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Elemental Carbon Exposure at Residence and Survival After Acute Myocardial Infarction
Journal article   Open access   Peer reviewed

Elemental Carbon Exposure at Residence and Survival After Acute Myocardial Infarction

Stephanie von Klot, Alexandros Gryparis, Cathryn Tonne, Jeffrey Yanosky, Brent A. Coull, Robert J. Goldberg, Darleen Lessard, Steven J. Melly, Helen H. Suh and Joel Schwartz
Epidemiology (Cambridge, Mass.), v 20(4), pp 547-554
Jul 2009
PMID: 19289965
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1097/EDE.0b013e31819d9501View
Published, Version of Record (VoR) Restricted

Abstract

Life Sciences & Biomedicine Public, Environmental & Occupational Health Science & Technology
Background: Particulate air pollution has been consistently related to cardiovascular mortality. Some evidence Suggests that particulate matter may accelerate the atherosclerotic process. Effects of within-city variations of particulate air pollution on survival after an acute cardiovascular event have been little explored. Methods: We conducted a cohort study of hospital survivors of acute myocardial infarction (MI) from file Worcester, MA, metropolitan area to investigate the long-term effects of within-city variation in traffic-related air pollution on mortality. The study builds on an ongoing community-wide investigation examining changes over time in MI incidence and case-fatality rates. We included confirmed cases of MI in 1995, 1997, 1999, 2001, and 2003. Long-term survival status was ascertained through 2005. A validated spatiotemporal land use regression model for traffic-related air pollution was developed and annual averages of elemental carbon at residence estimated. The effect of estimated elemental carbon on the long-term mortality of patients discharged after MI was analyzed using a Cox proportional hazards model, controlling for a variety of demographic, medical history, and clinical variables. Results: Of the 3895 patients with validated MI, 44% died during follow-up. Exposure to estimated elemental carbon in the year of entry into the study was 0.44 mu g/m(3) on average. All-cause mortality increased by 15% (95% confidence interval = 0.03%-29%) per interquartile range increase in estimated yearly elemental carbon (0.24 mu g/m(3)) after the second year of survival. No association between traffic-related pollution and all-cause mortality was observed during the first 2 years of follow-up. Conclusions: Chronic traffic-related particulate air pollution is associated with increased mortality in hospital survivors of acute MI after the second year of survival.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#11 Sustainable Cities and Communities
#3 Good Health and Well-Being

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Public, Environmental & Occupational Health
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