Academic journal article Environmental Health Perspectives

Particulate Matter Exposures, Mortality, and Cardiovascular Disease in the Health Professionals Follow-Up Study

Academic journal article Environmental Health Perspectives

Particulate Matter Exposures, Mortality, and Cardiovascular Disease in the Health Professionals Follow-Up Study

Article excerpt

BACKGROUND: The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes.

OBJECTIVES: In this study we explored these associations in the all-male Health Professionals Follow-Up Study prospective cohort.

METHODS: The same spatiotemporal exposure estimation models, similar outcomes, and biennially updated covariates were used as those previously applied in the female Nurses' Health Study cohort.

RESULTS: Among 17,545 men residing in the northeastern and midwestern United States, there were 2,813 deaths, including 746 cases of fatal coronary heart disease (CHD). An interquartile range change (4 [micro]g/[m.sup.3] in average exposure to PM [less than or equal to] 2.5 [micro]m in diameter in the 12 previous months was not associated with all-cause mortality [hazard ratio (HR) = 0.94; 95% confidence interval (CI), 0.87-1.00) or fatal CHD (HR = 0.99; 95% CI, 0.87-1.13) in fully adjusted models. Findings were similar for separate models of exposure to PM [less than and equal to]10 pm in diameter and PM between 2.5 and 10 pm in diameter and for copollutant models.

CONCLUSIONS: Among this cohort of men with high socioeconomic status living in the midwestern and northeastern United States, the results did not support an association of chronic PM exposures with all-cause mortality and cardiovascular outcomes in models with time-varying covariates. Whether these findings suggest sex differences in susceptibility or the protective impact of healthier lifestyles and higher socioeconomic status requires additional investigation.

KEY WORDS: air pollution, cardiovascular disease, mortality, particulate matter. Environ Health Perspect 9 130-1135 (2011). doi: 10.1289/ehp.l002921 [Online 31 March 2011]

The association of ambient particulate matter (PM) exposures with mortality and cardiovascular outcomes has been well established in studies of short-term exposure (Committee on the Medical Effects of Air Pollutants 2006; Levy et al. 2000; Samet et al. 2000a, 2000b; Zanobetti et al. 2000). The literature on health outcomes associated with long-term PM exposures has been growing. Beginning with the Harvard Six Cities Study and the American Cancer Society Study, researchers have reported increased risks of all-cause and cardiopulmonary mortality with chronic exposures (Dockery et al. 1993; Pope et al. 1995). More recent cohort studies have confirmed these findings (Brunekreef et al. 2009; Eftim et al. 2008; Laden et al. 2006; Miller et al. 2007; Pope et al. 2004; Puett et al. 2008, 2009).

A few recently published cohort studies have focused on women and have reported stronger effect estimates for fatal coronary heart disease (CHD) and all-cause mortality than previous studies (Miller et al. 2007; Puett et al. 2008, 2009).

Questions remain regarding sex differences in the associations of chronic PM exposures with all-cause and cardiovascular mortality. In the present study we applied the same spatiotemporal exposure modeling used in the all-female Nurses' Health Study cohort to examine similar relationships among the all-male Health Professionals Follow-Up Study cohort.

Materials and Methods

Study population. The Health Professionals Follow-Up Study cohort consists of 51,529 male dentists, pharmacists, optometrists, podiatrists, osteopaths, and veterinarians residing in the United States. The cohort began with a baseline questionnaire in 1986, when participants were 40-75 years of age. The Health Professionals Follow-Up Study was approved by the Harvard School of Public Health Institutional Review Board, and returning the completed questionnaires constituted implied consent to use the data in ongoing research. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.