Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Cardiology, Danderyd Hospital, Stockholm, Sweden.
Environ Health Perspect. 2019 Oct;127(10):107012. doi: 10.1289/EHP4757. Epub 2019 Oct 30.
Long-term exposure to particulate matter (PM) in ambient air has been associated with cardiovascular mortality, but few studies have considered incident disease in relation to PM from different sources.
We aimed to study associations between long-term exposure to different types of PM and sources, and incident ischemic heart disease (IHD) and stroke in three Swedish cities.
Based on detailed emission databases, monitoring data, and high-resolution dispersion models, we calculated source contributions to PM with aerodynamic diameter (), PM with aerodynamic diameter (), and black carbon (BC) from road wear, traffic exhaust, residential heating, and other sources in Gothenburg, Stockholm, and Umeå. Registry data for participants from four cohorts were used to obtain incidence of IHD and stroke for first hospitalization or death. We constructed time windows of exposure for same-year, 1- to 5-y, and 6- to 10-y averages preceding incidence from annual averages at residential addresses. Risk estimates were based on random effects meta-analyses of cohort-specific Cox proportional hazard models.
We observed 5,166 and 3,119 incident IHD and stroke cases, respectively, in 114,758 participants. Overall, few consistent associations were observed between the different air pollution measures and IHD or stroke incidence. However, same-year levels of ambient locally emitted BC (range: ) were associated with a 4.0% higher risk of incident stroke per interquartile range (IQR), [95% confidence interval (CI): 0.04, 7.8]. This association was primarily related to BC from traffic exhaust. (range: ) and (range: ) were not associated with stroke. Associations with incident IHD were observed only for exposure from residential heating.
Few consistent associations were observed between different particulate components and IHD or stroke. However, long-term residential exposure to locally emitted BC from traffic exhaust was associated with stroke incidence. The comparatively low exposure levels may have contributed to the paucity of associations. https://doi.org/10.1289/EHP4757.
长期暴露于环境空气中的颗粒物（PM）与心血管死亡率有关，但很少有研究考虑不同来源的 PM 与发病的关系。
我们旨在研究瑞典三个城市长期暴露于不同类型的 PM 和来源与缺血性心脏病（IHD）和中风发病之间的关系。
基于详细的排放数据库、监测数据和高分辨率的扩散模型，我们计算了哥德堡、斯德哥尔摩和于默奥的道路磨损、交通尾气、住宅供暖和其他来源的 PM 质量中值（）、PM 质量中值（）和黑碳（BC）的源贡献。四个队列的参与者的登记数据用于获得首次住院或死亡的 IHD 和中风的发病率。我们构建了暴露时间窗，用于在发病前的同一年、1-5 年和 6-10 年的平均水平，从居住地址的年度平均值开始。风险估计是基于队列特异性 Cox 比例风险模型的随机效应荟萃分析。
我们在 114758 名参与者中观察到 5166 例和 3119 例 IHD 和中风发病病例。总的来说，在不同的空气污染措施与 IHD 或中风发病之间很少观察到一致的关联。然而，同一年的环境局地排放 BC（范围：）水平与中风发病率每四分位距（IQR）增加 4.0%相关[95%置信区间（CI）：0.04，7.8]。这种关联主要与交通尾气的 BC 有关。BC 来自交通尾气。（范围：）和（范围：）与中风无关。与 IHD 发病相关的仅观察到来自住宅供暖的暴露。
在不同的颗粒成分与 IHD 或中风之间很少观察到一致的关联。然而，长期暴露于交通尾气产生的局地排放 BC 与中风发病率有关。相对较低的暴露水平可能导致关联较少。https://doi.org/10.1289/EHP4757.
