Increased allostatic load associated with ambient air pollution acting as a stressor: Cross-sectional evidence from the China multi-ethnic cohort study

Abstract

BackgroundAllostatic load measures the cumulative biological burden imposed by chronic stressors. Emerging experimental evidence supports that air pollution acting as a stressor activates the neuroendocrine system and then produces multi-organ effects, leading to allostatic load. However, relevant epidemiological evidence is limited. ObjectivesWe aim to explore the relationships between chronic exposure to ambient air pollution (PM1, PM2.5, PM10, and O3) and allostatic load in Chinese adults. MethodsThis cross-sectional study included 85,545 participants aged 30–79 from the baseline data of the China Multi-Ethnic Cohort (CMEC). Ambient air pollution levels were evaluated by a satellite-based random forest approach. The previous three-year average exposure concentrations were calculated for each participant based on the residential address. The outcome allostatic load was identified through the sum of the sex-specific scores of twelve biomarkers belonging to four major categories: cardiovascular, metabolic, anthropometric, and inflammatory parameters. We performed statistical analysis using a doubly robust approach which relies on inverse probability weighting and outcome model to adjust for confounding. ResultsLong-term exposure to ambient air pollution was significantly associated with an increased risk of allostatic load, with relative risk (95% confidence interval) of 1.040 (1.024, 1.057), 1.029 (1. 018, 1. 039), and 1.087 (1.074, 1.101) for each 10 μg/m3 increase in ambient PM2.5, PM10, and O3, respectively. No significant relationship was observed between chronic exposure to PM1 and allostatic load. The associations between air pollution and allostatic load are modified by some intrinsic factors and non-chemical stressors. The people with older, minority, lower education, and lower-income levels had a significantly higher allostatic load induced by air pollution. ConclusionsChronic exposure to ambient PM2.5, PM10, and O3 may increase the allostatic load. This finding provides epidemiological evidence that air pollution may be a chronic stressor, leading to widespread physiological burdens.