Long-term exposure to ambient ozone at workplace is positively and non-linearly associated with incident hypertension and blood pressure: longitudinal evidence from the Beijing-Tianjin-Hebei medical examination cohort

BMC Public Health

Research

Shuo Chen¹  Jingbo Zhang¹  Feng Liu¹  Ximing Xu²  Mianzhi Zhang³  Shitao Ma⁴  Rong Zhang⁴  Yujie Niu⁴  Pei Guo⁵  Fenghua Guo⁵  Minying Zhang⁵  Jiangshan He⁵  Xiaolong Xing⁵  Songhua Hu⁶  Li Zhang⁷  Chunjun Li⁸ 

[1] Beijing Physical Examination Center, Beijing, China;Big Data Center for Children’s Medical Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China;Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China;Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China;Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China;Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China;School of Medicine, Nankai University, Tianjin, China;School of Statistics and Data Science, Nankai University, Tianjin, China;Big Data Center for Children’s Medical Care, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China;Tianjin First Central Hospital, Tianjin, China;Tianjin Union Medical Center, Tianjin, China;

关键词: Air pollution;    Ozone;    Hypertension;    Blood pressure;    Occupational exposure;    Longitudinal studies;   

DOI  :  10.1186/s12889-023-16932-w

 received in 2023-07-15, accepted in 2023-10-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere is limited longitudinal evidence on the hypertensive effects of long-term exposure to ambient O3. We investigated the association between long-term O3 exposure at workplace and incident hypertension, diastolic blood pressure (DBP), systolic blood pressure (SBP), pulse pressure (PP), and mean arterial pressure (MAP) in general working adults.MethodsWe conducted a cohort study by recruiting over 30,000 medical examination attendees through multistage stratified cluster sampling. Participants completed a standard questionnaire and comprehensive medical examination. Three-year ambient O3 concentrations at each employed participant’s workplace were estimated using a two-stage machine learning model. Mixed-effects Cox proportional hazards models and linear mixed-effects models were used to examine the effect of O3 concentrations on incident hypertension and blood pressure parameters, respectively. Generalized additive mixed models were used to explore non-linear concentration-response relationships.ResultsA total of 16,630 hypertension-free working participants at baseline finished the follow-up. The mean (SD) O3 exposure was 45.26 (2.70) ppb. The cumulative incidence of hypertension was 7.11 (95% CI: 6.76, 7.47) per 100 person-years. Long-term O3 exposure was independently, positively and non-linearly associated with incident hypertension (Hazard ratios (95% CI) for Q2, Q3, and Q4 were 1.77 (1.34, 2.36), 2.06 (1.42, 3.00) and 3.43 (2.46, 4.79), respectively, as compared with the first quartile (Q1)), DBP (β (95% CI) was 0.65 (0.01, 1.30) for Q2, as compared to Q1), SBP (β (95% CI) was 2.88 (2.00, 3.77), 2.49 (1.36, 3.61) and 2.61 (1.64, 3.58) for Q2, Q3, and Q4, respectively), PP (β (95% CI) was 2.12 (1.36, 2.87), 2.03 (1.18, 2.87) and 2.14 (1.38, 2.90) for Q2, Q3, and Q4, respectively), and MAP (β (95% CI) was 1.39 (0.76, 2.02), 1.04 (0.24, 1.84) and 1.12 (0.43, 1.82) for Q2, Q3, and Q4, respectively). The associations were robust across sex, age, BMI, and when considering PM2.5 and NO2.ConclusionsTo our knowledge, this is the first cohort study in the general population that demonstrates the non-linear hypertensive effects of long-term O3 exposure. The findings are particularly relevant for policymakers and researchers involved in ambient pollution and public health, supporting the integration of reduction of ambient O3 into public health interventions.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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