Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia

Alari, Anna; Ranzani, Otavio; Milà, Carles; Olmos, Sergio; Basagaña Flores, Xavier; Dadvand, Payam; Duarte Salles, Talita, 1985-; Nieuwenhuijsen, Mark J.; Tonne, Cathryn

doi:http://dx.doi.org/10.1016/j.envint.2024.109230

Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia

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Alari A, Ranzani O, Milà C, Olmos S, Basagaña X, Dadvand P, et al. Long-term exposure to air pollution and lower respiratory infections in a large population-based adult cohort in Catalonia. Environ Int. 2024 Dec 25;195:109230. DOI: 10.1016/j.envint.2024.109230

Abstract

Background: Evidence is limited regarding the role of air pollution in acute lower respiratory infections among adults. We assessed the influence of long-term air pollution exposure on hospital admission for lower respiratory infections and whether there are vulnerable subgroups. Methods: We used a populational cohort in Catalonia, Spain, comprising 3,817,820 adults residing in Catalonia as of January 1, 2015. Air pollution exposure was assigned to individuaĺs residential address using locally-developed models. We characterized the concentration-response functions between long-term air pollution exposure and hospital admission for lower respiratory infections between 2015 and 2019. We assessed interaction between exposure and clinical and socio-economic factors on multiplicative and additive scales. Results: An interquartile range exposure increase was associated with an 8 % (95 % Confidence Interval: 5 %-11 %) for Nitrogen Dioxide, 10 % (95 % Confidence Interval: 8 %-13 %) for Particulate Matter with diameter equal to or smaller than 2.5 µm, 5 % (95 % Confidence Interval: 3 %-7%) for Particulate Matter with diameter equal to or smaller than 10 µm and 18 % (95 % Confidence Interval: 14 %-22%) for ozone (adjusted by Nitrogen Dioxide) increase in hospital admissions for respiratory infections. Concentration-response functions were non-linear, with steeper slopes at exposures below the median or at most extreme high values. Associations were consistently greater for individuals over 65 years or with hypertension diagnosis and males. Conclusions: Long-term exposure to air pollution was positively associated with hospital admission for lower respiratory infections. Individuals who were older than 65 years, hypertensive or male were most vulnerable.