title: Long-Term Exposure to Traffic-Related Air Pollution and Risk of Incident Atrial Fibrillation: A Cohort Study.
abstract: Atrial fibrillation is the most common sustained arrhythmia and is associated with cardiovascular morbidity and mortality. The few studies conducted on short-term effects of air pollution on episodes of atrial fibrillation indicate a positive association, though not consistently.
  
  
  
  The aim of this study was to evaluate the long-term impact of traffic-related air pollution on incidence of atrial fibrillation in the general population.
  
  
  
  In the Danish Diet, Cancer, and Health cohort of 57,053 people 50-64 years old at enrollment in 1993-1997, we identified 2,700 cases of first-ever hospital admission for atrial fibrillation from enrollment to end of follow-up in 2011. For all cohort members, exposure to traffic-related air pollution assessed as nitrogen dioxide (NO2) and nitrogen oxides (NOx) was estimated at all present and past residential addresses from 1984 to 2011 using a validated dispersion model. We used Cox proportional hazard model to estimate associations between long-term residential exposure to NO2and NOxand risk of atrial fibrillation, after adjusting for lifestyle and socioeconomic position.
  
  
  
  A 10 μg/m3higher 10-year time-weighted mean exposure to NO2preceding diagnosis was associated with an 8% higher risk of atrial fibrillation [incidence rate ratio: 1.08; 95% confidence interval (CI): 1.01, 1.14] in adjusted analysis. Though weaker, similar results were obtained for long-term residential exposure to NOx. We found no clear tendencies regarding effect modification of the association between NO2and atrial fibrillation by sex, smoking, hypertension or myocardial infarction.
  
  
  
  We found long-term residential traffic-related air pollution to be associated with higher risk of atrial fibrillation. Accordingly, the present findings lend further support to the demand for abatement of air pollution. Citation: Monrad M, Sajadieh A, Christensen JS, Ketzel M, Raaschou-Nielsen O, Tjønneland A, Overvad K, Loft S, Sørensen M. 2017. Long-term exposure to traffic-related air pollution and risk of incident atrial fibrillation: a cohort study. Environ Health Perspect 125:422-427; http://dx.doi.org/10.1289/EHP392.
authors.affiliation: Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Maria
authors.initials: M
authors.lastname: Monrad
authors.forename: Ahmad
authors.initials: A
authors.lastname: Sajadieh
authors.forename: Jeppe Schultz
authors.initials: JS
authors.lastname: Christensen
authors.forename: Matthias
authors.initials: M
authors.lastname: Ketzel
authors.forename: Ole
authors.initials: O
authors.lastname: Raaschou-Nielsen
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Steffen
authors.initials: S
authors.lastname: Loft
authors.forename: Mette
authors.initials: M
authors.lastname: Sørensen
mesh_terms: D000393:Air Pollutants / Q000032:analysis; D000397:Air Pollution / Q000706:statistics & numerical data*; D001281:Atrial Fibrillation / Q000453:epidemiology*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D052638:Particulate Matter / Q000032:analysis
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter