Background: Short telomeres are associated with chronic disease and early mortality. Urban and traffic pollution has been associated with telomere attrition in adults and children. The associations of household air pollution from biomass stoves and telomere length are unknown. Objectives: To investigate the associations between household air pollution and telomere length in adult women. Methods: We conducted a repeated-measure (one summer and two winter seasons) panel study of 137 rural Chinese women (mean age=55 γ), measured their 48-h personal exposure to fine particulate matter (PM2.5) and black carbon (BC), and collected their oral DNA that was analyzed for relative telomere length (RTL). Non-linear associations were assessed using natural cubic splines (2-4 DF). Multivariates mixed models were used to examine the relationship between air pollution exposure and telomere length. Results: Air pollution exposures ranged from 13-945 μg/m3 (arithmetic mean=141, SE: 11) for PM2.5 and 0.1-139 μg/m3 (mean=4.1, SE: 0.4) for BC. Spline models illustrated that the associations between air pollution and RTL were non-linear. A 1-ln (μg/m3) increase in air pollution was associated with lower RTL (PM2.5 [-0.45, 95% CI: -0.88, -0.02, p=0.04], BC [-0.81, 95% CI: -1.21, -0.39, p<0.001]) after adjusting for age, waist circumference, ethnicity, secondhand smoke, sodium intake, day of the week, and time of day. Additionally adjusting for ambient temperature reduced the effect of air pollution by 23-62% (BC [-0.62, 95% CI: -1.09, -0.15, p=0.01]; PM2.5 [-0.17, 95% CI: -0.72, 0.39], p=0.54), which may be due to more frequent biomass burning to heat homes when the outdoor temperature is colder. Conclusion: Household air pollution exposure is associated with shorter telomeres in rural Chinese women cooking with biomass fuel, with stronger associations for BC than PM2.5 mass.
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