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Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study.

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Title: Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study.
Authors: Cramer, Johannah1, Jørgensen, Jeanette T.1, Hoffmann, Barbara2, Loft, Steffen1, Bräuner, Elvira V.3, Prescott, Eva4, Ketzel, Matthias5,6, Hertel, Ole5, Brandt, Jørgen5, Jensen, Steen S.5, Backalarz, Claus7, Simonsen, Mette K.8, Andersen, Zorana J.1,9
Source: Environmental Health Perspectives. May2020, Vol. 128 Issue 5, p057003-1-057003-12. 12p. 3 Charts, 1 Graph, 1 Map.
Subject Terms: *Environmental exposure, *Particulate matter, Myocardial infarction risk factors, Cardiovascular diseases risk factors, Confidence intervals, Longitudinal method, Myocardial infarction, Noise, Questionnaires, Research funding, Self-evaluation, Lifestyles, Disease incidence, Proportional hazards models, Data analysis software, Descriptive statistics, Odds ratio
Geographic Terms: Denmark
Abstract: BACKGROUND: Air pollution exposure has been linked to coronary heart disease, although evidence on PM[Sub 2.5] and myocardial infarction (MI) incidence is mixed. OBJECTIVES: This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise. METHODS: We used data from the nationwide Danish Nurse Cohort on 22,882 female nurses (>44 years of age) who, at recruitment in 1993 or 1999, reported information on cardiovascular disease risk factors. Data on MI incidence was collected from the Danish National Patient Register until the end of 2014. Annual mean concentrations of particulate matter (PM) with a diameter <2.5 µg/m[Sup 3] (PM[Sub 2.5]), PM[Sub 10], nitrogen dioxide (NO[Sub 2]), and nitrogen oxides (NO[Sub x]) at the nurses’ residences since 1990 (PM[Sub 10] and PM[Sub 2.5]) or 1970 (NO[Sub 2] and NO[Sub x]) were estimated using the Danish Eulerian Hemispheric Model/Urban Background Model/AirGIS (DEHM/UBM/AirGIS) dispersion model. We used time-varying Cox regression models to examine the association between 1- and 3-y running means of these pollutants, as well as 23-y running means of NO[Sub 2] and NO[Sub x], with both overall and fatal incident MI. Associations were explored in three progressively adjusted models: Model 1, adjusted for age and baseline year; Model 2, with further adjustment for potential confounding by lifestyle and cardiovascular disease risk factors; and Model 3, with further adjustment for road traffic noise, modeled as the annual mean of a weighted 24-h average (L[Sub den]). RESULTS: Of the 22,882 women, 641 developed MI during a mean follow-up of 18.6 y, 121 (18.9%) of which were fatal. Reported hazard ratios (HRs) were based on interquartile range increases of 5.3, 5.5, 8.1, and 11.5µg/m[Sup 3] for PM[Sub 2.5], PM[Sub 10], NO[Sub 2], and NO[Sub X], respectively. In Model 1, we observed a positive association between a 3-y running mean of PM[Sub 2.5] and an overall incident MI with an HR = 1.20 (95% CI: 1.07, 1.35), which attenuated to HR = 1.06 (95% CI: 0.92, 1.23) in Model 2. In Model 1 for incident fatal MI, we observed a strong association with a 3-y running mean of PM[Sub 2.5], with an HR = 1.69 (95% CI: 1.33, 2.13), which attenuated to HR = 1.35 (95% CI: 1.01, 1.81) in Model 2. Similar associations were seen for PM[Sub 10], with 3-y, Model 2 estimates for overall and fatal incident MI of HR = 1.06 (95% CI: 0.91, 1.23) and HR = 1.35 (95% CI: 1.01, 1.81), respectively. No evidence of an association was observed for NO[Sub 2] or NO[Sub x]. For all pollutants, associations in Model 2 were robust to further adjustment for road traffic noise in Model 3 and were similar for a 1-y running mean exposure. CONCLUSIONS: We found no association between long-term exposure to PM[Sub 2.5], PM[Sub 10], NO[Sub 2], or NO[Sub x] and overall MI incidence, but we observed positive associations for PM[Sub 2.5] and PM[sub 10] with fatal MI. We present novel findings that the association between PM and MI incidence is robust to adjustment for road traffic noise. https://doi.org/10.1289/EHP5818 [ABSTRACT FROM AUTHOR]
Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Environmental+Health+Perspectives%22&quot;&gt;Environmental Health Perspectives&lt;/searchLink&gt;. May2020, Vol. 128 Issue 5, p057003-1-057003-12. 12p. 3 Charts, 1 Graph, 1 Map.
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  Data: BACKGROUND: Air pollution exposure has been linked to coronary heart disease, although evidence on PM[Sub 2.5] and myocardial infarction (MI) incidence is mixed. OBJECTIVES: This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise. METHODS: We used data from the nationwide Danish Nurse Cohort on 22,882 female nurses (&gt;44 years of age) who, at recruitment in 1993 or 1999, reported information on cardiovascular disease risk factors. Data on MI incidence was collected from the Danish National Patient Register until the end of 2014. Annual mean concentrations of particulate matter (PM) with a diameter &lt;2.5 &#194;&#181;g/m[Sup 3] (PM[Sub 2.5]), PM[Sub 10], nitrogen dioxide (NO[Sub 2]), and nitrogen oxides (NO[Sub x]) at the nurses&#226;€™ residences since 1990 (PM[Sub 10] and PM[Sub 2.5]) or 1970 (NO[Sub 2] and NO[Sub x]) were estimated using the Danish Eulerian Hemispheric Model/Urban Background Model/AirGIS (DEHM/UBM/AirGIS) dispersion model. We used time-varying Cox regression models to examine the association between 1- and 3-y running means of these pollutants, as well as 23-y running means of NO[Sub 2] and NO[Sub x], with both overall and fatal incident MI. Associations were explored in three progressively adjusted models: Model 1, adjusted for age and baseline year; Model 2, with further adjustment for potential confounding by lifestyle and cardiovascular disease risk factors; and Model 3, with further adjustment for road traffic noise, modeled as the annual mean of a weighted 24-h average (L[Sub den]). RESULTS: Of the 22,882 women, 641 developed MI during a mean follow-up of 18.6 y, 121 (18.9%) of which were fatal. Reported hazard ratios (HRs) were based on interquartile range increases of 5.3, 5.5, 8.1, and 11.5&#194;&#181;g/m[Sup 3] for PM[Sub 2.5], PM[Sub 10], NO[Sub 2], and NO[Sub X], respectively. In Model 1, we observed a positive association between a 3-y running mean of PM[Sub 2.5] and an overall incident MI with an HR = 1.20 (95% CI: 1.07, 1.35), which attenuated to HR = 1.06 (95% CI: 0.92, 1.23) in Model 2. In Model 1 for incident fatal MI, we observed a strong association with a 3-y running mean of PM[Sub 2.5], with an HR = 1.69 (95% CI: 1.33, 2.13), which attenuated to HR = 1.35 (95% CI: 1.01, 1.81) in Model 2. Similar associations were seen for PM[Sub 10], with 3-y, Model 2 estimates for overall and fatal incident MI of HR = 1.06 (95% CI: 0.91, 1.23) and HR = 1.35 (95% CI: 1.01, 1.81), respectively. No evidence of an association was observed for NO[Sub 2] or NO[Sub x]. For all pollutants, associations in Model 2 were robust to further adjustment for road traffic noise in Model 3 and were similar for a 1-y running mean exposure. CONCLUSIONS: We found no association between long-term exposure to PM[Sub 2.5], PM[Sub 10], NO[Sub 2], or NO[Sub x] and overall MI incidence, but we observed positive associations for PM[Sub 2.5] and PM[sub 10] with fatal MI. We present novel findings that the association between PM and MI incidence is robust to adjustment for road traffic noise. https://doi.org/10.1289/EHP5818 [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1289/EHP5818
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        Text: English
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        PageCount: 12
        StartPage: 057003-1
    Subjects:
      – SubjectFull: Environmental exposure
        Type: general
      – SubjectFull: Particulate matter
        Type: general
      – SubjectFull: Myocardial infarction risk factors
        Type: general
      – SubjectFull: Cardiovascular diseases risk factors
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Myocardial infarction
        Type: general
      – SubjectFull: Noise
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      – SubjectFull: Research funding
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      – SubjectFull: Self-evaluation
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        Type: general
      – SubjectFull: Odds ratio
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      – SubjectFull: Denmark
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      – TitleFull: Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study.
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              Text: May2020
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