Association between Air Pollution Exposure and Self-Report of Recent Respiratory Infection: A MESA Air study

Abstract

Background: Ambient air pollution has been linked to multiple adverse health outcomes. Most of these studies have use large-scale models to estimate air pollution exposures and have identified health outcomes based on hospital diagnosis codes. The Multi-Ethnic Study of Atherosclerosis (MESA) and MESA Air provide residence-level air pollution data. We investigated the association between these data and information collected prospectively on recent MESA participant infection. Methods & Results: MESA, a prospective cohort study, followed over 6800 participants with 5 study visits over 12 years. Data collected included participant self-report of recent respiratory infection. Individual ambient air pollution exposures to fine particulate matter (PM2.5), oxides of nitrogen (NOx and NO2), and black carbon (BC) were estimated. Cross-sectional and longitudinal associations were examined with generalized linear models for each pollutant adjusted for confounders: study site, season of exam, age, sex, race/ethnicity, smoking, and socio-economic status. Across all study sites, air pollution exposure estimates decreased. Report of recent respiratory infection was associated with season, the highest prevalence in winter. Nearly 18% of participants reported infection during the 2 weeks prior to their visit. Significant associations were seen between increased prevalence of infection and elevated exposures to PM2.5, NOx, and NO2. Discussion: In a large population-based cohort study, we found robust evidence that the prevalence of respiratory infection is increased in participants exposed to higher levels of ambient air pollution.