Emergency hospital admissions for cardiovascular diseases and ambient levels of carbon monoxide: results for 126 United States urban counties, 1999-2005.
Emergency hospital admissions for cardiovascular diseases and ambient levels of carbon monoxide: results for 126 United States urban counties, 1999-2005.
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DOI：
10.1161/circulationaha.109.851113
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发表时间：
2009-09-15
期刊：
影响因子：
37.8
通讯作者：
Samet JM
中科院分区：
文献类型：
--
作者：
Bell ML;Peng RD;Dominici F;Samet JM
Evidence on risk of cardiovascular (CVD) hospitalization associated with short-term exposure to outdoor carbon monoxide (CO), an air pollutant primarily generated by traffic, is inconsistent across studies. Uncertainties remain regarding the degree to which associations are attributable to other traffic pollutants and whether effects persist at low levels. We conducted a multi-site time-series study to estimate risk of CVD hospitalization associated with short-term CO exposure in 126 U.S. urban counties from 1999–2005 for >9.3 million Medicare enrollees ≥65 years of age. We considered models with adjustment by other traffic-related pollutants: nitrogen dioxide (NO2), fine particles (PM2.5), and Elemental Carbon (EC). We found a positive and statistically significant association between same day (L0) CO and increased risk of hospitalization for multiple CVD outcomes (ischemic heart disease, heart rhythm disturbances, heart failure, cerebrovascular disease, total CVD). The association remained positive and statistically significant, but was attenuated, with co-pollutant adjustment, especially NO2. A one part per million (ppm) increase in L0 daily 1-hour maximum CO was associated with a 0.96% (95% posterior interval 0.79, 1.12%) increase in risk of CVD admissions. With L0 NO2 adjustment, this estimate is 0.55% (0.36, 0.74%). The risk persisted at low CO levels <1 ppm. We found evidence of an association between short-term exposure to ambient CO and risk of CVD hospitalizations, even at levels well below current U.S. health-based regulatory standards. This evidence indicates that exposure to current CO levels may still pose a public health threat, particularly for persons with CVD.
