Rosenlund Mats, Berglind Niklas, Pershagen Göran, Hallqvist Johan, Jonson Tage, Bellander Tom
Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden.
Epidemiology. 2006 Jul;17(4):383-90. doi: 10.1097/01.ede.0000219722.25569.0f.
Cohort studies have reported increased risks of cardiopulmonary mortality from long-term air pollution exposure, but the evidence is limited and inconclusive. We studied the association between long-term exposure to source-specific air pollution and myocardial infarction (MI) in a case-control study of first-time MI cases and population controls age 45 to 70 years in Stockholm county in 1992 to 1994.
Home addresses during several decades were combined with historical emission databases and dispersion models to obtain annual mean levels of pollutants from traffic and heating during 30 years for 1397 cases and 1870 controls. Nitrogen dioxide (NO2), carbon monoxide (CO), and particulate matter with an aerodynamic diameter less than 10 microm (PM10) were used as indicators of traffic emissions and sulfur dioxide (SO2) as an indicator of emissions from residential heating.
There was no association between long-term average air pollution exposure and overall MI, but an increased risk of fatal MI was suggested, especially for out-of-hospital death. After adjustment for cardiovascular risk factors, the odds ratio for fatal MI associated with a 5th to 95th percentile difference in 30-year average exposure was 1.51 (95% confidence interval = 0.96-2.16) for NO2, 1.22 (0.98-1.52) for CO, 1.39 (0.94-2.07) for PM10, and 1.24 (0.77-2.02) for SO2. For out-of-hospital death, the odds ratio related to NO2 exposure was 2.17 (1.05-4.51).
This study provides some support for an association between long-term air pollution exposure and fatal cardiovascular disease.
队列研究报告称，长期暴露于空气污染中会增加心肺疾病死亡风险，但证据有限且尚无定论。我们在一项病例对照研究中，对1992年至1994年斯德哥尔摩郡45至70岁的首次心肌梗死（MI）病例和人群对照进行了研究，以探讨长期暴露于特定来源空气污染与心肌梗死之间的关联。
将几十年间的家庭住址与历史排放数据库和扩散模型相结合，以获取1397例病例和1870例对照在30年期间交通和供暖产生的污染物年平均水平。二氧化氮（NO2）、一氧化碳（CO）和空气动力学直径小于10微米的颗粒物（PM10）用作交通排放指标，二氧化硫（SO2）用作住宅供暖排放指标。
长期平均空气污染暴露与总体心肌梗死之间无关联，但提示致命性心肌梗死风险增加，尤其是院外死亡。在调整心血管危险因素后，30年平均暴露量第5至95百分位数差异与致命性心肌梗死相关的比值比，二氧化氮为1.51（95%置信区间=0.96-2.16），一氧化碳为1.22（0.98-1.52），PM10为1.39（0.94-2.07），二氧化硫为1.24（0.77-2.02）。对于院外死亡，与二氧化氮暴露相关的比值比为2.17（1.05-4.51）。
本研究为长期空气污染暴露与致命性心血管疾病之间的关联提供了一些支持。
