Table 4

Studies of long-term effects of air pollution on myocardial infarction (MI) outcomes

First author and year of publicationPopulation/data sourceLocation and time periodNumber of MI eventsAir pollution exposure variable(s)MI ascertainmentResult
Cohort studies
Miller 200729Cohort of postmenopausal women aged 50–79 years36 cities, USA 1994–8584 (cohort size  = 65 893)Average annual exposure to PM2.5*From annual questionnaires and national death index; independently adjudicated by investigatorPM2.5(Hazard ratio)1.06 (0.85 to 1.34)Per 10 μg/m3 increase
Abbey 199330Cohort of seventh-day AdventistsCalifornia, USA 1977–8262 (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 staffNO2“No association” (details not reported)
Abbey 199131Cohort of seventh-day AdventistsCalifornia, USA 1977–8262 (cohort size  = 6303)Cumulative exposure to total suspended particles (TSP), and O3* over a 5-year period before follow-upFrom hospital records; reviewed by a cardiologist on the study staffTSP(Hazard ratio)0.93 (0.57 to 1.51)⩾1000 vs <1000 h exposure to 200 μg/m3
O31.06 (0.69 to 1.61)⩾500 vs <500 h exposure to 10 pphm
Case–control studies
Tonne 200732Cases from community-based MI study; population controlsWorcester, Massachusetts, USA 1995–20035049 (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 criteriaCumulative traffic(Odds ratio)1.04 (1.02 to1.07)Per 794 vehicle-km
Rosenlund 200633Cases (aged 45–70 years) from coronary and intensive care unit discharge registers and death certificate data; population controlsStockholm, 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 constantFrom coronary units, ICUs, hospital discharge register, death certificates using standard diagnostic criteriaPM10CONO2SO2(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 200434Cases (aged 25–64 years) from coronary and intensive care discharge registers; population controlsKaunas, Lithuania 1997–2000448 (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 levelsNO2(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 200835Hospital discharge registry and regional cause of death registryRome, Italy 1998–20001056 (fatal) + 6513 (non-fatal)Mean annual NO2 exposureRecords with ICD9 codes of 410NO2(Relative risk)1.05 (0.97 to 1.15) fatal1.01 (0.97 to 1.05) non-fatalPer 10 μg/m3 increasePer 10 μg/m3 increase
  • *Based on measured data from monitoring stations.

  • AMI, acute myocardial infarction; ICU, intensive care unit.