Association between long-term exposure to dust PM_2.5 and blood lipids: A nationwide longitudinal study in China

Sand and dust storms have become increasingly serious issues because of the intensified climate change challenges, but evidence on the relationship between long-term exposure to dust-sourced fine particulate matter (dust PM_2.5) and blood lipids is limited, which is crucial for the early prevention of cardiovascular disease.

This study used longitudinal data with repeated measurements (683,759 observations from 292,754 participants) from the China National Stroke Screening Survey (CNSSS), a multicenter nationwide survey conducted between 2013 and 2019. Long-term exposure to dust PM_2.5 was constructed from multiple exposure data sources, with a spatial resolution of 10 km × 10 km. We employed individual fixed effect models to evaluate the associations between long-term exposure to dust PM_2.5 and blood lipid profiles, controlling for time-invariant confounding factors. Thin plate spline functions were used to model the nonlinear exposure-response relationships between dust PM_2.5 and each of the four blood lipid levels.

Each interquartile range (IQR) increase in cumulative 6-month exposure to dust PM_2.5 was associated with 3.32 % (95 % confidence interval [CI]: 3.02 %, 3.63 %), 2.04 % (95 % CI: 1.65 %, 2.42 %), and 1.11 % (95 % CI: 0.84 %, 1.37 %) increases in low-density lipoprotein (LDL-C), triglycerides (TG), and total cholesterol (TCHO) levels, respectively, and a 3.25 % (95 % CI: 2.94 %, 3.56 %) decrease in high-density lipoprotein cholesterol (HDL-C) levels. Dust PM_2.5 showed almost monotonic adverse effects on blood lipids, except for LDL-C.

Our results suggest that long-term exposure to dust PM_2.5 was deleteriously associated with blood lipids. Measures to mitigate the long-term hazard of dust exposure are imperative to improve adverse cardiovascular outcomes in the future.