Barcelona Institute for Global Health (ISGlobal), Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain.
Public Health Foundation of India, New Delhi, India.
Environ Int. 2020 Jun;139:105734. doi: 10.1016/j.envint.2020.105734. Epub 2020 Apr 30.
Air pollution is a leading preventable risk factor for cardiovascular diseases. Previous studies mostly relied on concentrations at residence, which might not represent personal exposure. Personal air pollution exposure has a greater variability compared with levels of ambient air pollution, facilitating evaluation of exposure-response functions and vascular pathophysiology. We aimed to evaluate the association between predicted annual personal exposure to PM and black carbon (BC) and three vascular damage markers in peri-urban South India.
We analyzed the third wave of the APCAPS cohort (2010-2012), which recruited participants from 28 villages. We used predicted personal exposure to PM and BC derived from 610 participant-days of 24 h average gravimetric PM and BC measurements and predictors related to usual time-activity. Outcomes included carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (cf-PWV) and augmentation index (AIx). We fit linear mixed models, adjusting for potential confounders and accounting for the clustered data structure. We evaluated nonlinear associations using generalized additive mixed models.
Of the 3017 participants (mean age 38 years), 1453 (48%) were women. The average PM exposure was 51 µg/m (range 13-85) for men, and 61 µg/m (range 40-120) for women, while the average BC was 4 µg/m (range 3-7) for men and 8 µg/m (range 3-22) for women. A 10 μg/m increase of PM was positively associated with CIMT (0.026 mm, 95% CI 0.014, 0.037), cf-PWV (0.069 m/s, 95% CI 0.008, 0.131) and AIx (0.8%, 95% CI 0.3, 1.3) among men. The exposure-response function for PM and AIx among men showed non-linearity, particularly within the exposure range dominated by tobacco smoking and occupational exposures. Both PM and BC were positively associated with AIx among women (0.6%, 95% CI 0.2, 1.0, per 10 μg/m PM; 0.5%, 95% CI 0.1, 0.8, per 2 μg/m BC).
Personal exposure to particulate matter was associated with vascular damage in a peri-urban population in South India. Personal exposure to particulate matter appears to have gender-specific effects on the type of vascular damage, potentially reflecting differences in sources of personal exposure by gender.
空气污染是导致心血管疾病的主要可预防风险因素。以往的研究主要依赖于居住地的浓度，而这些浓度可能无法代表个人暴露情况。与环境空气污染水平相比，个人空气污染暴露具有更大的可变性，有助于评估暴露-反应函数和血管病理生理学。我们旨在评估印度南部近郊区个人每年预测的 PM 和黑碳（BC）暴露与三种血管损伤标志物之间的关系。
我们分析了 APCAPS 队列的第三波研究（2010-2012 年），该研究从 28 个村庄招募了参与者。我们使用了由 610 名参与者 24 小时平均重量 PM 和 BC 测量和与通常时间-活动相关的预测指标得出的个人 PM 和 BC 预测暴露量。结果包括颈动脉内膜-中层厚度（CIMT）、颈动脉-股动脉脉搏波速度（cf-PWV）和增强指数（AIx）。我们使用线性混合模型进行拟合，调整了潜在混杂因素，并考虑了聚类数据结构。我们使用广义加性混合模型评估了非线性关联。
在 3017 名参与者（平均年龄 38 岁）中，有 1453 名（48%）为女性。男性 PM 的平均暴露量为 51μg/m（范围为 13-85μg/m），女性为 61μg/m（范围为 40-120μg/m），而男性的 BC 平均暴露量为 4μg/m（范围为 3-7μg/m），女性为 8μg/m（范围为 3-22μg/m）。PM 每增加 10μg/m，男性的 CIMT（0.026mm，95%CI 0.014，0.037）、cf-PWV（0.069m/s，95%CI 0.008，0.131）和 AIx（0.8%，95%CI 0.3，1.3）均呈正相关。男性 PM 和 AIx 的暴露-反应关系呈非线性，尤其是在以吸烟和职业暴露为主的暴露范围内。PM 和 BC 均与女性的 AIx 呈正相关（PM 每增加 10μg/m，0.6%，95%CI 0.2，1.0；BC 每增加 2μg/m，0.5%，95%CI 0.1，0.8）。
在印度南部近郊区人群中，个体对颗粒物的暴露与血管损伤有关。个体对颗粒物的暴露似乎对血管损伤的类型有性别特异性影响，这可能反映了性别不同的个体暴露源的差异。
