title: Exposure to ambient fine particulate matter and primary cardiac arrest among persons with and without clinically recognized heart disease.
abstract: The authors studied the association between incidence of primary cardiac arrest and daily measures of fine particulate matter (</=2.5 micro m) using a case-crossover study of 1,206 Washington State out-of-hospital cardiac arrests (1985-1994) among persons with (n = 774) and without (n = 432) clinically recognized heart disease. The authors compared particulate matter levels on the day of the cardiac event and the 2 days preceding the event with levels from matched reference days. The estimated relative risk for a 13.8- micro g/m(3) increase in fine particulate matter (nephelometry: 0.54 x 10(-1) km(-1 )bsp) on the day prior to cardiac arrest was 0.94 (95% confidence interval: 0.88, 1.02). Pollutant levels measured on the same day as the event and on the 2 days preceding the event demonstrated similar results. No increased risk was found among all cases with preexisting cardiac disease (odds ratio = 0.97, 95% confidence interval: 0.89, 1.07); however, an unexpected association appeared between current smokers with preexisting heart disease and increased particulate matter levels 2 days prior to the event (odds ratio = 1.29, 95% confidence interval: 1.06, 1.55). This association was not present in the 0- or 1-day lag analyses or in persons with other diseases. There was no consistent association between increased levels of fine particulate matter and risk of primary cardiac arrest.
authors.affiliation: Department of Environmental Health, School of Public Health, University of Washington, Seattle, WA 98105, USA. sulijh@u.washington.edu
authors.forename: J
authors.initials: J
authors.lastname: Sullivan
authors.forename: N
authors.initials: N
authors.lastname: Ishikawa
authors.forename: L
authors.initials: L
authors.lastname: Sheppard
authors.forename: D
authors.initials: D
authors.lastname: Siscovick
authors.forename: H
authors.initials: H
authors.lastname: Checkoway
authors.forename: J
authors.initials: J
authors.lastname: Kaufman
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D002248:Carbon Monoxide / Q000032:analysis; D016001:Confidence Intervals; D003327:Coronary Disease / Q000150:complications; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D012307:Risk Factors; D013458:Sulfur Dioxide / Q000032:analysis; D014861:Washington / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D013458:Sulfur Dioxide; D002248:Carbon Monoxide