[Air pollution and myocardial infarction. Strasbourg France, 1984-89].
BACKGROUND
Many studies have shown positive associations between urban air pollution, mortality and hospitalizations for cardiovascular diseases. This study tried to estimate short term effects of ambient air pollution on myocardial infarction on the basis of data collected in a morbidity registry.


METHODS
The daily number of myocardial infarctions between 1984 and 1989 was supplied by the Monica registry (Bas-Rhin). The pollution variables were daily mean and maximum of hourly measures of carbon monoxyde (CO), sulfur dioxide (SO(2)), particles (PM13), nitrogen monoxyde (NO) and nitrogen dioxide (NO(2)), mean and maximum of hourly measures of ozone (O(3)) between 10 a.m. and 6 p.m. Other data were influenza epidemics, daily temperature and humidity. The analysis was a Poisson regression controlling for trend, season, meteorological factors and pollutant, using non parametric smoothing. Influence of day of week and influenza were controlled through dummy variables.


RESULTS
For the hourly maximum of NO with a 5 day lag the association was statistically significant (square root relation): for an increase from percentile 25 (63 microg/m(3)) to percentile 75 (189 microg/m(3)), the RR was 1.087 (95% CI: 1.014-1.166). The association was significant during winter with a RR of 1.129 (95% CI: 1.028-1.241) for a percentile 25 (101 microg/m(3)) to percentile 75 (265 microg/m(3)) increase. A positive linear association was found with daily maximum of NO(2) during winter with a 5 day lag: the RR, for an increase from percentile 25 (59 microg/m(3)) to percentile 75 (107 microg/m(3)) was 1.095 (95% CI: 1.015-1.181). For the daily mean and maximum of O(3), a positive association was found but it was not robust. For other pollutants, no association was found.


CONCLUSIONS
The association between NO(2) and coronary events, hospitalizations and mortality, has been shown in several studies but not in all. This secondary pollutant could be a proxy for small particles.
Eilstein
D
D
Laboratoire d'Epidémiologie et de Santé Publique, Faculté de Médecine, 4, rue Kirschleger, 67085 Strasbourg Cedex.
Quénel
P
P
Hédelin
G
G
Kleinpeter
J
J
Arveiler
D
D
Schaffer
P
P
D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis* / Q000706:statistics & numerical data; D002248:Carbon Monoxide / Q000009:adverse effects / Q000032:analysis; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D009017:Morbidity / Q000639:trends; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D009569:Nitric Oxide / Q000009:adverse effects / Q000032:analysis; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis; D011159:Population Surveillance; D012042:Registries; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D013458:Sulfur Dioxide / Q000009:adverse effects / Q000032:analysis; D013997:Time Factors; D014504:Urban Health / Q000706:statistics & numerical data* / Q000639:trends; D014887:Weather
D000393:Air Pollutants; D013458:Sulfur Dioxide; D009569:Nitric Oxide; D002248:Carbon Monoxide; D009585:Nitrogen Dioxide