Short-term air pollution exposure associated with death from kidney diseases: a nationwide time-stratified case-crossover study in China from 2015 to 2019
Miao Cai, Jing Wei, Shiyu Zhang, Wei Liu, Lijun Wang, Zhengmin Qian, Hualiang Lin, Echu Liu, Stephen Edward McMillin, Yu Cao, Peng Yin
Abstract
Abstract Background Long-term exposure to air pollution has been associated with the onset and progression of kidney diseases, but the association between short-term exposure to air pollution and mortality of kidney diseases has not yet been reported. Methods A nationally representative sample of 101,919 deaths from kidney diseases was collected from the Chinese Center for Disease Control and Prevention from 2015 to 2019. A time-stratified case-crossover study was applied to determine the associations. Satellite-based estimates of air pollution were assigned to each case and control day using a bilinear interpolation approach and geo-coded residential addresses. Conditional logistic regression models were constructed to estimate the associations adjusting for nonlinear splines of temperature and relative humidity. Results Each 10 µg/m 3 increment in lag 0–1 mean concentrations of air pollutants was associated with a percent increase in death from kidney disease: 1.33% (95% confidence interval [CI]: 0.57% to 2.1%) for PM 1 , 0.49% (95% CI: 0.10% to 0.88%) for PM 2.5 , 0.32% (95% CI: 0.08% to 0.57%) for PM 10 , 1.26% (95% CI: 0.29% to 2.24%) for NO 2 , and 2.9% (95% CI: 1.68% to 4.15%) for SO 2 . Conclusions Our study suggests that short-term exposure to ambient PM 1 , PM 2.5 , PM 10 , NO 2 , and SO 2 might be important environmental risk factors for death due to kidney diseases in China.