Long-term traffic air and noise pollution in relation to mortality and hospital readmission among myocardial infarction survivors

TitleLong-term traffic air and noise pollution in relation to mortality and hospital readmission among myocardial infarction survivors
Publication TypeJournal Article
Year of Publication2016
AuthorsTonne C., Halonen J.I, Beevers S.D, Dajnak D., Gulliver J., Kelly F.J, Wilkinson P., Anderson H.R
JournalInt J Hyg Environ HealthInternational Journal of Hygiene and Environmental HealthInternational Journal of Hygiene and Environmental Health
Volume219
Pagination72-8
Date Published01/2016
ISBN Number1438-4639
Accession Number26454658
Abstract

BACKGROUND: There is relatively little evidence of health effects of long-term exposure to traffic-related pollution in susceptible populations. We investigated whether long-term exposure to traffic air and noise pollution was associated with all-cause mortality or hospital readmission for myocardial infarction (MI) among survivors of hospital admission for MI. METHODS: Patients from the Myocardial Ischaemia National Audit Project database resident in Greater London (n = 1 8,138) were followed for death or readmission for MI. High spatially-resolved annual average air pollution (11 metrics of primary traffic, regional or urban background) derived from a dispersion model (resolution 20 m x 20 m) and road traffic noise for the years 2003-2010 were used to assign exposure at residence. Hazard ratios (HR, 95% confidence interval (CI)) were estimated using Cox proportional hazards models. RESULTS: Most air pollutants were positively associated with all-cause mortality alone and in combination with hospital readmission. The largest associations with mortality per interquartile range (IQR) increase of pollutant were observed for non-exhaust particulate matter (PM(10)) (HR = 1.05 (95% CI 1.00, 1.10), IQR = 1.1 mug/m(3)); oxidant gases (HR = 1.05 (95% CI 1.00, 1.09), IQR = 3.2 mug/m(3)); and the coarse fraction of PM (HR = 1.05 (95% CI 1.00, 1.10), IQR = 0.9 mug/m(3)). Adjustment for traffic noise only slightly attenuated these associations. The association for a 5 dB increase in road-traffic noise with mortality was HR = 1.02 (95% CI 0.99, 1.06) independent of air pollution. CONCLUSIONS: These data support a relationship of primary traffic and regional/urban background air pollution with poor prognosis among MI survivors. Although imprecise, traffic noise appeared to have a modest association with prognosis independent of air pollution.

Short TitleInt. J. Hyg. Environ. HealthInt. J. Hyg. Environ. Health
Alternate JournalInternational journal of hygiene and environmental health