Air Pollutant Exposure Tied to Increased Heart Attack Risk

Exposure of up to a week associated with increased risk

TUESDAY, Feb. 14 (HealthDay News) -- Short-term exposure to all major air pollutants, except for ozone, is significantly associated with an increased risk of heart attack, according to a study published in the Feb. 15 issue of the Journal of the American Medical Association.

Hazrije Mustafic, M.D., M.P.H., of the University Paris Descartes, and colleagues conducted a systematic literature review and performed a meta-analysis of 34 studies. Keywords related to the type of exposure (air pollution, ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter ≤10 µm [PM10], and PM ≤2.5 µm [PM2.5]) and to the type of outcome (myocardial infarction [MI], heart attack, and acute coronary syndrome) were searched. Short-term exposure was defined as exposure of up to seven days. Analysis was based on each increment of 10 µg/m³ in pollutant concentration, with the exception of carbon monoxide, for which an increase of 1 mg/ m³ was used.

The researchers found that all the main air pollutants, except for ozone, were significantly associated with an increase in MI risk (carbon monoxide: relative risk [RR], 1.048; 95 percent confidence interval [CI], 1.026 to 1.070; nitrogen dioxide: RR, 1.011; 95 percent CI, 1.006 to 1.016; sulfur dioxide: RR, 1.010; 95 percent CI, 1.003 to 1.017; PM10: RR, 1.006; 95 percent CI, 1.002 to 1.009; and PM2.5: RR, 1.025; 95 percent CI, 1.015 to 1.036). The relative risk for ozone was 1.003 (95 percent CI, 0.997 to 1.010; P = 0.36). Subgroup analyses provided similar results. Population attributable fractions ranged between 0.6 and 4.5 percent, varying by pollutant.

"All the main air pollutants, with the exception of ozone, were significantly associated with a near-term increase in MI risk," the authors write.

Several authors disclosed financial ties to pharmaceutical and medical device companies.

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