Short-term exposure to fine particulate air pollution and emergency department visits for kidney diseases in the Atlanta metropolitan area

Toxicological evidence has shown that fine particulate matter (PM(2.5)) may affect distant organs, including kidneys, over the short term. However, epidemiological evidence is limited. OBJECTIVES: We investigated associations between short-term exposure to PM(2.5), major PM(2.5) components [elemental carbon (EC), organic carbon (OC), sulfate, and nitrate], and gaseous co-pollutants (O(3), CO, SO(2), NO(2), and NO(x)) and emergency department (ED) visits for kidney diseases during 2002–2008 in Atlanta, Georgia. METHODS: Log-linear time-series models were fitted to estimate the acute effects of air pollution, with single-day and unconstrained distributed lags, on rates of ED visits for kidney diseases [all renal diseases and acute renal failure (ARF)], controlling for meteorology (maximum air and dew-point temperatures) and time (season, day of week, holidays, and long-term time trend). RESULTS: For all renal diseases, we observed positive associations for most air pollutants, particularly 8-day cumulative exposure to OC [rate ratio (RR) = 1.018, (95% confidence interval [CI]: 1.003, 1.034)] and EC [1.016 (1.000, 1.031)] per interquartile range increase exposure. For ARF, we observed positive associations particularly for 8-day exposure to OC [1.034 (1.005, 1.064)], EC [1.032 (1.002, 1.063)], nitrate [1.032 (0.996, 1.069)], and PM(2.5) [1.026 (0.997, 1.057)] per interquartile range increase exposure. We also observed positive associations for most criteria gases. The RR estimates were generally higher for ARF than all renal diseases. CONCLUSIONS: We observed positive associations between short-term exposure to fine particulate air pollution and kidney disease outcomes. This study adds to the growing epidemiological evidence that fine particles may impact distant organs (e.g., kidneys) over the short term.