Long-term effects of ambient particulate matter on hypertension among royal Thai army officers: a retrospective cohort study 10.55131/jphd/2024/220106
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Abstract
Recent research on the link between exposure to ambient particulate matter with an aerodynamic diameter up to 2.5 microns (PM2.5) and hypertension risk has primarily concentrated on spatial variation (or between-individual comparisons). Research into temporal variations (or within-individual comparisons over time) has largely been neglected. This study sought to examine the spatial–temporal effects of long-term exposure to PM2.5 on hypertension risk among military personnel in Thailand. A retrospective cohort study was conducted, encompassing 40,984 Royal Thai Army officers from 400 army units stationed across 51 provinces in Thailand. Medical check-up data from 2018 to 2021 were analyzed alongside ambient PM2.5 data from 2015 to 2017, sourced from the Geo-Informatics and Space Technology Development Agency. Two parameters, PM2.5-baseline and PM2.5-change, were introduced to assess the impact of spatial and temporal PM2.5 variations on hypertension incidence. Cox proportional hazard regression was used, with hazard ratios (HR) with 95% confidence intervals (95% CI) serving as the measure of association. The association between PM2.5-baseline and hypertension incidence yielded hazard ratios in Quartiles 2 to 4 compared to Quartile 1 of: Q2 HR: 1.19, 95% CI: 1.10–1.28; Q3 HR: 1.10, 95% CI: 1.02–1.20; Q4 HR: 1.13, 95% CI: 1.05–1.22. Additionally, the PM2.5-change showed a J-shaped association with hypertension incidence. Our findings underscore the role of both temporal and spatial factors in hypertension development and highlight the necessity for comprehensive investigations into the causal relationship between PM2.5 exposure and hypertension risk. They also provide valuable insights for devising effective strategies to mitigate the adverse health impacts of PM2.5 pollution.
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References
World Health Organization. Ambient (outdoor) air pollution 2022 [Internet]. 2022 [cited 2023 Jan 20]. Available from: https://www.who.int/news-room/ fact-sheets/detail/ambient-(outdoor)-air-quality-and-health.
Song J, Gao Y, Hu S, Medda E, Tang G, Zhang D, et al. Association of long-term exposure to PM(2.5) with hypertension prevalence and blood pressure in China: a cross-sectional study. BMJ Open. 2021;11(12): e050159. doi: 10.1136/bmjopen-2021-050159.
World Health Organization. Hypertension 2021 [Internet]. WHO 2023 [cited 2023 Jan 20]. Available from: https://www.who.int/news-room/ fact-sheets/detail/hypertension.
Liu Q, Xu C, Ji G, Liu H, Shao W, Zhang C, et al. Effect of exposure to ambient PM(2.5) pollution on the risk of respiratory tract diseases: a meta-analysis of cohort studies. J Biomed Res. 2017;31(2):130-42. doi: 10.7555/ JBR.31.20160071.
Brook RD, Rajagopalan S. Particulate matter, air pollution, and blood pressure. Hypertens. 2009;3(5): 332-50.
Feng S, Gao D, Liao F, Zhou F, Wang X. The health effects of ambient PM2.5 and potential mechanisms. Ecotoxicol Environ Saf. 2016;128:67-74. doi: 10.1016/j.ecoenv.2016.01.030.
Cai Y, Zhang B, Ke W, Feng B, Lin H, Xiao J, et al. Associations of short-term and long-term exposure to ambient air pollutants with hypertension: a systematic review and meta-analysis. Hypertension. 2016;68(1):62-70. doi: 10.1161/HYPERTENSIONAHA.116.07218
Orellano P, Reynoso J, Quaranta N, Bardach A, Ciapponi A. Short-term exposure to particulate matter (PM(10) and PM(2.5)), nitrogen dioxide (NO(2)), and ozone (O(3)) and all-cause and cause-specific mortality: Systematic review and meta-analysis. Environ Int. 2020;142:105876. doi: 10.1016/j.envint.2020.105876.
Ren M, Zhang H, Benmarhnia T, Jalaludin B, Dong H, Wu K, et al. Short-term effects of real-time personal PM2.5 exposure on ambulatory blood pressure: A panel study in young adults. Sci Total Environ. 2019;697:134079.
Lin H, Guo Y, Zheng Y, Di Q, Liu T, Xiao J, et al. Long-Term Effects of Ambient PM(2.5) on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults. Hypertension. 2017;69(5):806-12. doi: 10.1161/HYPERTENSIONAHA.116.08839.
Ye Z, Li X, Han Y, Wu Y, Fang Y. Association of long-term exposure to PM(2.5) with hypertension and diabetes among the middle-aged and elderly people in Chinese mainland: a spatial study. BMC Public Health. 2022; 22(1):569. doi: 10.1186/s12889-022-12984-6.
Zhang Z, Laden F, Forman JP, Hart JE. Long-term exposure to particulate matter and self-reported hypertension: a prospective analysis in the Nurses' Health Study. Environ Health Perspect. 2016;124(9):1414-20. doi: 10.1289/ EHP163.
Bilenko N, van Rossem L, Brunekreef B, Beelen R, Eeftens M, Hoek G, et al. Traffic-related air pollution and noise and children's blood pressure: results from the PIAMA birth cohort study. Eur J Prev Cardiol. 2015;22(1):4-12. doi: 10.1177/2047487313505821.
Karamanos A, Lu Y, Mudway IS, Ayis S, Kelly FJ, Beevers SD, et al. Associations between air pollutants and blood pressure in an ethnically diverse cohort of adolescents in London, England. PLOS One. 2023;18(2): e0279719. doi: 10.1371/ journal.pone. 0279719.
Southerland VA, Brauer M, Mohegh A, Hammer MS, van Donkelaar A, Martin RV, et al. Global urban temporal trends in fine particulate matter (PM(2·5)) and attributable health burdens: estimates from global datasets. Lancet Planet Health. 2022;6(2):e139-e46. doi: 10.1016/S2542-5196(21)00350-8.
Denduangchai S. Correlation between the daily fine particulate matter (PM2.5) level and the number of visits with respiratory and cardiovascular diseases at Ratchaburi hospital, Amphoe Mueang, Ratchaburi province. Chiang Mai Med. 2021; 3:345-58. [in Thai]
Laorattapong A, Poobunjirdkul S, Thanapoom T, Jiamjarasrangsi W. The association between PM2.5 exposure and diabetes mellitus among Thai Army personnel. J Prev Med Public Health. 2023;56(5):449-57. doi: 10.3961/ jpmph.23.292.
Junrungruang K. Association of annual fine particulate matter (PM2.5) level with blood pressure and hypertension among the Royal Thai Army personnel: a cross-sectional study. Royal Thai Navy Med. 2023;50. [in Thai]
Abed Al Ahad M, Demšar U, Sullivan F, Kulu H. The spatial-temporal effect of air pollution on individuals' reported health and its variation by ethnic groups in the United Kingdom: a multilevel longitudinal analysis. BMC Public Health. 2023;23(1):897. doi: 10.1186/ s12889-023-15853-y.
Curran PJ, Bauer DJ. The disaggregation of within-person and between-person effects in longitudinal models of change. Annu Rev Psychol. 2011;62:583-619. doi: 10.1146/ annurev.psych.093008.100356.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr., et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-52. doi: 10.1161/ 01.HYP.0000107251.49515.c2.
Lwanga SK and Lemeshow S. Sample size determination in health studies. Geneva: World Health Organization. 1991.
Huang K, Yang X, Liang F, Liu F, Li J, Xiao Q, et al. Long-term exposure to fine particulate matter and hypertension incidence in China. Hypertension. 2019;73(6):1195-201. doi: 10.1161/ HYPERTENSIONAHA. 119.12666.
GISTDA. PM 2.5 [Internet]. [cited 2023 Jan 1]. Available from: https:// www.gistda.or.th/more_news.php?c_id=155. [in Thai]
Air4Thai. Regional Air Quality and Situation Reports [Internet]. [cited 2023 Jan 20]. Available from: http://air4thai. pcd.go.th/webV3/#/Home. [in Thai]
Office of the National Economic and Social Development Council. Gross Regional and Provincial Product Chain Volume [Internet]. [cited 2023 Jan 1]. Available from: https://www.nesdc. go.th/main.php?filename=gross_regional. [in Thai]
Thailand Physical Activity Knowledge Development Centre. Home Exercise Activity Guide. Nonthaburi: Sahamitr Printing And Publishing Co Ltd; 2020. [in Thai]
World Health Organization. Obesity and its treatment 2000 [Internet]. WHO 2000 [cited 2023 Jan 20]. Available from: https://apps.who.int/iris/bitstream/ handle/10665/206936/0957708211_eng.pdf?sequence=1&is.
Royston P, Sauerbrei W. Multivariable model-building: a pragmatic approach to regression anaylsis based on fractional polynomials for modelling continuous variables. West Sussex: John Wiley & Sons; 2008.
Leiby BD, Ahner DK. Multicollinearity applied stepwise stochastic imputation: a large dataset imputation through correlation-based regression. Big Data. 2023;10(1):1-20.
Doulatram-Gamgaram V, Valdés S, Maldonado-Araque C, Lago-Sampedro A, Badía-Guillén R, García-Escobar E, et al. Association between long term exposure to particulate matter and incident hypertension in Spain. Sci Rep. 2021;11(1):19702. doi: 10.1038/ s41598-021-99154-7.
Prabhakaran D, Mandal S, Krishna B, Magsumbol M, Singh K, Tandon N, et al. Exposure to particulate matter is associated with elevated blood pressure and incident hypertension in urban India. Hypertension. 2020;76(4): 1289-98. doi: 10.1161/ HYPERTENSIONAHA. 120.15373.
Coogan PF, White LF, Yu J, Burnett RT, Seto E, Brook RD, et al. PM2.5 and diabetes and hypertension incidence in the Black Women's Health Study. Epidemiology. 2016;27(2):202-10. doi: 10.1097/EDE.0000000000000418.
Wensu Z, Wen C, Fenfen Z, Wenjuan W, Li L. The Association between long-term exposure to particulate matter and incidence of hypertension among Chinese elderly: a retrospective cohort study. Front Cardiovasc Med. 2021; 8:784800. doi: 10.3389/fcvm.2021. 784800.
Guo C, Zeng Y, Chang LY, Yu Z, Bo Y, Lin C, et al. Independent and opposing associations of habitual exercise and chronic PM(2.5) exposures on hypertension incidence. Circulation. 2020;142(7):645-56. doi: 10.1161/CIRCULATIONAHA.120.045915.
Liu X, Zhang D, Liu Y, Sun X, Han C, Wang B, et al. Dose-response association between physical activity and incident hypertension: a systematic review and meta-analysis of cohort studies. Hypertension. 2017;69(5):813-20. doi: 10.1161/ HYPERTENSIONAHA.116.08994.
Royal Thai Army. Enhancing Military Personnel Health 2008 [Internet]. [cited 2023 August 20]. Available from: https://inspectorkm.rta.mi.th/ilc60/download/rules/person/04.%E0%B8%A3%E0%B8%B0%E0%B9%80%E0%B8%9A%E0%B8%B5%E0%B8%A2%E0%B8%9A,%E0%B8%84%E0%B8%B3%E0%B8%AA%E0%B8%B1%E0%B9%88%E0%B8%87%20%E0%B8%82%E0%B8%A7%E0%B8%B1%E0%B8%8D%20%E0%B8%A7%E0%B8%B4%E0%B8%99%E0%B8%B1%E0%B8%A2%20%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B8%AA%E0%B8%A7%E0%B8%B1%E0%B8%AA%E0%B8%94%E0%B8%B4%E0%B8%81%E0%B8%B2%E0%B8%A3/04.13%20%E0%B8%A3%E0%B8%B0%E0%B9%80%E0%B8%9A%E0%B8%B5%E0%B8%A2%E0%B8%9A%20%E0%B8%97%E0%B8%9A.%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B9%80%E0%B8%AA%E0%B8%A3%E0%B8%B4%E0%B8%A1%E0%B8%AA%E0%B8%A3%E0%B9%89%E0%B8%B2%E0%B8%87%E0%B8%AA%E0%B8%B8%E0%B8%82%E0%B8%A0%E0%B8%B2%E0%B8%9E2551.PDF. [in Thai]
Suka M, Odajima T, Okamoto M, Sumitani M, Igarashi A, Ishikawa H, et al. Relationship between health literacy, health information access, health behavior, and health status in Japanese people. Patient Educ Couns. 2015; 98(5):660-8. doi: 10.1016/ j.pec.2015. 02.013.
Office of the Prime Minister Thailand. Working hours and public holidays 1959 [Internet]. [cited 2023 Jan 01]. Available from: https://personweb. kku.ac.th/E-Administration/BackEnd/ Program/Manage/view2.php?FILE_ID=2910. [in Thai]