Exposure to ambient air pollution and elevated blood levels of gamma-glutamyl transferase in a large Austrian cohort

Gamma glutamyl transferase (GGT) is related to oxidative stress and an indicator for liver damage. We investigated the association between air pollution and GGT in a large Austrian cohort (N = 116,109) to better understand how air pollution affects human health.  Data come from voluntary prevention visits that were routinely collected within the Vorarlberg Health Monitoring and Prevention Program (VHM&PP). Recruitment was ongoing from 1985 to 2005. Blood was drawn and GGT measured centralized in two laboratories. Land use regression models were applied to estimate individuals' exposure at their home address for particulate matter (PM) with a diameter of <2.5 μm (PM2.5), <10 μm (PM10), fraction between 10 μm and 2.5 μm (PMcoarse), as well as PM2.5 absorbance (PM2.5abs), NO 2, NO x and eight components of PM. Linear regression models, adjusting for relevant individual and community-level confounders were calculated.  The study population was 56 % female with a mean age of 42 years and mean GGT was 19.0 units. Individual PM2.5 and NO 2 exposures were essentially below European limit values of 25 and 40 μg/m 3, respectively, with means of 13.58 μg/m 3 for PM2.5 and 19.93 μg/m 3 for NO 2. Positive associations were observed for PM2.5, PM10, PM2.5abs, NO 2, NO x, and Cu, K, S in PM2.5 and PM10 fractions and Zn mainly in PM2.5 fraction. The strongest association per interquartile range observed was an increase of serum GGT concentration by 1.40 % (95 %-CI: 0.85 %; 1.95 %) per 45.7 ng/m 3 S in PM2.5. Associations were robust to adjustments for other biomarkers, in two-pollutant models and the subset with a stable residential history.  We found that long-term exposure to air pollution (PM2.5, PM10, PM2.5abs, NO 2, NO x) as well as certain elements, were positively associated with baseline GGT levels. The elements associated suggest a role of traffic emissions, long range transport and wood burning.