Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Occup Environ Med. 2012 Sep;69(9):651-7. doi: 10.1136/oemed-2011-100285. Epub 2012 Jun 12.
Ambient particulate air pollution has been linked to cardiovascular disease. Occupational particle exposure levels may be several times higher than ambient levels but has been less studied.
The authors investigated the association between occupational exposure to particles and the incidence of ischaemic heart disease (IHD).
The cohort included all manual workers in the Swedish national census of 1980 with information on demographic data and occupation. Information on hospital admissions for acute myocardial infarction or other IHDs and cause of death were obtained from nation-wide registers. A job-exposure matrix for exposure to small (<1 μm) and large (>1 μm) particles was developed. HRs were calculated with Cox regression with adjustment for sex, age, socioeconomic group and urban/rural residential area.
Exposure to small particles was associated with an increased HR for acute myocardial infarction of 1.12 (95% CI 1.09 to 1.15), and HR for exposure to large particles was 1.14 (95% CI 1.10 to 1.18). The association was somewhat stronger for workers exposed to small particles for more than 5 years, 1.21 (95% CI 1.11 to 1.31), but no trend with exposure intensity was found. The risk associated with exposure to small particles was higher among women than among men, 1.30 (95% CI 1.12 to 1.51) and 1.10 (95% CI 1.07 to 1.14), respectively. Findings were essentially similar for other IHDs.
This explorative study gives some support to the hypothesis that occupational exposure to particles increases the risk of acute myocardial infarction and other IHD. The findings must be interpreted cautiously due to lack of smoking data.
环境颗粒物空气污染与心血管疾病有关。职业性颗粒物暴露水平可能是环境水平的数倍，但研究较少。
作者研究了职业性颗粒物暴露与缺血性心脏病（IHD）发病之间的关系。
该队列包括瑞典 1980 年全国人口普查中所有体力劳动者，包括人口统计学数据和职业信息。通过全国登记册获得因急性心肌梗死或其他 IHD 住院以及死因的信息。开发了一个用于小粒径（<1 μm）和大粒径（>1 μm）颗粒物暴露的职业暴露矩阵。采用 Cox 回归计算 HR，并校正性别、年龄、社会经济群体和城乡居住区域。
暴露于小粒径颗粒物与急性心肌梗死的 HR 增加 1.12（95%CI 1.09 至 1.15）相关，暴露于大粒径颗粒物的 HR 为 1.14（95%CI 1.10 至 1.18）。暴露于小粒径颗粒物超过 5 年的工人，这种相关性更强，HR 为 1.21（95%CI 1.11 至 1.31），但未发现暴露强度与风险之间存在趋势。暴露于小粒径颗粒物与女性发生急性心肌梗死的相关性高于男性，HR 分别为 1.30（95%CI 1.12 至 1.51）和 1.10（95%CI 1.07 至 1.14）。对于其他 IHD，结果基本相似。
这项探索性研究为职业性颗粒物暴露增加急性心肌梗死和其他 IHD 风险的假说提供了一定支持。由于缺乏吸烟数据，这些发现必须谨慎解释。
