Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan
Air pollution is one of the most alarming environmental issues which causes multiple health hazards. An association between air pollution and cardiovascular diseases has been established through many prior studies. In this study, we aimed to evaluate the risk of long-term exposure to air pollution (...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.796423/full |
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| author | Shu-Hui Liao Chien-Shan Chiu Chien-Shan Chiu Li-Ho Jang Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Chorng-Kuang How Chorng-Kuang How Vivian Chia-Rong Hsieh Ming-Shun Hsieh Ming-Shun Hsieh Ming-Shun Hsieh |
| author_facet | Shu-Hui Liao Chien-Shan Chiu Chien-Shan Chiu Li-Ho Jang Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Chorng-Kuang How Chorng-Kuang How Vivian Chia-Rong Hsieh Ming-Shun Hsieh Ming-Shun Hsieh Ming-Shun Hsieh |
| author_sort | Shu-Hui Liao |
| collection | DOAJ |
| description | Air pollution is one of the most alarming environmental issues which causes multiple health hazards. An association between air pollution and cardiovascular diseases has been established through many prior studies. In this study, we aimed to evaluate the risk of long-term exposure to air pollution (PM2.5, CO, and NO2) and its association with the risk of developing peripheral arterial occlusive disease (PAOD). PAOD is a condition involving impairment of perfusion of blood in the distal parts of the aorta due to narrowing of the arteries (arterial stenosis) and has been reported as a risk factor for developing cardiovascular diseases. Furthermore, the risk of PAOD increases with age, and hence is a serious public health issue and a cause for concern, especially for an aging society such as Taiwan. Two national-scale databases from Taiwan, the national health insurance database (NHIRD) and the Taiwan air quality-monitoring database (TAQMD), were linked to conduct this cohort study between 2003 and 2013. Cox proportional hazards regression with time-dependent modeling was used to evaluate the hazard ratio (HR) for PAOD with respect to daily exposure to air pollutants. The concentrations of each of the pollutants of interest (PM2.5, NO2, and CO) were categorized into four categories according to the daily average concentration of air pollutants for every quarter of the year, Q1 to Q4 (Q4 = highest). The cumulative incidence of PAOD was examined by Kaplan–Meier analysis with two-tailed log-rank test. A total of 1,598 PAOD cases were identified during the 10-year follow-up period, along with 98,540 non-PAOD controls. In the multivariate analysis, after adjusting for age, gender, urbanization level, residential area, baseline comorbidities, and medications, the adjusted HRs were PM2.5 = 1.14 (95% CI 1.13–1.16), NO2 = 1.03 (95% CI 1.02–1.04), and CO = 2.35 (95% CI 1.95–2.84). Kaplan–Meier analysis showed that CO (P < 0.0001) and PM2.5 (P < 0.0001) concentrations were strongly and positively associated with the cumulative incidence of PAOD during the follow-up period. Findings from this study established that prolonged exposure to air pollutants CO and PM2.5 are significant factors that, among other well-known causes, may also play a potential role in PAOD pathogenesis. |
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| language | English |
| last_indexed | 2024-12-12T06:37:59Z |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-a8d673631bdd47abbece637d02df4c8e2022-12-22T00:34:25ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.796423796423Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in TaiwanShu-Hui Liao0Chien-Shan Chiu1Chien-Shan Chiu2Li-Ho Jang3Sung-Yuan Hu4Sung-Yuan Hu5Sung-Yuan Hu6Sung-Yuan Hu7Sung-Yuan Hu8Chorng-Kuang How9Chorng-Kuang How10Vivian Chia-Rong Hsieh11Ming-Shun Hsieh12Ming-Shun Hsieh13Ming-Shun Hsieh14Department of Pathology and Laboratory, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, TaiwanDepartment of Dermatology, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Biomedical Sciences, National Chung Hsing University, Taichung, TaiwanDepartment of Critical Care, Saint Paul's Hospital, Taoyuan, TaiwanDepartment of Emergency Medicine, Taichung Veterans General Hospital, Taichung, TaiwanSchool of Medicine, Chung Shan Medical University, Taichung, TaiwanInstitute of Medicine, Chung Shan Medical University, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanSchool of Medicine, Chung Shan Medical University, Taichung, Taiwan0Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan1Department of Health Services Administration, China Medical University, Taichung, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan0Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan2Department of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, TaiwanAir pollution is one of the most alarming environmental issues which causes multiple health hazards. An association between air pollution and cardiovascular diseases has been established through many prior studies. In this study, we aimed to evaluate the risk of long-term exposure to air pollution (PM2.5, CO, and NO2) and its association with the risk of developing peripheral arterial occlusive disease (PAOD). PAOD is a condition involving impairment of perfusion of blood in the distal parts of the aorta due to narrowing of the arteries (arterial stenosis) and has been reported as a risk factor for developing cardiovascular diseases. Furthermore, the risk of PAOD increases with age, and hence is a serious public health issue and a cause for concern, especially for an aging society such as Taiwan. Two national-scale databases from Taiwan, the national health insurance database (NHIRD) and the Taiwan air quality-monitoring database (TAQMD), were linked to conduct this cohort study between 2003 and 2013. Cox proportional hazards regression with time-dependent modeling was used to evaluate the hazard ratio (HR) for PAOD with respect to daily exposure to air pollutants. The concentrations of each of the pollutants of interest (PM2.5, NO2, and CO) were categorized into four categories according to the daily average concentration of air pollutants for every quarter of the year, Q1 to Q4 (Q4 = highest). The cumulative incidence of PAOD was examined by Kaplan–Meier analysis with two-tailed log-rank test. A total of 1,598 PAOD cases were identified during the 10-year follow-up period, along with 98,540 non-PAOD controls. In the multivariate analysis, after adjusting for age, gender, urbanization level, residential area, baseline comorbidities, and medications, the adjusted HRs were PM2.5 = 1.14 (95% CI 1.13–1.16), NO2 = 1.03 (95% CI 1.02–1.04), and CO = 2.35 (95% CI 1.95–2.84). Kaplan–Meier analysis showed that CO (P < 0.0001) and PM2.5 (P < 0.0001) concentrations were strongly and positively associated with the cumulative incidence of PAOD during the follow-up period. Findings from this study established that prolonged exposure to air pollutants CO and PM2.5 are significant factors that, among other well-known causes, may also play a potential role in PAOD pathogenesis.https://www.frontiersin.org/articles/10.3389/fcvm.2022.796423/fullperipheral arterial occlusive disease (PAOD)PM2.5carbon monoxide (CO)nitrogen dioxide (NO2)air pollutantsprolonged exposure |
| spellingShingle | Shu-Hui Liao Chien-Shan Chiu Chien-Shan Chiu Li-Ho Jang Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Sung-Yuan Hu Chorng-Kuang How Chorng-Kuang How Vivian Chia-Rong Hsieh Ming-Shun Hsieh Ming-Shun Hsieh Ming-Shun Hsieh Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan Frontiers in Cardiovascular Medicine peripheral arterial occlusive disease (PAOD) PM2.5 carbon monoxide (CO) nitrogen dioxide (NO2) air pollutants prolonged exposure |
| title | Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan |
| title_full | Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan |
| title_fullStr | Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan |
| title_full_unstemmed | Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan |
| title_short | Long-Term Exposures to Air Pollutants and Risk of Peripheral Arterial Occlusive Disease: A Nationwide Cohort Study in Taiwan |
| title_sort | long term exposures to air pollutants and risk of peripheral arterial occlusive disease a nationwide cohort study in taiwan |
| topic | peripheral arterial occlusive disease (PAOD) PM2.5 carbon monoxide (CO) nitrogen dioxide (NO2) air pollutants prolonged exposure |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.796423/full |
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