Document Detail

Traffic-related air pollution in relation to incidence and prognosis of coronary heart disease.
MedLine Citation:
PMID:  18091421     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Long-term air pollution exposure is associated with increased mortality, but the association with incidence of fatal and nonfatal coronary heart disease is less certain. Moreover, it is unknown how chronic exposure to air pollution affects prognosis among survivors of a first coronary event. This study evaluated the association between long-term traffic-related air pollution exposure and incidence of nonfatal and fatal coronary events, as well as subsequent hospital readmission and mortality among myocardial infarction survivors. METHODS: The study population comprised all residents of Rome aged 35-84 years during the period 1998-2000. Residential nitrogen dioxide (NO2) exposure as a marker of traffic pollution was assessed by a land-use regression model in 1995-1996 (R = 0.69). A total of 11,167 incident coronary events were observed (4654 fatal, including 3598 out-of-hospital coronary deaths, and 6513 nonfatal). The cohort of 6513 survivors was followed 4.0-7.5 years for readmission or mortality, starting 28 days from the date of first event. Relative risks per 10 mug/m of NO2 exposure, adjusted for age, sex, and socioeconomic status, were calculated by Poisson regression (population-based incidence) and Cox regression (cohort analysis). RESULTS: The relative risk for incidence in coronary events per 10 mug/m of NO2 was 1.03 (95% confidence interval = 1.00-1.07). Stronger associations were found for fatal cases (1.07; 1.02-1.12) and out-of-hospital deaths (1.08; 1.02-1.13). Using NO2 exposure at the time of the first event, there was no association of air pollution exposure with either subsequent hospital readmission or mortality among survivors of the first coronary event. CONCLUSIONS: Long-term air pollution exposure increases the risk of coronary heart disease, particularly fatal events. Hospital readmission or subsequent mortality among survivors was not associated with traffic air pollution.
Mats Rosenlund; Sally Picciotto; Francesco Forastiere; Massimo Stafoggia; Carlo A Perucci
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epidemiology (Cambridge, Mass.)     Volume:  19     ISSN:  1044-3983     ISO Abbreviation:  Epidemiology     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-02-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9009644     Medline TA:  Epidemiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-8     Citation Subset:  IM    
Department of Epidemiology, Rome E Local Health Authority, Rome, Italy.
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MeSH Terms
Aged, 80 and over
Air Pollutants / analysis,  toxicity*
Cohort Studies
Environmental Exposure / adverse effects*
Middle Aged
Myocardial Infarction / mortality*
Nitric Oxide / analysis,  toxicity*
Proportional Hazards Models
Rome / epidemiology
Urban Population
Vehicle Emissions / analysis,  toxicity*
Reg. No./Substance:
0/Air Pollutants; 0/Vehicle Emissions; 10102-43-9/Nitric Oxide

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