Rosenlund Mats, Bellander Tom, Nordquist Tobias, Alfredsson Lars
Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden.
Epidemiology. 2009 Mar;20(2):265-71. doi: 10.1097/EDE.0b013e318190ea68.
Although long-term air pollution exposure has been linked to cardiovascular mortality, data on incidence and nonfatal coronary disease are limited and inconclusive. The aim of this study was to investigate the association between long-term residential exposure to air pollution from traffic and the risk of nonfatal and fatal myocardial infarction.
The records of all individuals aged 15 to 79 with a first event of myocardial infarction in Stockholm County during 1985 to 1996 were retrieved from a registry. Population controls were randomly selected from the study base stratified by age, sex, and calendar year. Individual socioeconomic data and home addresses were obtained from population censuses 1970 to 1995. Annual air pollution exposure was assessed by dispersion modeling at the home addresses of 24,347 cases and 276,926 controls.
Five-year average traffic-generated air pollution exposure corresponding to a difference in nitrogen dioxide from the fifth to the 95th percentile (31 microg/m) was associated with an odds ratio for fatal myocardial infarction adjusted for age, sex, calendar year, and socioeconomic status of 1.23 (95% confidence interval [CI] = 1.15-1.32). The corresponding odds ratio was 2.54 (1.96-3.29) among those with least expected misclassification of true individual exposure (those who did not move between censuses). Different time-windows and analyses of other pollutants including carbon monoxide and particles less than 10 mum in diameter (PM10) produced weaker associations. There was no increased risk for nonfatal myocardial infarction (ORs 0.94-0.98).
Long-term exposure to traffic-generated air pollution is associated with fatal myocardial infarction but not with nonfatal infarction.
尽管长期暴露于空气污染与心血管疾病死亡率相关，但关于发病率和非致命性冠心病的数据有限且尚无定论。本研究的目的是调查长期居住暴露于交通产生的空气污染与非致命性和致命性心肌梗死风险之间的关联。
从一个登记处检索了1985年至1996年期间斯德哥尔摩县所有年龄在15至79岁之间首次发生心肌梗死的个体记录。从按年龄、性别和历年分层的研究基础中随机选择人群对照。个体社会经济数据和家庭住址来自1970年至1995年的人口普查。通过扩散模型对24347例病例和276926例对照的家庭住址处的年度空气污染暴露进行评估。
五年平均交通产生的空气污染暴露，对应二氧化氮从第5百分位数到第95百分位数的差异（31微克/立方米），与经年龄、性别、历年和社会经济状况调整后的致命性心肌梗死优势比为1.23（95%置信区间[CI]=1.15 - 1.32）相关。在真实个体暴露误分类可能性最小的人群（在两次人口普查之间未搬家的人）中，相应的优势比为2.54（1.96 - 3.29）。不同的时间窗以及对包括一氧化碳和直径小于10微米的颗粒物（PM10）在内的其他污染物的分析产生的关联较弱。非致命性心肌梗死风险没有增加（优势比为0.94 - 0.98）。
长期暴露于交通产生的空气污染与致命性心肌梗死相关，但与非致命性梗死无关。
