Abstract
Introduction: The olfactory nerve is anatomically susceptible to injury from pollution in inspired air. Fine particulate matter (PM2.5) exposure has been implicated in ecologic and pathologic studies of olfaction, but there are no large-scale epidemiological studies investigating this relationship. Methods: We performed a cross-sectional analysis of urban respondents from the National Social Life, Health, and Aging Project, a representative sample of home-dwelling US adults age 57-85 years (n=2,210). Olfaction was tested using a validated 5-item Sniffin’ Sticks odor identification test, with dysfunction defined as ≤3 correct odorants identified. Exposure to PM2.5 at each respondent’s home was estimated as moving averages (1-12 months) prior to the date of olfactory assessment using validated spatio-temporal models. Odds ratios for olfactory dysfunction were computed using multivariate logistic regression, adjusting for potential confounders. Several effect modifiers of the PM2.5-olfaction relationship were also considered. Results: PM2.5 exposures averaged over 3-12 months were significantly associated with olfactory dysfunction in urban-dwelling respondents. The strongest effect was for 6 month average exposure (per 1-IQR increase in PM2.5: OR 1.28, 95% CI 1.05-1.55) after adjusting for confounders, with similar effect sizes for 3-12 month exposures. Interestingly, the most deleterious effects were observed among the youngest respondents (57-64 years old: OR 2.15, 95% CI 1.45-3.20), and those living in the Northeast (OR 2.12, 95% CI 1.17-3.83) and South (OR 1.43, 95% CI 0.97-2.10). Conclusions: We show for the first time that ambient air pollution exposure is associated with poor olfaction among urban-living, older US adults. Given the major quality of life burden caused by olfactory dysfunction, and the millions of people exposed to high PM2.5 levels, these findings have important implications for patients, physicians, and public health officials worldwide.
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