IS RISK OF FATAL STROKE ASSOCIATED WITH LONG-TERM EXPOSURE TO GASEOUS AMBIENT AIR POLLUTANTS? RESULTS FROM THE AHSMOG STUDY (original) (raw)

Epidemiology, 2003

Abstract

ABSTRACT The relationship between ambient air pollution and cardiovascular disease is currently a topic of debate. If there is a relationship, this could have great implications for policy regulations. Methods: To study the health effect of long-term ambient air pollution, a cohort of 6,338 nonsmoking, white California Seventh-day Adventists was followed with respect to health outcomes from 1977. To be included in the study, participants must have lived within 10 miles of their 1977 address for the previous 10 years. At baseline in 1977, a comprehensive lifestyle and diet questionnaire was completed and the cohort was followed with update of residence and workplace in order to assess monthly averages of ambient air pollutants throughout the study period. Exposure to environmental tobacco smoke, dusts and fumes in the workplaces, and time spent outdoors was assessed through selfadministered questionnaires in 1977, 1987, and again in 1992. The risk of fatal stroke (ICD: 430-438) was ascertained between 1977 and 1992 through matching with death certificates obtained from the National Death Index (NDI). Monthly indices of gaseous ambient air pollutant concentrations (O3, NO2, SO2) were obtained from the California Air Resource Board monitoring stations from 1973-1992, and interpolated to zip code centroids. Cox proportional hazards were used to estimate relative risks (RR) of CHD death associated with an interquartile range (IQR) increase in mean concentrations of each ambient air pollutant averaged over the 5-year period immediately preceding death. The analyses excluded those with prevalent strock at baseline and was controlled for age, pack-years of past cigarette smoking, history of diabetes, history of hypertension, BMI, years of education, and total exercise level. Results: Elevated risk of fatal stroke was found for all gaseous ambient air pollution levels with the highest risk estimates for SO2. Table: ISEE-346

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