nitrogen dioxide with lung function: A cross-sectional study in China

Environ Int. 2020 Nov:144:105977. doi: 10.1016/j.envint.2020.105977. Epub 2020 Aug 3.

Authors

Dongni Hou¹, Yihui Ge², Cuicui Chen¹, Qiang Tan³, Renjie Chen², Yanjie Yang¹, Li Li¹, Jian Wang¹, Maosong Ye¹, Chun Li¹, Xia Meng², Haidong Kan², Jing Cai⁴, Yuanlin Song⁵

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
² School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
³ Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
⁴ School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China. Electronic address: jingcai@fudan.edu.cn.
⁵ Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Qingpu Branch, Shanghai, China; Shanghai Respiratory Research Institute, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: song.yuanlin@zs-hosptial.sh.cn.

PMID: 32758714
DOI: 10.1016/j.envint.2020.105977

Abstract

Background: Few studies have evaluated the effects of ambient air pollution exposure on lung function, especially in areas with high air pollution levels.

Objectives: To investigate the associations of annual concentrations of particulate matter with diameters < 2.5 μm (PM_2.5) and nitrogen dioxide (NO₂) with adult lung function in Shanghai, China.

Methods: We included 5276 permanent residents aged ≥ 20 years. Annual residential exposure to PM_2.5 and NO₂ was estimated by validated satellite-based and land use regression models, respectively. The effects of PM_2.5 and NO₂ on lung function were estimated separately using multivariable linear regression, adjusting for potential confounders.

Results: Higher exposure to PM_2.5 and NO₂ was significantly associated with lower forced vital capacity (FVC), inspiration capacity (IC), and vital capacity (VC). An increase of 10 μg/m³ in the annual average PM_2.5 exposure was associated with a 45.83 ml (95% CI: -82.59, -9.07) lower FVC, 1.36 (95% CI: -2.42, -0.29) lower FVC of % predicted (FVC_%pred), 121.98 ml (95% CI: -164.38, -79.57) lower IC, and 89.12 ml (95% CI -124.94, -53.3) lower VC. For NO₂, an increase of 10 μg/m³ in the annual average concentration was associated with 26.65 ml (95% CI: -46.29, -7.00) lower FVC, 0.70 (95% CI: -1.27, 0.13) lower FVC_%pred, 65.26 ml (95% CI: -87.76, -42.76) lower IC, and 45.88 ml (95% CI: -65.03, -26.73) lower VC. The estimated effects on FEV1 were -10.25 ml (95% CI: -40.92, 20.42) and -0.29% (95% CI: -1.40, 0.82) per 10 μg/m³ increase in PM_2.5 and -0.74 ml (95% CI: -17.13, 15.65) and 0.01% (95% CI: -0.58, 0.61) per 10 μg/m³ increase in NO₂, which were not statistically significant. Stratified analysis showed that the estimated effects of PM_2.5 were greater in the healthy subgroup than the COPD patients. Obese individuals were more susceptible to adverse effects of PM_2.5 and NO₂ on lung function. Education level showed no or only weak evidence of modification of the associations between air pollution and lung function.

Conclusion: In this study, long-term exposure to ambient air pollutants was significantly associated with impaired lung function, presenting as restrictive ventilatory patterns.

Keywords: Air pollution; Chronic obstructive pulmonary disease; Nitrogen dioxide; Obesity; Particulate matter; Respiratory function tests.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
China
Cross-Sectional Studies
Environmental Exposure / analysis
Humans
Lung / chemistry
Nitrogen Dioxide / toxicity
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Air Pollutants
Particulate Matter
Nitrogen Dioxide