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Long-term air pollution exposure may increase risk for coronary events
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Long-term exposure to airborne environmental pollutants may be associated with the incidence of acute coronary events.
According to data culled from the European Study of Cohorts for Air Pollution Effects (ESCAPE), this association appears to exist at levels of exposure below current European limit values.
The meta-analysis was based on data from 11 cohorts from ESCAPE. The cohorts comprised 100,166 patients in Demark, Finland, Germany, Italy and Sweden. Participants were free of coronary events at baseline and followed for an average of 11.5 years.
For each cohort setting, researchers gauged exposure to air pollution using a method developed for the ESCAPE study. They measured particulate matter (in micrometers) of differing sizes: <2.5 mcm (PM2.5), 2.5 mcm to 10 mcm (coarse particles) and <10 mcm (PM10) at 20 sites. They also measured nitrogen oxides (NOx and NO2) at 40 different sites in three separate 2-week intervals for 1 year. Long-term exposure to particulate matter was then analyzed for association with incidence of coronary events.
Overall, 5,157 participants experienced coronary events. The researchers reported an association between a 5-mcg/m3 increase in approximate annual PM2.5 exposure and a 13% increased risk for coronary events (HR=1.13, 95% CI, 0.98-1.3). A 10-mcg/m3 increase in approximate annual exposure to PM10 was associated with a 12% increased risk for coronary events (HR=1.12; 95% CI, 1.01-1.25).
The correlation between pollutant exposure and coronary events persisted even at concentrations below the annual European limit of 25 mcg/m3 for PM2.5 (HR=1.18; 95% CI, 1.01-1.39 for each 5-mcg/m3 increase in PM2.5) and below 40 mcg/m3 for PM10 (HR=1.12; 95% CI, 1-1.27 for each 10-mcg/m3 increase in PM10), according to the study abstract.
Minor correlations were observed with nitrogen oxides and coronary events, and no link was observed between coronary events and traffic factors.
“The results of this study, together with other ESCAPE findings, support lowering of European limits for particulate air pollution to adequately protect public health,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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