Concomitant exposure to air pollution, green space and noise, and risk of myocardial infarction: a cohort study from Denmark

Aslak Harbo Poulsen*, Mette Sørensen, Ulla A. Hvidtfeldt, Matthias Ketzel, Jesper H. Christensen, Jørgen Brandt, Lise M. Frohn, Andreas Massling, Jibran Khan, Thomas Münzel, Ole Raaschou-Nielsen

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

12 Citations (Scopus)

Abstract

AIMS: The three correlated environmental exposures (air pollution, road traffic noise, and green space) have all been associated with the risk of myocardial infarction (MI). The present study aimed to analyse their independent and cumulative association with MI.

METHODS AND RESULTS: In a cohort of all Danes aged 50 or older in the period 2005-17, 5-year time-weighted average exposure to fine particles (PM2.5), ultrafine particles, elemental carbon, nitrogen dioxide (NO2), and road traffic noise at the most and least exposed façades of residence was estimated. Green space around residences was estimated from land use maps. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence interval (CI), and cumulative risk indices (CRIs) were calculated. All expressed per interquartile range. Models were adjusted for both individual and neighbourhood-level socio-demographic covariates. The cohort included 1 964 702 persons. During follow-up, 71 285 developed MI. In single-exposure models, all exposures were associated with an increased risk of MI. In multi-pollutant analyses, an independent association with risk of MI was observed for PM2.5 (HR: 1.026; 95% CI: 1.002-1.050), noise at most exposed façade (HR: 1.024; 95% CI: 1.012-1.035), and lack of green space within 150 m of residence (HR: 1.018; 95% CI: 1.010-1.027). All three factors contributed significantly to the CRI (1.089; 95% CI: 1.076-1.101).

CONCLUSION: In a nationwide cohort study, air pollution, noise, and lack of green space were all independently associated with an increased risk of MI. The air pollutant PM2.5 was closest associated with MI risk.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
Volume31
Issue1
Pages (from-to)131-141
Number of pages11
ISSN2047-4873
DOIs
Publication statusPublished - Jan 2024

Keywords

  • Air pollution
  • Cohort study
  • Epidemiology
  • Green space
  • Myocardial infarction
  • Traffic noise

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