Long-term effects of air pollution on end stage renal disease

点击翻译按钮获取中文摘要

Long-term exposure to ambient air pollution is more and more shown to be related to various chronic diseases, among them, cardiovascular diseases and diabetes. Despite its high burden of disease and therefore public health relevance, renal disease has received so far little attention in this context, probably also because of limited availability of suitable data. The fact that almost everybody is exposed to more or less high air pollutant concentrations and no clear threshold has been identified for chronic diseases so far, may lead to a relatively high burden of disease attributable to air pollution.Large population-based cohorts with information on renal disease are rare and the few related air pollution studies available to date mostly used exposure data on a coarse spatial scale. To date, only one study investigated end stage renal disease (ESRD) and found an important effect in 2 millions of US-veterans (i.e. mostly older men). The authors estimated that 13 % of the incidence of ESRD in the US could be attributable to ambient air pollution with particles of less than 10 μm in diameter. The aim of this project is to investigate the effects of long-term exposure to air pollution on the incidence of ESRD in two large cohorts from the general adult population, one from Austria and one from Italy. Nitrogen oxides, ozone, particulate matter and several of its components including metals, and traffic indicators will be investigated. The exposure estimates to be used are specific to each person’s home address and for a part of the study population residential history can be taken into account. Besides overall ESRD, ESRD with different underlying pathologies such as diabetes or hypertension will be studied. Important synergies are expected with the current project "Effects of Low-Level Air Pollution: A Study in Europe" (ELAPSE) which is financed by the Health Effects Institute in the US. The techniques developed for studying specifically mediating effects leading to ESRD will be very useful for further application not only regarding other environmental risks but also for investigating the influence of life-style factors.