Long-term exposure to ambient air pollution and renal function in African Americans: the Jackson Heart Study.

Renal dysfunction is prevalent in the US among African Americans. Air pollution is associated with renal dysfunction in mostly white American populations, but has not been studied among African Americans. We evaluated cross-sectional associations between 1-year and 3-year fine particulate matter (PM2.5) and ozone (O3) concentrations, and renal function among 5090 African American participants in the Jackson Heart Study. We used mixed-effect linear regression to estimate associations between 1-year and 3-year PM2.5 and O3 and estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio (UACR), serum creatinine, and serum cystatin C, adjusting for: sociodemographic factors, health behaviors, and medical history and accounting for clustering by census tract. At baseline, JHS participants had mean age 55.4 years, and 63.8% were female; mean 1-year and 3-year PM2.5 concentrations were 12.2 and 12.4 µg/m3, and mean 1-year and 3-year O3 concentrations were 40.2 and 40.7 ppb, respectively. Approximately 6.5% of participants had reduced eGFR (< 60 mL/min/1.73m2) and 12.7% had elevated UACR (> 30 mg/g), both indicating impaired renal function. Annual and 3-year O3 concentrations were inversely associated with eGFR and positively associated with serum creatinine; annual and 3-year PM2.5 concentrations were inversely associated with UACR. We observed impaired renal function associated with increased O3 but not PM2.5 exposure among African Americans.

A National County-Level Assessment of U.S. Nursing Facility Characteristics Associated with Long-Term Exposure to Traffic Pollution in Older Adults.

Long-term exposure to ambient air pollution increases disease risk in older adults. Nursing facilities located near major roadways potentially expose older adults to traffic pollution. No studies, however, have described the association between nursing facilities and traffic pollution. We obtained data on facility- and census-tract-level characteristics of 15,706 U.S. facilities from the Medicare Nursing Home Compare datasets. We calculated distance to major roadways and traffic density for each facility. In the contiguous U.S. (as of 2014), 345,792 older adults, about 27% of residents in non-hospital facilities, lived within 150 m major roadways (A1 or A2) in 3876 (28% of sampled) facilities. Nationally, for-profit facilities, high-occupancy facilities, and facilities in census tracts with higher percentages of minorities were more likely to have higher exposure to traffic. Counties in Virginia, New York City, and Rhode Island have the highest percent of residents and facilities near major roads. Nationally, over one-quarter of sampled facilities are located near major roadways. Attributes potentially associated with higher exposure to traffic included "for-profit" and "higher minority census tract". Proximity to major roadways may be an important factor to consider in siting nursing facilities. Our results inform potential intervention strategy at both county and facility level.