Exposure to Traffic-Related Air Pollution in Relation to Progression in Physical Disability among Older Adults

• Published in: Environmental health perspectives 2016-07, Vol.124 (7), p.1000-1008
• Main Authors: Weuve, Jennifer, Kaufman, Joel D, Szpiro, Adam A, Curl, Cynthia, Puett, Robin C, Beck, Todd, Evans, Denis A, Mendes de Leon, Carlos F
• Format: Article
• Language: English
• Subjects: Age; Aged; Aging; Air Pollutants - analysis; Air pollution; Air Pollution - statistics & numerical data; Automotive emissions; Censuses; Chronic illnesses; Disabled Persons - statistics & numerical data; Disease; Disease Progression; Environmental Exposure; Exposure; Geographic Information Systems; Health aspects; Humans; Investigations; Mortality; Nitrogen oxides; Older people; Outdoor air quality; Physically disabled persons; Pollutants; Population; Remote sensing; Roads & highways; Studies; Trends; Vehicle Emissions - analysis
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.1510089

Physical disability is common though not inevitable in older age and has direct bearing on a person's ability to perform activities essential for self-care and independent living. Air pollution appears to increase the risk of several chronic diseases that contribute to the progression of disability. We evaluated long-term exposure to traffic-related air pollution (TRAP) in relation to progression in physical disability. We conducted our investigation within the Chicago Health and Aging Project. We measured participants' exposures to TRAP using two surrogates: residential proximity to major roads (1993 onwards) and ambient concentrations of oxides of nitrogen (NOX; 1999 onwards), predicted via a geographic information systems-based spatiotemporal smoothing model (cross-validation R2 = 0.87) that incorporated community-based monitoring and resolved intraurban exposure gradients at a spatial scale of tens of meters. Participants' lower-extremity physical ability was assessed every 3 years (1993-2012) via tandem stand, chair stand, and timed walking speed. In multivariable-adjusted analyses (n = 5,708), higher long-term NOX exposure was associated with significantly faster progression in disability. Compared with the 5-year decline in physical ability score among participants in the lowest quartile of NOX exposure, decline among those in the highest exposure quartile was 1.14 units greater (95% confidence interval [CI]: -1.86, -0.42), equivalent to 3 additional years of decline among those in the lowest exposure quartile. The association was linear across the continuum of NOX exposure: per 10-ppb increment in exposure, the 5-year decline in physical ability score was 0.87 unit greater (95% CI: -1.35, -0.39). Proximity to a major road was not associated with disability progression (n = 9,994). These data join a growing body of evidence suggesting that TRAP exposures may accelerate aging-related declines in health. Weuve J, Kaufman JD, Szpiro AA, Curl C, Puett RC, Beck T, Evans DA, Mendes de Leon CF. 2016. Exposure to traffic-related air pollution in relation to progression in physical disability among older adults. Environ Health Perspect 124:1000-1008; http://dx.doi.org/10.1289/ehp.1510089.