title: Ambient air pollution and daily mortality among survivors of myocardial infarction.
abstract: BACKGROUND
  Certain subgroups in the general population, such as persons with existing cardiovascular or respiratory disease, may be more likely to experience adverse health effects from air pollution.
  
  
  METHODS
  In this European multicenter study, 25,006 myocardial infarction (MI) survivors in 5 cities were recruited from 1992 to 2002 via registers, and daily mortality was followed for 6 to 12 years in relation to ambient particulate and gaseous air pollution exposure. Daily air pollution levels were obtained from central monitor sites, and particle number concentrations were measured in 2001 and estimated retrospectively based on measured pollutants and meteorology. City-specific effect estimates from time-series analyses with Poisson regression were pooled over all 5 cities.
  
  
  RESULTS
  Particle number concentrations and PM10 averaged over 2 days (lag 0-1) were associated with increased total nontrauma mortality for patients of age 35 to 74 (5.6% [95% confidence interval, 2.8%-8.5%] per 10,000/cm and 5.1% [1.6%-9.3%] per 10 microg/m, respectively). For longer averaging times (5 and 15 days), carbon monoxide and nitrogen dioxide were also associated with mortality. There were no clear associations with ozone or sulfur dioxide.
  
  
  CONCLUSIONS
  Exposure to traffic-related air pollution was associated with daily mortality in MI survivors. Point estimates suggest a stronger effect of air pollution in MI survivors than among the general population.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Niklas.Berglind@ki.se
authors.forename: Niklas
authors.initials: N
authors.lastname: Berglind
authors.forename: Tom
authors.initials: T
authors.lastname: Bellander
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.forename: Stephanie
authors.initials: S
authors.lastname: von Klot
authors.forename: Pasi
authors.initials: P
authors.lastname: Aalto
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
authors.forename: Markku
authors.initials: M
authors.lastname: Kulmala
authors.forename: Timo
authors.initials: T
authors.lastname: Lanki
authors.forename: Hannelore
authors.initials: H
authors.lastname: Löwel
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Sally
authors.initials: S
authors.lastname: Picciotto
authors.forename: Veikko
authors.initials: V
authors.lastname: Salomaa
authors.forename: Massimo
authors.initials: M
authors.lastname: Stafoggia
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.forename: Fredrik
authors.initials: F
authors.lastname: Nyberg
mesh_terms: D000328:Adult; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009203:Myocardial Infarction; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D016012:Poisson Distribution; D012042:Registries; D017741:Survivors; D001335:Vehicle Emissions / Q000506:poisoning
chemical_list: D052638:Particulate Matter; D001335:Vehicle Emissions