Institute for Risk Assessment Sciences (IRAS), division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, Netherlands.
MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St. Mary's Campus, London, UK.
Environ Health Perspect. 2018 Dec;126(12):127007. doi: 10.1289/EHP3047.
There is growing evidence that exposure to ultrafine particles (UFP; particles smaller than [Formula: see text]) may play an underexplored role in the etiology of several illnesses, including cardiovascular disease (CVD).
We aimed o investigate the relationship between long-term exposure to ambient UFP and incident cardiovascular and cerebrovascular disease (CVA). As a secondary objective, we sought to compare effect estimates for UFP with those derived for other air pollutants, including estimates from two-pollutant models.
Using a prospective cohort of 33,831 Dutch residents, we studied the association between long-term exposure to UFP (predicted via land use regression) and incident disease using Cox proportional hazard models. Hazard ratios (HR) for UFP were compared to HRs for more routinely monitored air pollutants, including particulate matter with aerodynamic diameter [Formula: see text] ([Formula: see text]), PM with aerodynamic diameter [Formula: see text] ([Formula: see text]), and [Formula: see text].
Long-term UFP exposure was associated with an increased risk for all incident CVD [[Formula: see text] per [Formula: see text]; 95% confidence interval (CI): 1.03, 1.34], myocardial infarction (MI) ([Formula: see text]; 95% CI: 1.00, 1.79), and heart failure ([Formula: see text]; 95% CI: 1.17, 2.66). Positive associations were also estimated for [Formula: see text] ([Formula: see text]; 95% CI: 1.01, 1.48 per [Formula: see text]) and coarse PM ([Formula: see text]; HR for all [Formula: see text]; 95% CI: 1.01, 1.45 per [Formula: see text]). CVD was not positively associated with [Formula: see text] (HR for all [Formula: see text]; 95% CI: 0.75, 1.28 per [Formula: see text]). HRs for UFP and CVAs were positive, but not significant. In two-pollutant models ([Formula: see text] and [Formula: see text]), positive associations tended to remain for UFP, while HRs for [Formula: see text] and [Formula: see text] generally attenuated towards the null.
These findings strengthen the evidence that UFP exposure plays an important role in cardiovascular health and that risks of ambient air pollution may have been underestimated based on conventional air pollution metrics. https://doi.org/10.1289/EHP3047.
越来越多的证据表明，超细颗粒（UFP；直径小于[公式：见文本]的颗粒）暴露可能在多种疾病（包括心血管疾病（CVD））的病因学中发挥了尚未充分研究的作用。
我们旨在调查长期暴露于环境 UFP 与心血管和脑血管疾病（CVA）事件之间的关系。作为次要目标，我们试图比较 UFP 的效应估计值与其他空气污染物的估计值，包括来自双污染物模型的估计值。
使用荷兰 33831 名居民的前瞻性队列，我们使用 Cox 比例风险模型研究了长期暴露于 UFP（通过土地使用回归预测）与疾病发生之间的关联。UFP 的风险比（HR）与更常规监测的空气污染物（包括空气动力学直径[公式：见文本]的颗粒物（PM[Formula：见文本]）、空气动力学直径[Formula：见文本]的 PM（PM[Formula：见文本]）和[Formula：见文本]）的 HR 进行了比较。
长期 UFP 暴露与所有 CVD 事件的风险增加相关[公式：见文本]每[Formula：见文本]；95%置信区间（CI）：1.03，1.34]、心肌梗死（MI）[公式：见文本]；95%CI：1.00，1.79]和心力衰竭[公式：见文本]；95%CI：1.17，2.66）。还估计了[Formula：见文本]（[Formula：见文本]；每[Formula：见文本]增加[Formula：见文本]；95%CI：1.01，1.48）和粗颗粒物（PM[Formula：见文本]）的正相关关系（所有[Formula：见文本]的 HR；95%CI：每[Formula：见文本]增加[Formula：见文本]；1.01，1.45）。CVD 与[Formula：见文本]之间没有正相关关系（所有[Formula：见文本]的 HR；95%CI：每[Formula：见文本]增加[Formula：见文本]；0.75，1.28）。UFP 和 CVA 的 HR 为正，但不显著。在双污染物模型中（[Formula：见文本]和[Formula：见文本]），UFP 的正相关关系往往仍然存在，而[Formula：见文本]和[Formula：见文本]的 HR 则普遍向零衰减。
这些发现加强了证据，表明 UFP 暴露在心血管健康中起着重要作用，并且基于常规空气污染指标，大气污染风险可能被低估。
