Using Distributed Lag Non-Linear Models to Estimate Exposure Lag-Response Associations between Long-Term Air Pollution Exposure and Incidence of Cardiovascular Disease

Hedi Katre Kriit, Eva M. Andersson, Hanne K. Carlsen, Niklas Andersson, Petter L. S. Ljungman, Göran Pershagen, David Segersson, Kristina Eneroth, Lars Gidhagen, Mårten Spanne, Peter Molnar, Patrik Wennberg, Annika Rosengren, Debora Rizzuto, Karin Leander, Diego Yacamán-Méndez, Patrik K. E. Magnusson, Bertil Forsberg, Leo Stockfelt and Johan N. Sommar
Additional contact information
Hedi Katre Kriit: Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
Eva M. Andersson: Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Hanne K. Carlsen: Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Niklas Andersson: Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
Petter L. S. Ljungman: Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
Göran Pershagen: Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
David Segersson: Swedish Meteorological and Hydrological Institute, 60176 Norrköping, Sweden
Kristina Eneroth: SLB-Analys, Environment and Health Administration, 10420 Stockholm, Sweden
Lars Gidhagen: Swedish Meteorological and Hydrological Institute, 60176 Norrköping, Sweden
Mårten Spanne: Environmental Department of the City of Malmö, 20580 Malmo, Sweden
Peter Molnar: Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Patrik Wennberg: Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 90187 Umeå, Sweden
Annika Rosengren: Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska University Hospital, 40530 Gothenburg, Sweden
Debora Rizzuto: Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden
Karin Leander: Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
Diego Yacamán-Méndez: Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
Patrik K. E. Magnusson: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden
Bertil Forsberg: Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
Leo Stockfelt: Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
Johan N. Sommar: Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden

IJERPH, 2022, vol. 19, issue 5, 1-18

Abstract: Long-term air pollution exposure increases the risk for cardiovascular disease, but little is known about the temporal relationships between exposure and health outcomes. This study aims to estimate the exposure-lag response between air pollution exposure and risk for ischemic heart disease (IHD) and stroke incidence by applying distributed lag non-linear models (DLNMs). Annual mean concentrations of particles with aerodynamic diameter less than 2.5 µm (PM 2.5 ) and black carbon (BC) were estimated for participants in five Swedish cohorts using dispersion models. Simultaneous estimates of exposure lags 1–10 years using DLNMs were compared with separate year specific (single lag) estimates and estimates for lag 1–5- and 6–10-years using moving average exposure. The DLNM estimated no exposure lag-response between PM 2.5 total, BC, and IHD. However, for PM 2.5 from local sources, a 20% risk increase per 1 µg/m 3 for 1-year lag was estimated. A risk increase for stroke was suggested in relation to lags 2–4-year PM 2.5 and BC, and also lags 8–9-years BC. No associations were shown in single lag models. Increased risk estimates for stroke in relation to lag 1–5- and 6–10-years BC moving averages were observed. Estimates generally supported a greater contribution to increased risk from exposure windows closer in time to incident IHD and incident stroke.

Keywords: particulate matter; distributed lag non-linear models; multicohort; ischemic heart disease; stroke; air pollution (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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