Jones Joshua S, Nedkoff Lee, Heyworth Jane S, Almeida Osvaldo P, Flicker Leon, Golledge Jonathan, Hankey Graeme J, Lim Elizabeth H, Nieuwenhuijsen Mark, Yeap Bu B, Trevenen Michelle L
Medical School, The University of Western Australia, Perth, Western Australia, Australia.
School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia.
Environ Epidemiol. 2023 Jul 14;7(4):e255. doi: 10.1097/EE9.0000000000000255. eCollection 2023 Aug.
Exposure to particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM) is associated with increased risk of heart disease, but less is known about the relationship at low concentrations. This study aimed to determine the dose-response relationship between long-term PM exposure and risk of incident ischemic heart disease (IHD), incident heart failure (HF), and incident atrial fibrillation (AF) in older men living in a region with relatively low ambient air pollution.
PM exposure was estimated for 11,249 older adult males who resided in Perth, Western Australia and were recruited from 1996 to 1999. Participants were followed until 2018 for the HF and AF outcomes, and until 2017 for IHD. Cox-proportional hazards models, using age as the analysis time, and adjusting for demographic and lifestyle factors were used. PM was entered as a restricted cubic spline to model nonlinearity.
We observed a mean PM concentration of 4.95 μg/m (SD 1.68 μg/m) in the first year of recruitment. After excluding participants with preexisting disease and adjusting for demographic and lifestyle factors, PM exposure was associated with a trend toward increased incidence of IHD, HF, and AF, but none were statistically significant. At a PM concentration of 7 μg/m the hazard ratio for incident IHD was 1.04 (95% confidence interval [CI] = 0.86, 1.25) compared with the reference category of 1 μg/m.
We did not observe a significant association between long-term exposure to low-concentration PM air pollution and IHD, HF, or AF.
暴露于空气动力学直径小于或等于2.5μm的颗粒物(PM)与心脏病风险增加相关,但对于低浓度下的关系了解较少。本研究旨在确定长期暴露于PM与居住在环境空气污染相对较低地区的老年男性发生缺血性心脏病(IHD)、心力衰竭(HF)和房颤(AF)风险之间的剂量反应关系。
对1996年至1999年从澳大利亚西部珀斯招募的11249名老年男性进行PM暴露评估。对参与者进行随访,直至2018年观察HF和AF结局,直至2017年观察IHD结局。使用Cox比例风险模型,以年龄作为分析时间,并对人口统计学和生活方式因素进行调整。将PM作为受限立方样条输入以模拟非线性。
在招募的第一年,我们观察到PM平均浓度为4.95μg/m³(标准差1.68μg/m³)。在排除患有既往疾病的参与者并对人口统计学和生活方式因素进行调整后,PM暴露与IHD、HF和AF发病率增加的趋势相关,但均无统计学意义。与1μg/m³的参考类别相比,在PM浓度为7μg/m³时,IHD发病的风险比为1.04(95%置信区间[CI]=0.86,1.25)。
我们未观察到长期暴露于低浓度PM空气污染与IHD、HF或AF之间存在显著关联。