Abstract
There is limited evidence that exposure to traffic-related air pollution is associated with the development of chronic lung allograft dysfunction and graft failure among lung transplant recipients. In this study we explore associations between traffic related air pollution and transplant failure among solid organ transplant recipients in Great Britain. We included all first lung, heart, liver and kidney transplants in Great Britain between 2000 and 2008. For each transplant recipient we used ESCAPE methods to model annual average air pollution exposure including nitrogen dioxide, nitrogen oxides and particulate matter (PM10, PM2.5, PMcoarse) for residential postcodes at time of transplant. We also included distance from residential postcode to nearest road and to nearest major road as well as traffic intensity on nearest major road. We fitted Cox regression models to assess associations between each air pollutant and transplant failure after adjustment for age, sex, socioeconomic and donor age/smoking status. We did not find any consistent association between first lung, liver, kidney or heart transplant failure and any of the analysed air pollutants or road metrics. The hazard ratio for distance to nearest road was 1.02 (95% CI 0.94-1.11), 1.01 (95% CI 0.91-1.11), 1.03 (95% CI 0.97-1.08) and 1.02 (95% CI 0.98-1.06) for lung, heart, liver and kidney failure, respectively. No consistent associations were seen in sensitivity analyses stratified by age-group (>60 years vs <60) and year of transplant. Our analysis did not find consistent associations between traffic related air pollution exposure and the risk of transplant failure. These findings contradict the limited current evidence on this topic and suggest that further work is need before any policies are developed.
Published Version
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