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Karamanos A, Lu Y, Mudway IS, Ayis S, Kelly FJ, Beevers SD, Dajnak D, Fecht D, Elia C, Tandon S, Webb AJ, Grande AJ, Molaodi OR, Maynard MJ, Cruickshank JK, Harding S. Associations between air pollutants and blood pressure in an ethnically diverse cohort of adolescents in London, England. PLoS One 2023; 18:e0279719. [PMID: 36753491 PMCID: PMC9907839 DOI: 10.1371/journal.pone.0279719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/13/2022] [Indexed: 02/09/2023] Open
Abstract
Longitudinal evidence on the association between air pollution and blood pressure (BP) in adolescence is scarce. We explored this association in an ethnically diverse cohort of schoolchildren. Sex-stratified, linear random-effects modelling was used to examine how modelled residential exposure to annual average nitrogen dioxide (NO2), particulate matter (PM2.5, PM10) and ozone (O3), measures in μg/m3, associated with blood pressure. Estimates were based on 3,284 adolescents; 80% from ethnic minority groups, recruited from 51 schools, and followed up from 11-13 to 14-16 years old. Ethnic minorities were exposed to higher modelled annual average concentrations of pollution at residential postcode level than their White UK peers. A two-pollutant model (NO2 & PM2.5), adjusted for ethnicity, age, anthropometry, and pubertal status, highlighted associations with systolic, but not diastolic BP. A μg/m3 increase in NO2 was associated with a 0.30 mmHg (95% CI 0.18 to 0.40) decrease in systolic BP for girls and 0.19 mmHg (95% CI 0.07 to 0.31) decrease in systolic BP for boys. In contrast, a 1 μg/m3 increase in PM2.5 was associated with 1.34 mmHg (95% CI 0.85 to 1.82) increase in systolic BP for girls and 0.57 mmHg (95% CI 0.04 to 1.03) increase in systolic BP for boys. Associations did not vary by ethnicity, body size or socio-economic advantage. Associations were robust to adjustments for noise levels and lung function at 11-13 years. In summary, higher ambient levels of NO2 were associated with lower and PM2.5 with higher systolic BP across adolescence, with stronger associations for girls.
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Affiliation(s)
- A. Karamanos
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
| | - Y. Lu
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
- Clinical Research Center of The Third Xiangya Hospital, Central South University, Changsha, China
| | - I. S. Mudway
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - S. Ayis
- Faculty of Life Sciences & Medicine, Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
| | - F. J. Kelly
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - S. D. Beevers
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - D. Dajnak
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - D. Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, United Kingdom
| | - C. Elia
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
| | - S. Tandon
- Faculty of Life Sciences & Medicine, Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
| | - A. J. Webb
- Faculty of Life Sciences & Medicine, Department of Clinical Pharmacology, King’s College London BHF Centre of Excellence, School of Cardiovascular Medicine and Sciences, King’s College, London, United Kingdom
| | - A. J. Grande
- Curso de Medicina, Universidade Estadual do Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - O. R. Molaodi
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - M. J. Maynard
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - J. K. Cruickshank
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
| | - S. Harding
- School of Life Course/Nutritional Sciences, King’s College London, London, United Kingdom
- Faculty of Life Sciences & Medicine, Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London, United Kingdom
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Karamanos A, Mudway I, Kelly F, Beevers SD, Dajnak D, Elia C, Cruickshank JK, Lu Y, Tandon S, Enayat E, Dazzan P, Maynard M, Harding S. Air pollution and trajectories of adolescent conduct problems: the roles of ethnicity and racism; evidence from the DASH longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2029-2039. [PMID: 33929549 PMCID: PMC8519907 DOI: 10.1007/s00127-021-02097-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 04/23/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE No known UK empirical research has investigated prospective associations between ambient air pollutants and conduct problems in adolescence. Ethnic minority children are disproportionately exposed to structural factors that could moderate any observed relationships. This prospective study examined whether exposure to PM2.5 and NO2 concentrations is associated with conduct problems in adolescence, and whether racism or ethnicity moderate such associations. METHODS Longitudinal associations between annual mean estimated PM2.5 and NO2 concentrations at the residential address and trajectories of conduct problems, and the potential influence of racism and ethnicity were examined school-based sample of 4775 participants (2002-2003 to 2005-2006) in London, using growth curve models. RESULTS Overall, in the fully adjusted model, exposure to lower concentrations of PM2.5 and NO2 was associated with a decrease in conduct problems during adolescence, while exposure to higher concentrations was associated with a flattened trajectory of conduct symptoms. Racism amplified the effect of PM2.5 (β = 0.05 (95% CI 0.01 to 0.10, p < 0.01)) on adolescent trajectories of conduct problems over time. At higher concentrations of PM2.5, there was a divergence of trajectories of adolescent conduct problems between ethnic minority groups, with White British and Black Caribbean adolescents experiencing an increase in conduct problems over time. CONCLUSION These findings suggest that the intersections between air pollution, ethnicity, and racism are important influences on the development of conduct problems in adolescence.
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Affiliation(s)
- A Karamanos
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK.
| | - I Mudway
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - F Kelly
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - S D Beevers
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - D Dajnak
- MRC Centre for Environment and Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London, UK
| | - C Elia
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - J K Cruickshank
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - Y Lu
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
| | - S Tandon
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - E Enayat
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - P Dazzan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Maynard
- School of Clinical and Applied Sciences, Leeds Beckett University, London, UK
| | - S Harding
- Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, 57 Waterloo Road, London, SE1 8WA, UK
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Carey IM, Anderson HR, Atkinson RW, Beevers S, Cook DG, Dajnak D, Gulliver J, Kelly FJ. Traffic pollution and the incidence of cardiorespiratory outcomes in an adult cohort in London. Occup Environ Med 2016; 73:849-856. [PMID: 27343184 PMCID: PMC5241502 DOI: 10.1136/oemed-2015-103531] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/13/2016] [Accepted: 05/25/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The epidemiological evidence for adverse health effects of long-term exposure to air and noise pollution from traffic is not coherent. Further, the relative roles of background versus near traffic pollution concentrations in this process are unclear. We investigated relationships between modelled concentrations of air and noise pollution from traffic and incident cardiorespiratory disease in London. METHODS Among 211 016 adults aged 40-79 years registered in 75 Greater London practices between 2005 and 2011, the first diagnosis for a range of cardiovascular and respiratory outcomes were identified from primary care and hospital records. Annual baseline concentrations for nitrogen oxide (NOx), particulate matter with a median aerodynamic diameter <2.5 μm (PM2.5) attributable to exhaust and non-exhaust sources, traffic intensity and noise were estimated at 20 m2 resolution from dispersion models, linked to clinical data via residential postcode. HRs were adjusted for confounders including smoking and area deprivation. RESULTS The largest observed associations were between traffic-related air pollution and heart failure (HR=1.10 for 20 μg/m3 change in NOx, 95% CI 1.01 to 1.21). However, no other outcomes were consistently associated with any of the pollution indicators, including noise. The greater variations in modelled air pollution from traffic between practices, versus within, hampered meaningful fine spatial scale analyses. CONCLUSIONS The associations observed with heart failure may suggest exacerbatory effects rather than underlying chronic disease. However, the overall failure to observe wider associations with traffic pollution may reflect that exposure estimates based on residence inadequately represent the relevant pattern of personal exposure, and future studies must address this issue.
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Affiliation(s)
- I M Carey
- Population Health Research Institute, St George's University of London, London, UK
| | - H R Anderson
- MRC-PHE Centre for Environment and Health, King's College London, London, UK
| | - R W Atkinson
- Population Health Research Institute, St George's University of London, London, UK
| | - S Beevers
- MRC-PHE Centre for Environment and Health, King's College London, London, UK
| | - D G Cook
- Population Health Research Institute, St George's University of London, London, UK
| | - D Dajnak
- MRC-PHE Centre for Environment and Health, King's College London, London, UK
| | - J Gulliver
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - F J Kelly
- MRC-PHE Centre for Environment and Health, King's College London, London, UK
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