Multimorbidity is defined as having two or more physical or mental health conditions and affects 27 percent of adults in UK primary care. It increases the use of healthcare services and the costs of primary and secondary care, but its association with air pollution has not been studied in the UK until now.
Health Consequences due to Air Pollution
The strongest associations were observed for co-occurring neurological, respiratory, cardiovascular, and common mental health conditions such as depression and anxiety.
This research was funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and the NIHR Applied Research Collaboration (ARC) South London.
Dr. Amy Ronaldson, Research Associate at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, and first author on the study said: “People with more than one long-term health condition have a lower quality of life and greater dependence on the healthcare system. Our NIHR funded research has indicated that those who live in areas of higher traffic-related air pollution are at greater risk of having multiple health conditions. The study does not prove that air pollution causes multimorbidity, but it does warrant further research in this area. It could be that simple measures to reduce traffic levels could potentially improve lives and lessen the pressure on our healthcare systems.”
Researchers analyzed data from UK Biobank – a large-scale biomedical database and research resource containing anonymized genetic, lifestyle, and health information from half a million UK participants aged between 40 and 69 years. Participants were assessed for 36 physical and five mental health chronic conditions. Multimorbidity was defined as having two or more of these conditions.
Physical and mental health data from the UK Biobank in 2010 were linked with the estimated concentration of air pollution at the residential address of the participants.
For participants exposed to above 30µg/m3 of NO2 the research showed a 20 percent increased risk of having two or more co-occurring conditions compared to those participants that were exposed to concentrations of NO2 below 20µg/m3.
Amongst those with multiple conditions, increased exposure to both PM2.5 and NO2 was linked to a greater severity of the co-occurring conditions.
Dr Ioannis Bakolis, Reader at the IoPPN, King’s College London, and senior author on the study said: “How air pollution affects multiple organs and systems at the same time is not yet fully understood, but there is some evidence that mechanisms such as inflammation, oxidative stress, and immune activation could be triggered by air particulates, which can cause damage to the brain, heart, blood, lungs, and gut.
“Our study suggests that it could be through shared mechanisms that air pollution negatively impacts several body systems and increases the likelihood of people developing multiple long-term health conditions. More research is needed to understand just how air pollution affects the different bodily systems, but it may be that tackling air pollution could help prevent and alleviate the debilitating impact of multiple long-term health conditions.”
Researchers identified several patterns in the associations: the strongest links were primarily between conditions relating to the respiratory system (asthma, chronic obstructive pulmonary disease) as well as the cardiovascular system (atrial fibrillation, coronary heart disease, heart failure), but also to neurological and common mental conditions (stroke, substance abuse, depression, anxiety).
The study, ‘Associations between air pollution and multimorbidity in the UK Biobank: A cross-sectional study’ was published in Frontiers in Public Health.
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