Racial Difference in the Association of Long-Term Exposure to Fine Particulate Matter (PM 2.5 ) and Cardiovascular Disease Mortality among Renal Transplant Recipients

Salem Dehom, Synnove Knutsen, Khaled Bahjri, David Shavlik, Keiji Oda, Hatem Ali, Lance Pompe and Rhonda Spencer-Hwang
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Salem Dehom: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA
Synnove Knutsen: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA
Khaled Bahjri: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA
David Shavlik: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA
Keiji Oda: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA
Hatem Ali: Redlands Community Hospital, 305 Terracina Blvd, Redlands, CA 92350, USA
Lance Pompe: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA
Rhonda Spencer-Hwang: School of Public Health, Loma Linda University, 24951 Circle Drive, Loma Linda, CA 92354, USA

IJERPH, 2021, vol. 18, issue 8, 1-14

Abstract: Ambient air pollutants are known risk factors for cardiovascular disease (CVD) morbidity and mortality with significant racial disparities. However, few studies have explored racial differences among highly susceptible subpopulations, such as renal transplant recipients (RTRs). Despite improvements in quality of life after transplantation, CVD remains the major cause of mortality, especially among Black recipients. This study aimed to evaluate potential racial differences in the association between long-term levels of PM 2.5 and the risk of all-cause, total CVD, and coronary heart disease (CHD) mortality among RTRs. This retrospective study consists of 93,857 non-smoking adults who received a renal transplant between 2001 and 2015. Time-dependent Cox regression was used to assess the association between annual concentrations of PM 2.5 and mortality risk. In the multivariable-adjusted models, a 10 ?g/m 3 increase in ambient PM 2.5 levels found increased risk of all-cause (HR = 3.45, 95% CI: 3.08–3.78), CVD (HR = 2.38, 95% CI: 1.94–2.92), and CHD mortality (HR = 3.10, 95% CI: 1.96–4.90). Black recipients had higher risks of all-cause (HR = 4.09, 95% CI: 3.43–4.88) and CHD mortality (HR = 6.73, 95% CI: 2.96–15.32). High levels of ambient PM 2.5 were associated with all-cause, CVD, and CHD mortality. The association tended to be higher among Black recipients than non-Blacks.

Keywords: air pollution; cardiovascular disease; mortality; transplantation; racial differences (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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