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Residential Exposure to Traffic-Related Air Pollution and Survival after Heart Failure

Medina-Ramón, Mercedes ; Goldberg, Robert ; Melly, Steven John ; Mittleman, Murray A. ; Schwartz, Joel David

Medina-Ramón, Mercedes, Robert Goldberg, Steven Melly, Murray A. Mittleman, and Joel Schwartz. 2008. Residential Exposure to Traffic-Related Air Pollution and Survival after Heart Failure. Environmental Health Perspectives 116(4): 481-485. [Peer Reviewed Journal]

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  • Title:
    Residential Exposure to Traffic-Related Air Pollution and Survival after Heart Failure
  • Author/Creator: Medina-Ramón, Mercedes ; Goldberg, Robert ; Melly, Steven John ; Mittleman, Murray A. ; Schwartz, Joel David
  • Language: English
  • Subjects: Air Pollution ; Epidemiology ; Follow-Up Studies ; Heart Failure ; Survival
  • Is Part Of: Medina-Ramón, Mercedes, Robert Goldberg, Steven Melly, Murray A. Mittleman, and Joel Schwartz. 2008. Residential Exposure to Traffic-Related Air Pollution and Survival after Heart Failure. Environmental Health Perspectives 116(4): 481-485.
  • Description: Background: Although patients with heart failure (HF) have been identified as particularly susceptible to the acute effects of air pollution, the effects of long-term exposure to air pollution on patients with this increasingly prevalent disease are largely unknown. Objective: This study was designed to examine the mortality risk associated with residential exposure to traffic-related air pollution among HF patients. Methods: A total of 1,389 patients hospitalized with acute HF in greater Worcester, Massachusetts, during 2000 were followed for survival through December 2005. We used daily traffic within 100 and 300 m of residence as well as the distance from residence to major roadways and to bus routes as proxies for residential exposure to traffic-related air pollution. We assessed mortality risks for each exposure variable using Cox proportional hazards models adjusted for prognostic factors. Results: After the 5-year follow-up, only 334 (24%) subjects were still alive. An interquartile range increase in daily traffic within 100 m of home was associated with a mortality hazard ratio (HR) of 1.15 [95% confidence interval (CI), 1.05–1.25], whereas for traffic within 300 m this association was 1.09 (95% CI, 1.01–1.19). The mortality risk decreased with increasing distance to bus routes (HR = 0.88; 95% CI, 0.81–0.96) and was larger for those living within 100 m of a major roadway or 50 m of a bus route (HR = 1.30; 95% CI, 1.13–1.49). Adjustment for area-based income and educational level slightly attenuated these associations. Conclusions: Residential exposure to traffic-related air pollution increases the mortality risk after hospitalization with acute HF. Reducing exposure to traffic-related emissions may improve the long-term prognosis of HF patients.
  • Identifier: ISSN: 0091-6765 ; DOI: 10.1289/ehp.10918