Medical Effects: Heart Disease: Are Females at Greater Risk than Men?

The Association between Fatal Coronary Heart Disease and Ambient
Particulate Air Pollution: Are Females at Greater Risk?

Conclusion: In summary, in this study we found an elevated risk of fatal CHD associated with ambient levels of PM10, PM10–2.5, and PM2.5 in females but not in males. The risk estimates were strengthened when adjusting for gaseous pollutants and were highest for PM2.5. Our findings are in line with findings by others of an effect of PM on CPD mortality, but are of greater magnitude, possibly because the outcome was limited to fatal CHD with better control of confounding factors such as alcohol and tobacco.

Lie Hong Chen, Synnove F. Knutsen, David Shavlik, W. Lawrence Beeson, Floyd Petersen, Mark Ghamsary, and David Abbey; Department of Epidemiology and Biostatistics, Loma Linda University, Loma Linda, California, USA:

Vol.113 | NUMBER 12 | December 2005 • Environmental Health Perspectives

Abstract: The purpose of this study was to assess the effect of long-term ambient particulate matter (PM) on risk of fatal coronary heart disease (CHD). A cohort of 3,239 nonsmoking, non-Hispanic white adults was followed for 22 years. Monthly concentrations of ambient air pollutants were obtained from monitoring stations [PM < 10 μm in aerodynamic diameter (PM10), ozone, sulfur dioxide, nitrogen dioxide] or airport visibility data [PM < 2.5 μm in aerodynamic diameter (PM2.5)] and interpolated to ZIP code centroids of work and residence locations. All participants had completed a detailed lifestyle questionnaire at baseline (1976), and follow-up information on environmental tobacco smoke and other personal sources of air pollution were available from four subsequent questionnaires from 1977 through 2000. Persons with prevalent CHD, stroke, or diabetes at baseline (1976) were excluded, and analyses were controlled for a number of potential confounders, including lifestyle. In females, the relative risk (RR) for fatal CHD with each 10-μg/m3 increase in PM2.5 was 1.42 [95% confidence interval (CI), 1.06–1.90] in the single pollutant model and 2.00 (95% CI, 1.51–2.64) in the two-pollutant model with O3. Corresponding RRs for a 10-μg/m3 increase in PM10-2.5 and PM10 were 1.62 and 1.45, respectively, in all females and 1.85 and 1.52 in postmenopausal females. No associations were found in males. A positive association with fatal CHD was found with all three PM fractions in females but not in males. The risk estimates were strengthened when adjusting for gaseous pollutants, especially O3, and were highest for PM2.5. These findings could have great implications for policy regulations.

Key words: air pollution, coronary disease, ischemic heart disease, long-term exposure, mortality, particulate matter.

Environ Health Perspect 113:1723–1729 (2005).
doi:10.1289/ehp.8190 available via [Online 2 August 2005]

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