Clean air policy reduces the atherogenic lipid profile levels: Results from China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) Study

J Hazard Mater. 2024 Oct 5:478:135394. doi: 10.1016/j.jhazmat.2024.135394. Epub 2024 Aug 8.

Abstract

Evidence of the associations between long-term exposure to PM2.5 and O3 and human blood lipid concentrations is abundant yet inconclusive. Whether clean air policies could improve lipid profiles remains unclear. In total, 2979312 participants from a Chinese nationwide prospective study were included. For cross-sectional analyses, linear mixed-effects models were utilized to assess the associations of pollutants with lipid profiles (TC, LDL-C, TG, HDL-C). For longitudinal analyses, a quasi-experimental design and difference-in-differences models were employed to investigate the impact of China's Clean Air Act. In the cross-sectional analyses, each IQR increase in PM2.5 was associated with 2.49 % (95 % CI: 2.36 %, 2.62 %), 2.51 % (95 % CI: 2.26 %, 2.75 %), 3.94 % (95 % CI: 3.65 %, 4.23 %), and 1.54 % (95 % CI: 1.38 %, 1.70 %) increases in TC, LDL-C, TG, and HDL-C, respectively. For each IQR increase in O3, TC, LDL-C, TG, and HDL-C changed by 1.06 % (95 % CI: 0.95 %, 1.17 %), 1.21 % (95 % CI: 1.01 %, 1.42 %), 1.78 % (95 % CI: 1.54 %, 2.02 %), and -0.63 % (95 % CI: -0.76 %, -0.49 %), respectively. Longitudinal analyses showed that the intervention group experienced greater TC, LDL-C, and HDL-C reductions (1.77 %, 4.26 %, and 7.70 %, respectively). Our findings suggest that clean air policies could improve lipid metabolism and should be implemented in countries with heavy air pollution burdens.

Keywords: Air quality improvement; Cohort study; Lipids; O(3); PM(2.5).

MeSH terms

  • Adult
  • Aged
  • Air Pollutants* / analysis
  • Air Pollution* / analysis
  • Air Pollution* / prevention & control
  • Atherosclerosis / blood
  • Atherosclerosis / prevention & control
  • China
  • Cross-Sectional Studies
  • Environmental Exposure
  • Female
  • Humans
  • Lipids* / blood
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Ozone / analysis
  • Particulate Matter* / analysis
  • Prospective Studies

Substances

  • Particulate Matter
  • Air Pollutants
  • Lipids
  • Ozone