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Open Access Gold as soon as Publ. Version/Full Text is submitted to ZB.
Elemental carbon exposure at residence and survival after acute myocardial infarction.
Epidemiology 20, 547-554 (2009)
Background: Particulate air pollution has been consistently related to cardiovascular mortality. Some evidence Suggests that particulate matter may accelerate the atherosclerotic process. Effects of within-city variations of particulate air pollution on survival after an acute cardiovascular event have been little explored. Methods: We conducted a cohort study of hospital survivors of acute myocardial infarction (MI) from file Worcester, MA, metropolitan area to investigate the long-term effects of within-city variation in traffic-related air pollution on mortality. The study builds on an ongoing community-wide investigation examining changes over time in MI incidence and case-fatality rates. We included confirmed cases of MI in 1995, 1997, 1999, 2001, and 2003. Long-term survival status was ascertained through 2005. A validated spatiotemporal land use regression model for traffic-related air pollution was developed and annual averages of elemental carbon at residence estimated. The effect of estimated elemental carbon on the long-term mortality of patients discharged after MI was analyzed using a Cox proportional hazards model, controlling for a variety of demographic, medical history, and clinical variables. Results: Of the 3895 patients with validated MI, 44% died during follow-up. Exposure to estimated elemental carbon in the year of entry into the study was 0.44 mu g/m(3) on average. All-cause mortality increased by 15% (95% confidence interval = 0.03%-29%) per interquartile range increase in estimated yearly elemental carbon (0.24 mu g/m(3)) after the second year of survival. No association between traffic-related pollution and all-cause mortality was observed during the first 2 years of follow-up. Conclusions: Chronic traffic-related particulate air pollution is associated with increased mortality in hospital survivors of acute MI after the second year of survival.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
particulate air-pollution; long-term exposure; case-fatality rates; cardiopulmonary mortality; epidemiologic evidence; regression-models; los-angeles; health; heart; risk
ISSN (print) / ISBN
1044-3983
e-ISSN
1531-5487
Journal
Epidemiology
Quellenangaben
Volume: 20,
Issue: 4,
Pages: 547-554
Publisher
Lippincott Williams & Wilkins
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)