nitrogen-dioxide and Coronary-Artery-Disease

Ambient air pollution is the environmental factor with the most significant impact on human health. Several epidemiological studies provide evidence for an association between ambient air pollution and human health. However, the recent economic literature has challenged the identification strategy used in these studies. This paper contributes to the ongoing discussion by investigating the association between ambient air pollution and morbidity using hospital admission data from Switzerland. Our identification strategy rests on the construction of geographically explicit pollution measures derived from a dispersion model that replicates atmospheric conditions and accounts for several emission sources. The reduced form estimates account for location and time fixed effects and show that ambient air pollution has a substantial impact on hospital admissions. In particular, we show that [Formula: see text] and [Formula: see text] are positively associated with admission rates for coronary artery and cerebrovascular diseases while we find no similar correlation for PM10 and [Formula: see text]. Our robustness checks support these findings and suggest that dispersion models can help in reducing the measurement error inherent to pollution exposure measures based on station-level pollution data. Therefore, our results may contribute to a more accurate evaluation of future environmental policies aiming at a reduction of ambient air pollution exposure.

Topics: Air Pollutants; Air Pollution; Animals; Cerebrovascular Disorders; Coronary Artery Disease; Environmental Monitoring; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Sulfur Dioxide; Switzerland

Epidemiologic evidence of the mechanisms of the association between long-term exposure to air pollution and coronary heart disease (CHD) is limited and relies heavily on studies performed in Europe and the United States, where air pollution levels are relatively low. In particular, the association between air pollution and CHD in patients with underlying risks for CHD is understudied.. To determine whether air pollution and proximity to traffic are associated with the coronary artery calcium (CAC) score, a key atherosclerotic marker.. In this prospective, population-based cross-sectional study in a large-scale setting in China, 8867 consecutive patients aged 25 to 92 years with suspected CHD were recruited between November 17, 2015, and September 13, 2017. Participants were excluded if they had previous myocardial infarction, stenting, or coronary artery bypass grafting or incomplete risk factors and exposure data. Each participant underwent assessment of CAC and CHD risk factors at baseline. Data were analyzed from December 2017 to November 2018.. Annual means of fine particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) were estimated at the participants' residences using a validated geostatistical prediction model. Exposure to a nearby roadway was also estimated.. Computed tomography measurement of CAC score.. The mean (SD) age of the 8867 participants was 56.9 (10.4) years; 4378 (53.6%) were men. Annual mean (SD) PM2.5, NO2, and O3 measurements were 70.1 (20.0), 41.4 (14.7), and 93.9 (10.5) μg/m3, respectively. The mean (SD) CAC score was 91.4 (322.2) Agatston units. Exposure to PM2.5 and NO2, adjusting for CHD risk factors and multiple pollutants, were independently associated with increases in CAC scores of 27.2% (95% CI, 10.8% to 46.1%) per 30 μg/m3 PM2.5 and 24.5% (95% CI, 3.6% to 49.7%) per 20 μg/m3 NO2. For PM2.5, odds of both detectable CAC (Agatston score >0; odds ratio, 1.28; 95% CI, 1.13 to 1.45) and severe CAC (Agatston score >400; odds ratio, 1.59; 95% CI, 1.20 to 2.12) were increased. Associations of CAC with PM2.5 and NO2 were greater among male participants (PM2.5: 42.2%; 95% CI, 24.3% to 62.7%; NO2: 45.7%; 95% CI, 25.3% to 69.5%) and elderly participants (PM2.5: 50.1%; 95% CI, 28.8% to 75.0%; NO2: 55.5%; 95% CI, 31.8% to 83.6%) and those with diabetes (PM2.5: 62.2%; 95% CI, 30.9% to 101.0%; NO2: 31.2%; 95% CI, 13.9% to 51.0%). Independent association with CAC score was 9.0% (95% CI, -1.4% to 20.4%) for O3 per 15 μg/m3 and 2.4% (95% CI, -0.6% to 5.4%) for distance near roadway per 50% decrease.. In this large Chinese study, long-term exposures to PM2.5 and NO2 were independently associated with severity of CAC. This finding may provide support for the pathophysiological role of coronary atherosclerosis through which air pollution exposure may be associated with CHD.

Topics: Adult; Aged; Aged, 80 and over; Air Pollution; Beijing; Biomarkers; China; Coronary Artery Disease; Cross-Sectional Studies; Environmental Exposure; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Residence Characteristics; Traffic-Related Pollution; Vascular Calcification