title: The association between chronic exposure to traffic-related air pollution and ischemic heart disease.
abstract: Increasing evidence links air pollution to the risk of cardiovascular disease. This study investigated the association between ischemic heart disease (IHD) prevalence and exposure to traffic-related air pollution (nitrogen dioxide [NO₂], fine particulate matter [PM₂.₅], and ozone [O₃]) in a population of susceptible subjects in Toronto. Local (NO₂) exposures were modeled using land use regression based on extensive field monitoring. Regional exposures (PM₂.₅, O₃) were modeled as confounders using inverse distance weighted interpolation based on government monitoring data. The study sample consisted of 2360 patients referred during 1992 to 1999 to a pulmonary clinic at the Toronto Western Hospital in Toronto, Ontario, Canada, to diagnose or manage a respiratory complaint. IHD status was determined by clinical database linkages (ICD-9-CM 412-414). The association between IHD and air pollutants was assessed with a modified Poisson regression resulting in relative risk estimates. Confounding was controlled with individual and neighborhood-level covariates. After adjusting for multiple covariates, NO₂ was significantly associated with increased IHD risk, relative risk (RR) = 1.33 (95% confidence interval [CI]: 1.2, 1.47). Subjects living near major roads and highways had a trend toward an elevated risk of IHD, RR = 1.08 (95% CI: 0.99, 1.18). Regional PM₂.₅ and O₃ were not associated with risk of IHD.
authors.affiliation: School of Public Health, University of California Berkeley, Berkeley, California 94720-7360, USA. beckerman@berkeley.edu
authors.forename: Bernardo S
authors.initials: BS
authors.lastname: Beckerman
authors.forename: Michael
authors.initials: M
authors.lastname: Jerrett
authors.forename: Murray
authors.initials: M
authors.lastname: Finkelstein
authors.forename: Pavlos
authors.initials: P
authors.lastname: Kanaroglou
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Brook
authors.forename: M Altaf
authors.initials: MA
authors.lastname: Arain
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Sears
authors.forename: David
authors.initials: D
authors.lastname: Stieb
authors.forename: John
authors.initials: J
authors.lastname: Balmes
authors.forename: Kenneth
authors.initials: K
authors.lastname: Chapman
mesh_terms: D000368:Aged; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000032:analysis; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000453:epidemiology; D009585:Nitrogen Dioxide / Q000032:analysis / Q000633:toxicity*; D009864:Ontario / Q000453:epidemiology; D010083:Oxidants, Photochemical / Q000032:analysis / Q000633:toxicity*; D010126:Ozone / Q000032:analysis / Q000633:toxicity*; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D016012:Poisson Distribution; D015995:Prevalence; D012044:Regression Analysis; D012306:Risk
chemical_list: D010083:Oxidants, Photochemical; D052638:Particulate Matter; D010126:Ozone; D009585:Nitrogen Dioxide