A Global Assessment of Air Pollution and Cardiovascular and Respiratory Disease in the Prospective Urban and Rural Epidemiological Study

Globally, it is estimated that outdoor and indoor air pollution account for 3.2 and 3.6 million deaths annually. Most of these deaths are due to cardiovascular and respiratory diseases experienced by populations in low and medium income countries, where air pollution exposures are typically highest. However, the large majority of epidemiological research has been conducted in developed countries. The objective of this study is therefore to conduct a global assessment of indoor and outdoor air pollution exposures and their associations with cardiovascular and respiratory disease. I will use data from the Prospective Urban and Rural Epidemiological (PURE) study, which includes 153,996 adults residing in 628 communities in 17 low, middle, and high-income countries. I will conduct outdoor air pollution exposure assessments for these communities using state-of-the-art satellite-based methods in combination with Geographic Information Systems and will assess indoor air pollution using household-level measures of solid fuel use collected in the PURE questionnaire. Analyses will examine associations between these air pollution exposure estimates and individual measures of cardiovascular and respiratory disease, after accounting for other known or suspected risk factors. This research will provide a seminal global analysis of air pollution and cardiovascular and respiratory disease that will address a substantial gap in the existing literature, contribute to enhancing global burden of disease estimates, and identify potential susceptible populations.