| Chronic Fine and Coarse Particulate Exposure, Mortality, and Coronary Heart Disease in the Nurses' Health Study Robin C. Puett,1,2,3 Jaime E. Hart,3,4 Jeff D Yanosky,3,* Christopher Paciorek,5,6 Joel Schwartz,3,7 Helen Suh,3 Frank E Speizer,3,4 and Francine Laden3,4,7 1South Carolina Cancer Prevention and Control Program, and 2Departments of Epidemiology and Biostatistics and Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA; 3Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA; 4Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA;
5Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA; 6Department of Statistics, University of California at Berkeley, Berkeley, California, USA; 7Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA Abstract
Background: The relationship of fine particulate matter < 2.5 µm in diameter (PM2.5) air pollution with mortality and cardiovascular disease is well established, with more recent long-term studies reporting larger effect sizes than earlier long-term studies. Some studies have suggested the coarse fraction, particles between 2.5 and 10 µm (PM10‒2.5) , may also be important. With respect to mortality and cardiovascular events, questions remain regarding the relative strength of effect sizes for chronic exposure to fine and coarse particles. Objectives: We examined the relationship of chronic PM2.5 and PM10‒2.5 exposures with all-cause mortality and fatal and nonfatal incident coronary heart disease (CHD) , adjusting for time-varying covariates. Methods: The current study included women from the Nurses’ Health Study living in metropolitan areas of the northeastern and midwestern United States. Follow-up was from 1992 to 2002. We used geographic information systems–based spatial smoothing models to estimate monthly exposures at each participant’s residence. Results: We found increased risk of all-cause mortality [hazard ratio (HR) , 1.26 ; 95% confidence interval (CI) , 1.02‒1.54] and fatal CHD (HR = 2.02 ; 95% CI, 1.07‒3.78) associated with each 10-µg/m3 increase in annual PM2.5 exposure. The association between fatal CHD and PM10‒2.5 was weaker. Conclusions: Our findings contribute to growing evidence that chronic PM2.5 exposure is associated with risk of all-cause and cardiovascular mortality. Key words: air pollution, cardiovascular disease, mortality, particulate matter. Environ Health Perspect 117:1697–1701 (2009) . doi:10.1289/ehp.0900572 available via http://dx.doi.org/ [Online 15 June 2009]
Address correspondence to R. Puett, University of South Carolina CPCP, 915 Greene St., Room 229, Columbia, SC 29201 USA. Telephone: (803) 576-5650. Fax: (803) 576-5626. E-mail: rpuett@mailbox.sc.edu *Current address: Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA. This work was presented at the Twentieth Conference of the International Society for Environmental Epidemiology in October 2008. We acknowledge the dedication of the Nurse’s Health Study participants and members of Channing Laboratory. Grants from the U.S. Environmental Protection Agency’s Science to Achieve Results program (83054501-0) , National Cancer Institute (PPG grant CA87969) , and National Heart, Lung and Blood Institute (1F32 HL083648) supported this research. The authors declare they have no competing financial interests. Received 14 January 2009 ; accepted 15 June 2009.
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