Table 4
Studies of long-term effects of air pollution on myocardial infarction (MI) outcomes
| First author and year of publication | Population/data source | Location and time period | Number of MI events | Air pollution exposure variable(s) | MI ascertainment | Result | ||
| Cohort studies | ||||||||
| Miller 200729 | Cohort of postmenopausal women aged 50–79 years | 36 cities, USA 1994–8 | 584 (cohort size = 65 893) | Average annual exposure to PM2.5* | From annual questionnaires and national death index; independently adjudicated by investigator | PM2.5 | (Hazard ratio)1.06 (0.85 to 1.34) | Per 10 μg/m3 increase |
| Abbey 199330 | Cohort of seventh-day Adventists | California, USA 1977–82 | 62 (cohort size = 6303) | Average and cumulative exposure to ambient NO2 estimated for places of residence/work* | From hospital records; reviewed by a cardiologist on the study staff | NO2 | “No association” (details not reported) | |
| Abbey 199131 | Cohort of seventh-day Adventists | California, USA 1977–82 | 62 (cohort size = 6303) | Cumulative exposure to total suspended particles (TSP), and O3* over a 5-year period before follow-up | From hospital records; reviewed by a cardiologist on the study staff | TSP | (Hazard ratio)0.93 (0.57 to 1.51) | ⩾1000 vs <1000 h exposure to 200 μg/m3 |
| O3 | 1.06 (0.69 to 1.61) | ⩾500 vs <500 h exposure to 10 pphm | ||||||
| Case–control studies | ||||||||
| Tonne 200732 | Cases from community-based MI study; population controls | Worcester, Massachusetts, USA 1995–2003 | 5049 (controls = 10 277) | Cumulative traffic at place of residence (average daily traffic within 100 m multiplied by total length of road) | AMI reviewed and independently validated according to diagnostic criteria | Cumulative traffic | (Odds ratio)1.04 (1.02 to1.07) | Per 794 vehicle-km |
| Rosenlund 200633 | Cases (aged 45–70 years) from coronary and intensive care unit discharge registers and death certificate data; population controls | Stockholm, Sweden 1992–4 (exposure estimated over 30 years before events) | 1397 (controls = 1870) | 30-Year mean annual NO2, CO, SO2 modelled from source-specific emissions database PM estimated in 2000 and assumed constant | From coronary units, ICUs, hospital discharge register, death certificates using standard diagnostic criteria | PM10CONO2SO2 | (Odds ratios)1.0 (0.79 to 1.27)1.04 (0.89 to 1.21)0.99 (0.76 to 1.30)1.03 (0.78 to 1.36) | Per 5 μg/m3 increasePer 300 μg/m3 increasePer 30 μg/m3 increasePer 40 μg/m3 increase |
| Grazuleviciene 200434 | Cases (aged 25–64 years) from coronary and intensive care discharge registers; population controls | Kaunas, Lithuania 1997–2000 | 448 (controls = 1777) | NO2 exposure in district of residence (categorised into high/medium/low tertiles) | Records with ICD10 codes of I21 and consistent symptoms, ECG, marker levels | NO2 | (Odds ratios)1.00 (ref)1.43 (1.04 to 1.96)1.43 (1.07 to 1.35) | Low (mean 13.1 μg/m3)Medium (mean 18.7 μg/m3)High (mean 24.7 μg/m3) |
| Population-based studies | ||||||||
| Rosenlund 200835 | Hospital discharge registry and regional cause of death registry | Rome, Italy 1998–2000 | 1056 (fatal) + 6513 (non-fatal) | Mean annual NO2 exposure | Records with ICD9 codes of 410 | NO2 | (Relative risk)1.05 (0.97 to 1.15) fatal1.01 (0.97 to 1.05) non-fatal | Per 10 μg/m3 increasePer 10 μg/m3 increase |
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*Based on measured data from monitoring stations.
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AMI, acute myocardial infarction; ICU, intensive care unit.
