Rioux Christine L, Tucker Katherine L, Mwamburi Mkaya, Gute David M, Cohen Steven A, Brugge Doug
Department of Public Health and Community Medicine, Tufts University, Boston, Massachusetts 02155 , USA.
Environ Health Perspect. 2010 Jun;118(6):803-11. doi: 10.1289/ehp.0901182. Epub 2010 Feb 2.
Traffic exposure may increase cardiovascular disease (CVD) risk via systemic inflammation and elevated blood pressure, two important clinical markers for managing disease progression.
We assessed degree and consistency of association between traffic exposure indicators as predictors of C-reactive protein (CRP) and pulse pressure (PP) in an adult U.S. Puerto Rican population (n = 1,017).
Cross-sectional information on health and demographics and blood data was collected. Using multiple linear regression, we tested for associations between CRP, PP, and six traffic exposure indicators including residential proximity to roads with > 20,000 vehicles/day and traffic density [vehicle miles traveled per square mile (VMT/mi2)]. Diabetes and obesity [body mass index (BMI) >or= 30 kg/m2] were tested as effect modifiers.
CRP was positively associated with traffic density in the total population [36% CRP difference with 95% confidence interval (CI) 2.5-81%] for residence within the highest versus lowest VMT/mi2 level. With BMI >or= 30, CRP showed significant positive associations with five of six traffic indices including residence <or= 200 m versus > 200 m of a roadway [22.7% CRP difference (95% CI, 3.15-46.1)] and traffic density in the third highest versus lowest VMT/mi2 level [28.1% difference (95% CI, 1.0-62.6)]. PP was positively associated with residence within <or= 100 m of a roadway for the total population [2.2 mmHg (95% CI, 0.13-4.3 mmHg)] and persons with BMI >or= 30 [3.8 mmHg (95% CI, 0.88-6.8)]. Effect estimates approximately doubled for residence within <or= 200 m of two or more roadways, particularly in persons with diabetes [8.1 mmHg (95% CI, 2.2-14.1)].
Traffic exposure at roadway volumes as low as 20,000-40,000 vehicles/day may increase CVD risk through adverse effects on blood pressure and inflammation. Individuals with elevated inflammation profiles, that is, BMI >or= 30, may be more susceptible to the effects of traffic exposure.
交通暴露可能通过全身炎症反应和血压升高增加心血管疾病(CVD)风险,这是管理疾病进展的两个重要临床指标。
我们评估了美国波多黎各成年人群(n = 1,017)中作为C反应蛋白(CRP)和脉压(PP)预测指标的交通暴露指标之间的关联程度和一致性。
收集了关于健康、人口统计学和血液数据的横断面信息。使用多元线性回归,我们测试了CRP、PP与六个交通暴露指标之间的关联,包括居住在每日车流量超过20,000辆的道路附近以及交通密度[每平方英里行驶的车辆英里数(VMT/mi2)]。将糖尿病和肥胖[体重指数(BMI)≥30 kg/m2]作为效应修饰因素进行测试。
在最高与最低VMT/mi2水平的居住人群中,CRP与交通密度呈正相关[CRP差异为36%,95%置信区间(CI)为2.5 - 81%]。当BMI≥30时,CRP与六个交通指标中的五个呈显著正相关,包括居住在距离道路≤200 m与>200 m处[CRP差异为22.7%(95% CI,3.15 - 46.1)]以及第三高与最低VMT/mi2水平的交通密度[差异为28.1%(95% CI,1.0 - 62.6)]。对于总体人群,PP与居住在距离道路≤100 m处呈正相关[2.2 mmHg(95% CI,0.13 - 4.3 mmHg)],对于BMI≥30的人群为[3.8 mmHg(95% CI,0.88 - 6.8)]。对于居住在两条或更多道路≤200 m范围内的人群,效应估计值大约翻倍,尤其是糖尿病患者[8.1 mmHg(95% CI,2.2 - 14.1)]。
每日车流量低至20,000 - 40,000辆的交通暴露可能通过对血压和炎症的不利影响增加CVD风险。炎症水平升高的个体,即BMI≥30的个体,可能更容易受到交通暴露的影响。