ESC Congress 2026 Abstract · Oct 26, 2026

Long-term light pollution exposure and mortality: a nationwide population-based analysis

By Jemielita P, Lip GYH, Swieczkowski M et al.

Background: Cardiovascular (CV) diseases remain the leading cause of death worldwide. Beyond established risk factors, increasing attention has focused on environmental determinants of CV risk. In addition to air pollution (AP), chronic exposure to outdoor artificial light at night (O-ALAN) has emerged as a widespread environmental factor potentially associated with adverse CV and overall outcomes. Purpose: To examine the association between chronic O-ALAN exposure and CV and all-cause mortality in a nationwide analysis. Methods: We analyzed individual-level mortality data from Poland for 2014-2023, obtained from the National Health Fund, to compute age-standardized CV and all-cause mortality rates (SDR) per 100.000 according to the European Standard Population. Chronic O-ALAN exposure was defined as the county-level mean for 2014-2022 derived from Suomi NPP satellite data. Spatial distribution and national temporal trends of O-ALAN are presented in Figure 2. AP data were obtained from the Copernicus program and ground monitoring stations. The primary analysis was conducted in a cross-sectional framework for 2023 using linear regression with Huber-White robust standard errors. Ten sequential models were constructed, progressively adjusting for meteorological factors, AP, socioeconomic status, and greenness (NDVI). Results were expressed as the change in SDR per interquartile range (IQR) increase in O-ALAN exposure. Model diagnostics included assessment of influential observations and sensitivity analyses excluding high-leverage units. Due to strong correlations between O-ALAN and indicators of urbanization and population density (r≈0.85), these variables were not included simultaneously in the primary models. Results: During 2014-2023, a total of 5.386.726 deaths were recorded, with a mean age at death of 73.5 years; 48% occurred in females. Of these, 2.084.773 deaths were attributed to CV diseases, with a mean age of 78.8 years and 54% occurring in females. Mean CV and all-cause SDR were 492.8 and 1148.3 per 100.000, respectively. Mean O-ALAN was 3.80 nW/cm²/sr (IQR 1.53). Higher O-ALAN was consistently associated with higher mortality (Figure 1). In crude models, an IQR increase in O-ALAN was associated with a 9.4 (95% CI: 5.1-13.8, p<0.001) increase in CV SDR and a 44.9 (95% CI: 34.1-55.7, p<0.001) increase in all-cause SDR per 100.000. In fully adjusted models, corresponding increases were 27.7 (95% CI: 19.2-36.3, p<0.001) and 61.8 (95% CI: 41.3-82.3, p<0.001), respectively. Associations remained robust in sensitivity analyses. At the population level, this magnitude corresponds to approximately 10.441 (95% CI: 7234.3-13647.66) excess CV deaths annually in Poland. Conclusions: Chronic exposure to O-ALAN was associated with higher cardiovascular and all-cause mortality at the population level. These findings highlight O-ALAN as a potentially relevant environmental correlate of CVD risk requiring further investigation.

doi.org/10.1093/eurheartj/ehag785.3522Open accessPopulations