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

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 dia- betes 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, respec- tively, 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, espe- cially O3, and were highest for PM2.5. These findings could have great implications for policy reg-