This site is intended for health professionals only


Air pollution linked to multiple long-term health conditions

Air pollution linked to multiple long-term health conditions

People living in areas with high levels of air pollution from traffic are more likely to have multiple long-term physical and mental health conditions, according to a new study.

Researchers at King’s College London have found that exposure to traffic-related air pollution, specifically fine particulate matter and nitrogen dioxide, is associated with an increased risk of having at least two long-term health conditions, with both physical and mental health affected.

The most commonly observed conditions include neurological, respiratory and cardiovascular conditions, as well as anxiety and depression.

The research, published in Frontiers in Public Health, is the first to look at possible associations between air pollution and multimorbidity in the UK.

Multimorbidity, defined as having two or more physical or mental health conditions, affects 27% of adults in UK primary care. Having multiple conditions increases a patient’s use of health care services and the associated costs at both primary and secondary care levels.

The researchers used data from the UK Biobank to determine levels of multimorbidity in more than 364,000 people in England, aged between 50 and 69.

Participants were assessed for 36 physical and 5 mental health chronic conditions,  and the data was linked to estimated concentrations of air pollution at the residential address of the participants.

The analysis showed that participants who were exposed to high levels of fine particulate material (above 10µg/m3) had a 21% increased risk of two or more co-occurring conditions compared to those exposed to concentrations below 10µg/m3. People exposed to high levels of nitrogen dioxide (over 30µg/m3) also had a 20% increased risk of multimorbidity compared to those exposed to 20µg/m3 or less.

For participants with multiple conditions, exposure to both pollutants was linked to greater severity of the co-occurring conditions.

Dr Amy Ronaldson, from King’s College London and first author of 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 research has indicated that those people that live in areas of higher traffic-related air pollution are at greater risk of having multiple health conditions.’

Conditions which were shown to be associated with exposure to high levels of air pollution included asthma and chronic obstructive pulmonary disease, heart disease, strokes, as well as an increased likelihood of substance abuse, depression and anxiety.

Dr Ioannis Bakolis, from King’s, 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.’

The researchers stated that the study does not prove air pollution causes multimorbidity, but further research in this area is needed to understand the association.

Dr Bakolis added: ‘It may be that tackling air pollution could help prevent and alleviate the debilitating impact of multiple long-term health conditions.’

In October, a study showed that unborn foetuses could already have pollution particles in their lungs, brain and other vital organs in their first trimester.

In May, practice nurses in London received training on how to advise patients to reduce their exposure to air pollution, in a first-of-its-kind project. 

See how our symptom tool can help you make better sense of patient presentations
Click here to search a symptom