Long-Term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women

Miller, Kristin A.; Siscovick, David S.; Sheppard, Lianne; Shepherd, Kristen; Sullivan, Jeffrey; Anderson, Garnet L.; Kaufman, Joel D.

doi:10.1056/nejmoa054409

Cited by 1,628 publications

(1,237 citation statements)

References 26 publications

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“…Odds ratios using both the standard linear and threshold models were estimated for all ACS, STEMI, NSTEMI, UA, and NSTE‐ACS events for all patients and for patients with and without CAD. For comparison purposes, and consistent with reporting from various studies and reviews of the literature,1, 2, 3, 4, 5, 6, 7, 8, 11, 14, 15, 16 odds ratios associated with 10‐μg/m 3 incremental increases in PM 2.5 concentration are presented.…”

Section: Methodsmentioning

confidence: 93%

“…Various prospective cohort studies of long‐term exposure (years or decades) have found that elevated PM 2.5 exposures are associated with increased risk of cardiovascular disease mortality3, 4, 5, 6, 7, 8, 9 and may contribute to the initiation and progression of related chronic diseases including atherosclerosis, hypertension, and diabetes 10, 11. The Global Burden of Disease 2010 analysis reported comparative burden of disease risk assessments from 67 risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Short‐Term Exposure to Fine Particulate Matter Air Pollution Is Preferentially Associated With the Risk of ST‐Segment Elevation Acute Coronary Events

Pope

Muhlestein

Anderson

et al. 2015

JAHA

120

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BackgroundAir pollution is associated with greater cardiovascular event risk, but the types of events and specific persons at risk remain unknown. This analysis evaluates effects of short‐term exposure to fine particulate matter air pollution with risk of acute coronary syndrome events, including ST‐segment elevation myocardial infarction, non–ST‐segment elevation myocardial infarction, unstable angina, and non–ST‐segment elevation acute coronary syndrome.Methods and ResultsAcute coronary syndrome events treated at Intermountain Healthcare hospitals in urban areas of Utah's Wasatch Front were collected between September 1993 and May 2014 (N=16 314). A time‐stratified case‐crossover design was performed matching fine particulate matter air pollution exposure at the time of each event with referent periods when the event did not occur. Patients served as their own controls, and odds ratios were estimated using nonthreshold and threshold conditional logistic regression models. In patients with angiographic coronary artery disease, odds ratios for a 10‐μg/m3 increase in concurrent‐day fine particulate matter air pollution >25 μg/m³ were 1.06 (95% CI 1.02–1.11) for all acute coronary syndrome, 1.15 (95% CI 1.03–1.29) for ST‐segment elevation myocardial infarction, 1.02 (95% CI 0.97–1.08) for non–ST‐segment elevation myocardial infarction, 1.09 (95% CI 1.02–1.17) for unstable angina, and 1.05 (95% CI 1.00–1.10) for non–ST‐segment elevation acute coronary syndrome events. Excess risk from fine particulate matter air pollution exposure was not observed in patients without angiographic coronary artery disease.ConclusionsElevated fine particulate matter air pollution exposures contribute to triggering acute coronary events, especially ST‐segment elevation myocardial infarction, in those with existing seriously diseased coronary arteries but not in those with nondiseased coronary arteries.

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Section: Methodsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Short‐Term Exposure to Fine Particulate Matter Air Pollution Is Preferentially Associated With the Risk of ST‐Segment Elevation Acute Coronary Events

Pope

Muhlestein

Anderson

et al. 2015

JAHA

120

View full text Add to dashboard Cite

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“…Epidemiological, biomedical and clinical studies indicate that air pollution, for example, ambient particulate matter (PM), is strongly associated with increased cardiovascular diseases. [50][51][52] Future research should elucidate whether and to which extent also the inhalation of welding fumes, including zinc-and copper-containing metal fumes, contribute to an increased risk for this type of disease. A large long-term epidemiological study with male metal workers showed an increased risk for cardiovascular diseases after longterm exposure to welding processed particles, also after adjustment for smoking.…”

Section: Discussionmentioning

confidence: 99%

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

Baumann

Gube

Markert

et al. 2017

J Expo Sci Environ Epidemiol

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Zinc-and copper-containing welding fumes increase systemic C-reactive protein (CRP). The aim of this study was to investigate the performance of the biomarkers serum amyloid A (SAA) and soluble vascular cell adhesion molecule-1 (VCAM-1) in this regard. Fifteen male subjects were exposed under controlled conditions to welding fumes containing either zinc, or copper, or copper and zinc for 6 h. Plasma samples were collected before, 6 and 24 h after start of exposure and biomarkers therein were measured by electrochemiluminescent assay. For each exposure, systemic concentrations of systemic SAA, but not VCAM-1, increased significantly at 24 h after exposure start compared with baseline ("copper only": P = 0.0005, "zinc only": P = 0.027, "copper and zinc": P = 0.001). SAA showed a wider range of concentrations than did CRP and its levels increased up to 19-fold after welding fume exposure. The recognition of copper as a potential harmful component in welding fumes, also independent from zinc, deserves further consideration. SAA might represent a new sensitive biomarker for potential subclinical sterile inflammation after inhalation of copper-and/or zinc-containing welding fumes. As elevations of CRP and SAA protein have both been linked to a higher risk for cardiovascular disease, these findings might particularly be important for long-term welders. Journal of Exposure Science and Environmental Epidemiology INTRODUCTIONA large number of workers are exposed to welding fumes containing various types of gases and metal particles in occupational settings. Depending on the constitution of the welding fumes and the respective exposure conditions, epidemiological studies have shown that welding fume exposure is associated with the risk of health impairment through respiratory illness, inflammation and cardiovascular disease. [1][2][3][4] Zinc and copper play an increasing role in modern joining technology, especially in the automotive industry, and hence exposures from workers become more frequent. In a recent study, a distinct increase of systemic C-reactive protein (CRP) has been shown after inhalation of welding fume from a metal inert gas brazing process of zinc-coated steel using a copper-containing welding wire at an average fume concentration of 2.5 mg/m 3 . 5 A further study tested the effect of elevated systemic CRP levels after exposure with three different doses of this welding fume and found increases of CRP after exposure with 2.0 and 2.5 mg/m 3 average fume concentration, but not at 1.4 mg/m 3 . Hence, it was concluded that the no-observed-effect level for systemic inflammation after such exposures was 1.4 mg/m 3 and the lowest observed effect level was 2.0 mg/m 3 . 6 This corresponds to zinc concentrations of 0.84 mg/m 3 and 1.2 mg/m 3 , respectively, and copper concentrations of 0.24 mg/m 3 and 0.34 mg/m 3 , respectively. 6 A subsequent third study showed that the observed effects were due to the zinc as well as copper present in the welding fume, as the welding fumes which contained either zinc and no cop...

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“…These studies are also supported by findings of significant health effect gradients within metropolitan areas that relate more to local sources and air quality gradients (of which traffic is a prime example) than to regional and between-city gradients (Jerrett et al, 2005a;Miller et al, 2007). However, studies based on traffic proximity or relative intensity cannot link the observed associations with the specific aspects of vehicular traffic that might be responsible, which include not only tailpipe emissions but also fugitive emissions from vehicle or roadway wear, noise, or socioeconomic effects associated with undesirable residential locations.…”

Section: Introductionmentioning

confidence: 73%

On exposure and response relationships for health effects associated with exposure to vehicular traffic

Lipfert

Wyzga

2008

J Expo Sci Environ Epidemiol

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This work examines various metrics and models that have been used to estimate long-term health effects of exposure to vehicular traffic. Such health impacts may include effects of air pollution due to emissions of combustion products and from vehicle or roadway wear, of noise, stress, or from socioeconomic effects associated with preferred residential locations. Both categorical and continuous exposure metrics are considered, typically for distances between residences and roadways, or for traffic density or intensity. It appears that continuous measures of exposure tend to yield lower risk estimates that are also more precise than categorical measures based on arbitrary criteria. The selection of appropriate exposure increments to characterize relative risks is also important in comparing pollutants and other agents. Confounding and surrogate variables are also important issues, since studies of traffic proximity or density cannot identify the specific agents related to traffic exposures that might be responsible for the various health endpoints that have been implicated. Studies based on ambient air quality measurements are necessarily restricted to species for which data are available, some of which may be serving as markers for the actual agents of harm. Studies based on modeled air quality are limited by the accuracy of mobile source emission inventories, which may not include poorly maintained (high emitting) vehicles. Additional exposure modeling errors may result from precision limitations of geocoding methods. Studies of the health effects of traffic are progressing from establishing the existence of relationships to describing them in more detail, but effective remedies or control strategies have generally not yet been proposed in the context of these epidemiological studies. Resolution of these dose-response uncertainties is important for the development of effective public health strategies for the future.

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Long-Term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women

Abstract: Long-term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women. Exposure differences within cities are associated with the risk of cardiovascular disease.

Cited by 1,628 publications

References 26 publications

Short‐Term Exposure to Fine Particulate Matter Air Pollution Is Preferentially Associated With the Risk of ST‐Segment Elevation Acute Coronary Events

Short‐Term Exposure to Fine Particulate Matter Air Pollution Is Preferentially Associated With the Risk of ST‐Segment Elevation Acute Coronary Events

Systemic serum amyloid A as a biomarker for exposure to zinc and/or copper-containing metal fumes

On exposure and response relationships for health effects associated with exposure to vehicular traffic

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