expert reaction to study looking at air pollution exposure and atrial ... - Science Media Centre

expert reaction to study looking at air pollution exposure and atrial fibrillation risk | Science Media Centre

A study published in PNAS looks at air pollution, genetic susceptibility, and the risk of atrial fibrillation.

Prof Anna Hansell, Professor of Environmental Epidemiology; Director of the Centre for Environmental Health and Sustainability; and Director of the NIHR Health Protection Research Unit in Environmental Exposures and Health, University of Leicester, said:

“Investigation of interactions between combinations of genetic factors and air pollution is important to identify those who may be most susceptible to ill effects of air pollution. However, given some issues with the way in which air pollution exposure has been estimated in this paper, it is difficult to have confidence in the estimated size of the effects. Given known associations of long-term air pollution with heart disease including atrial fibrillation – even at lower concentrations – reduction of air pollution levels is important to improve public health. However, more studies are needed before considering targeted medical care for individuals with a particular genetic make-up, in relation to air pollution exposures.

“Detailed comments on air pollution exposure estimates: Unfortunately, and in common with some other recent studies, the researchers have incorrectly averaged estimates of two different air pollution models in UK Biobank used to estimate exposures at enrolment in the study (the ESCAPE model for 2010 and a European model for 2005-7). This may introduce bias as these models are different and were not designed to be combined. Results affected are for PM10 and NO2 air pollutant analyses (which are the two pollutants where additive interactions between the air pollutant and the genetic risk score were identified). In supplementary analyses, the authors added in a further two different types of exposure models at 1mk and 3km grids to look at impacts of cumulative exposure and short-term exposure respectively. They didn’t find effects in these supplementary analyses, but the spatial scale may have resulted in making it more difficult to detect effects due to errors in estimating exposure especially for NO2 pollution, which is much higher along roads (therefore the actual exposures may be diluted if using a 1km average). Issues with exposure models and potential impact on results were not discussed in the paper. While interactions between air pollution and genetic factors is certainly plausible, further studies exploring these are needed.”

‘Air pollution, genetic susceptibility, and the risk of atrial fibrillation: A large prospective cohort study’ by Yudiyang Ma et al. was published in PNAS at 20:00 UK time on Monday 31 July 2023.

DOI: 10.1073/pnas.2302708120

Declared interests

Prof Anna Hansell: “I do not have conflicts of interest to report. I am Chair of the Committee on the Medical Effects of Air Pollution (COMEAP), but comments here are in a personal capacity as Professor of Environmental Epidemiology at the University of Leicester.”