Changes in traffic exposure and the risk of incident myocardial infarction and all-cause mortality.
Changes in traffic exposure and the risk of incident myocardial infarction and all-cause mortality.
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DOI：
10.1097/ede.0b013e31829d5dae
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Laden F
中科院分区：
文献类型：
--
作者：
Hart JE;Rimm EB;Rexrode KM;Laden F
与交通有关的暴露，如空气污染和噪音，与心血管疾病发病率和死亡率的增加有关。然而，很少有研究能够检查暴露变化对风险变化的影响。我们的目的是探讨1990-2008年护士健康研究中交通暴露变化与风险变化的关系。前瞻性确定了心肌梗死（MI）事件和全因死亡率。作为交通风险的代理，我们计算了1986-2006年所有住宅地址与道路的距离，并根据距离和道路类型将地址视为“近”或“远”。为了检查暴露变化的影响，将每对连续地址分类为：（1）始终接近，（2）始终远离，（3）从接近到远离的变化，以及（4）从远离到接近的变化。我们还研究了地址对之间NO2水平的变化。在调整各种危险因素的时变考克斯比例风险模型中，与那些一直远离交通的居民相比，居住在始终靠近交通的居民的妇女发生MI的风险更高（HR= 1.11; 95%置信区间= 1.01 - 1.22），全因死亡的风险更高（1.05; 1.00 - 1.10）。从远离交通到靠近交通的女性中风险最高（MI事件：HR=1.50（95%CI：（1.11-2.03）;全因死亡率：HR=1.17（95%CI：1.00-1.37））。与先前地址相比，NO2每增加1 ppb，MI事件的HR=1.22（95%CI：0.99-1.50）。1.03全因死亡率（95%CI：0.92-1.15）。我们的研究结果表明，交通暴露的变化（测量为道路接近度或NO2水平的变化）与MI风险和全因死亡率的变化相关。
Traffic related exposures, such as air pollution and noise, have been associated with increased cardiovascular morbidity and mortality. Few studies, however, have been able to examine the effects of changes in exposure on changes in risk. Our objective was to explore the associations of changes in traffic exposure with changes in risk 1990–2008 in the Nurses’ Health Study. Incident myocardial infarction (MI) and all-cause mortality were prospectively identified. As a proxy for traffic exposure, we calculated residential distance to roads at all residential addresses 1986–2006, and considered addresses to be “close” or “far” based on distance and road type. To examine the effect of changes in exposure, each consecutive pair of addresses was categorized as: (1) consistently close, (2) consistently far, (3) change from close to far, and (4) change from far to close. We also examined the change in NO2 levels between address pairs. In time-varying Cox proportional hazards models adjusted for a variety of risk factors, women living at residences consistently close to traffic were at a higher risk of an incident MI (HR= 1.11; 95% confidence interval = 1.01 – 1.22) and a higher risk of all-cause mortality (1.05; 1.00 – 1.10), compared with those consistently far. The highest risks were seen among women who moved from being far from traffic to close (incident MI: HR=1.50 (95%CI: (1.11–2.03); all-cause mortality: HR=1.17 (95%CI: 1.00–1.37)). Each 1ppb increase in NO2 compared with the previous address was associated with a HR=1.22 for incident MI (95%CI: 0.99–1.50). 1.03 for all-cause mortality (95%CI: 0.92–1.15). Our results suggest that changes in traffic exposure (measured as roadway proximity or change in NO2 levels) are associated with changes in risk of MI and all-cause mortality.