title: Particulate matter exposures, mortality, and cardiovascular disease in the health professionals follow-up study.
abstract: BACKGROUND
  The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes.
  
  
  OBJECTIVE
  In this study we explored these associations in the all-male Health Professionals Follow-Up Study prospective cohort.
  
  
  METHODS
  The same spatiotemporal exposure estimation models, similar outcomes, and biennially updated covariates were used as those previously applied in the female Nurses' Health Study cohort.
  
  
  RESULTS
  Among 17,545 men residing in the northeastern and midwestern United States, there were 2,813 deaths, including 746 cases of fatal coronary heart disease (CHD). An interquartile range change (4 µg/m3) in average exposure to PM ≤ 2.5 µm in diameter in the 12 previous months was not associated with all-cause mortality [hazard ratio (HR) = 0.94; 95% confidence interval (CI), 0.87-1.00] or fatal CHD (HR = 0.99; 95% CI, 0.87-1.13) in fully adjusted models. Findings were similar for separate models of exposure to PM ≤ 10 µm in diameter and PM between 2.5 and 10 µm in diameter and for copollutant models.
  
  
  CONCLUSIONS
  Among this cohort of men with high socioeconomic status living in the midwestern and northeastern United States, the results did not support an association of chronic PM exposures with all-cause mortality and cardiovascular outcomes in models with time-varying covariates. Whether these findings suggest sex differences in susceptibility or the protective impact of healthier lifestyles and higher socioeconomic status requires additional investigation.
authors: South Carolina Cancer Prevention and Control Program and Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA. rpuett@mailbox.sc.edu
authors: Robin C
authors: RC
authors: Puett
authors: Jaime E
authors: JE
authors: Hart
authors: Helen
authors: H
authors: Suh
authors: Murray
authors: M
authors: Mittleman
authors: Francine
authors: F
authors: Laden
mesh_terms: D000328:Adult; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality*; D006281:Health Occupations / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects*; D011446:Prospective Studies
chemical_list: D052638:Particulate Matter