title: The effect of secondary inorganic aerosols, soot and the geographical origin of air mass on acute myocardial infarction hospitalisations in Gothenburg, Sweden during 1985-2010: a case-crossover study.
abstract: BACKGROUND
  The relative importance of different sources of air pollution for cardiovascular disease is unclear. The aims were to compare the associations between acute myocardial infarction (AMI) hospitalisations in Gothenburg, Sweden and 1) the long-range transported (LRT) particle fraction, 2) the remaining particle fraction, 3) geographical air mass origin, and 4) influence of local dispersion during 1985-2010.
  
  
  METHODS
  A case-crossover design was applied using lag0 (the exposure the same day as hospitalisation), lag1 (exposure one day prior hospitalisation) and 2-day cumulative average exposure (CA2) (mean of lag0 and lag1). The LRT fractions included PMion (sum of sulphate, nitrate and ammonium) and soot measured at a rural site. The difference between urban PM10 (particulate matter with an aerodynamic diameter smaller than 10 μm) and rural PMion was a proxy for locally generated PM10 (PMrest). The daily geographical origin of air mass was estimated as well as days with limited or effective local dispersion. The entire year was considered, as well as warm and cold periods, and different time periods.
  
  
  RESULTS
  In total 28 215 AMI hospitalisations occurred during 26 years. PM10, PMion, PMrest and soot did not influence AMI for the entire year. In the cold period, the association was somewhat stronger for PMrest than for urban PM10; the strongest associations were observed during 1990-2000 between AMI and CA2 of PMrest (6.6% per inter-quartile range (IQR), 95% confidence interval 2.1 to 11.4%) and PM10 (4.1%, 95% CI 0.2% - 8.2%). Regarding the geographical air mass origins there were few associations. Days with limited local dispersion showed an association with AMI in the cold period of 2001-2010 (6.7%, 95% CI 0.0% - 13.0%).
  
  
  CONCLUSIONS
  In the cold period, locally generated PM and days with limited local dispersion affected AMI hospitalisations, indicating importance of local emissions from e.g. traffic.
authors: Janine
authors: J
authors: Wichmann
authors: Karin
authors: K
authors: Sjöberg
authors: Lin
authors: L
authors: Tang
authors: Marie
authors: M
authors: Haeger-Eugensson
authors: Annika
authors: A
authors: Rosengren
authors: Eva M
authors: EM
authors: Andersson
authors: Lars
authors: L
authors: Barregard
authors: Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Medicinaregatan 16A, Gothenburg, Sweden. gerd.sallsten@amm.gu.se.
authors: Gerd
authors: G
authors: Sallsten
mesh_terms: D000208:Acute Disease; D000328:Adult; D000336:Aerosols / Q000633:toxicity*; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000633:toxicity; D018592:Cross-Over Studies; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced / Q000453:epidemiology*; D052638:Particulate Matter / Q000633:toxicity*; D012621:Seasons; D053260:Soot / Q000633:toxicity*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000336:Aerosols; D000393:Air Pollutants; D052638:Particulate Matter; D053260:Soot