Chronic particulate exposure, mortality, and coronary heart disease in the nurses' health study.
Adverse health effects of exposures to acute air pollution have been well studied. Fewer studies have examined effects of chronic exposure. Previous studies used exposure estimates for narrow time periods and were limited by the geographic distribution of pollution monitors. This study examined the association of chronic particulate exposures with all-cause mortality, incident nonfatal myocardial infarction, and fatal coronary heart disease (CHD) in a prospective cohort of 66,250 women from the Nurses' Health Study in northeastern US metropolitan areas. Nonfatal outcomes were assessed through self-report and medical record review and fatalities through death certificates and medical record review. During follow-up (1992-2002), 3,785 deaths and 1,348 incident fatal CHD and nonfatal myocardial infarctions occurred. In age- and calendar-time-adjusted models, 10-microg/m(3) increases in 12-month average exposures to particulate matter <10 microm in diameter were associated with increased all-cause mortality (16%, 95% confidence interval: 5, 28) and fatal CHD (43%, 95% confidence interval: 10, 86). Adjustment for body mass index and physical activity weakened these associations. Body mass index and smoking modified the association between exposure to particulate matter <10 microm in diameter and fatal CHD. In this population, increases in such exposures were associated with increases in all-cause and CHD mortality. Never smokers with higher body mass indexes were at greatest risk of fatal CHD.
Department of Environmental Health Sciences, University of South Carolina, 2221 Devine Street, Columbia, SC 29208, USA. rpuett@gwm.sc.edu
Robin C
RC
Puett
Joel
J
Schwartz
Jaime E
JE
Hart
Jeff D
JD
Yanosky
Frank E
FE
Speizer
Helen
H
Suh
Christopher J
CJ
Paciorek
Lucas M
LM
Neas
Francine
F
Laden
D000328:Adult; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality*; D003644:Death Certificates; D004781:Environmental Exposure / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D009726:Nurses; D052638:Particulate Matter / Q000009:adverse effects*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D052638:Particulate Matter