TY - JOUR
T1 - Source-Specific Air Pollution Including Ultrafine Particles and Risk of Myocardial Infarction
T2 - A Nationwide Cohort Study from Denmark
AU - Poulsen, Aslak Harbo
AU - Sørensen, Mette
AU - Hvidtfeldt, Ulla Arthur
AU - Christensen, Jesper H.
AU - Brandt, Jørgen
AU - Frohn, Lise Marie
AU - Ketzel, Matthias
AU - Andersen, Christopher
AU - Raaschou-Nielsen, Ole
PY - 2023/5/1
Y1 - 2023/5/1
N2 - BACKGROUND: Air pollution is negatively associated with cardiovascular health. Impediments to efficient regulation include lack of knowledge about which sources of air pollution contributes most to health burden and few studies on effects of the potentially more potent ultrafine particles (UFP). OBJECTIVE: The authors aimed to investigate myocardial infarction (MI) morbidity and specific types and sources of air pollution. METHODS: We identified all persons living in Denmark in the period 2005–2017, age >50 y and never diagnosed with MI. We quantified 5-y running time-weighted mean concentrations of air pollution at residencies, both total and apportioned to traffic and nontraffic sources. We evaluated particulate matter (PM) with aerodynamic diameter ≤2:5 lm (PM
2:5), <0:1 lm (UFP), elemental carbon (EC), and nitrogen dioxide (NO
2). We used Cox pro-portional hazards models, with adjustment for time-varying exposures, and personal and area-level demographic and socioeconomic covariates from high-quality administrative registers. RESULTS: In this nationwide cohort of 1,964,702 persons (with 18 million person-years of follow-up and 71,285 cases of MI), UFP and PM
2:5 were associated with increased risk of MI with hazard ratios (HRs) per interquartile range (IQR) of 1.040 [95% confidence interval (CI): 1.025, 1.055] and 1.053 (95% CI: 1.035, 1.071), respectively. HRs per IQR of UFP and PM
2:5 from nontraffic sources were similar to the total (1.034 and 1.051), whereas HRs for UFP and PM
2:5 from traffic sources were smaller (1.011 and 1.011). The HR for EC from traffic sources was 1.013 (95% CI: 1.003, 1.023). NO
2 from nontraffic sources was associated with MI (HR = 1:048; 95% CI: 1.034, 1.062) but not from traffic sources. In general, nontraffic sources contributed more to total air pollution levels than national traffic sources. CONCLUSIONS: PM
2:5 and UFP from traffic and nontraffic sources were associated with increased risk of MI, with nontraffic sources being the domi-nant source of exposure and morbidity. https://doi.org/10.1289/EHP10556.
AB - BACKGROUND: Air pollution is negatively associated with cardiovascular health. Impediments to efficient regulation include lack of knowledge about which sources of air pollution contributes most to health burden and few studies on effects of the potentially more potent ultrafine particles (UFP). OBJECTIVE: The authors aimed to investigate myocardial infarction (MI) morbidity and specific types and sources of air pollution. METHODS: We identified all persons living in Denmark in the period 2005–2017, age >50 y and never diagnosed with MI. We quantified 5-y running time-weighted mean concentrations of air pollution at residencies, both total and apportioned to traffic and nontraffic sources. We evaluated particulate matter (PM) with aerodynamic diameter ≤2:5 lm (PM
2:5), <0:1 lm (UFP), elemental carbon (EC), and nitrogen dioxide (NO
2). We used Cox pro-portional hazards models, with adjustment for time-varying exposures, and personal and area-level demographic and socioeconomic covariates from high-quality administrative registers. RESULTS: In this nationwide cohort of 1,964,702 persons (with 18 million person-years of follow-up and 71,285 cases of MI), UFP and PM
2:5 were associated with increased risk of MI with hazard ratios (HRs) per interquartile range (IQR) of 1.040 [95% confidence interval (CI): 1.025, 1.055] and 1.053 (95% CI: 1.035, 1.071), respectively. HRs per IQR of UFP and PM
2:5 from nontraffic sources were similar to the total (1.034 and 1.051), whereas HRs for UFP and PM
2:5 from traffic sources were smaller (1.011 and 1.011). The HR for EC from traffic sources was 1.013 (95% CI: 1.003, 1.023). NO
2 from nontraffic sources was associated with MI (HR = 1:048; 95% CI: 1.034, 1.062) but not from traffic sources. In general, nontraffic sources contributed more to total air pollution levels than national traffic sources. CONCLUSIONS: PM
2:5 and UFP from traffic and nontraffic sources were associated with increased risk of MI, with nontraffic sources being the domi-nant source of exposure and morbidity. https://doi.org/10.1289/EHP10556.
U2 - 10.1289/EHP10556
DO - 10.1289/EHP10556
M3 - Journal article
C2 - 37235386
AN - SCOPUS:85160288285
SN - 0091-6765
VL - 131
SP - 57010
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
IS - 5
M1 - 057010
ER -