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Long-Term Exposure to Traffic-Related Air Pollution and Risk of Incident Atrial Fibrillation: A Cohort Study

Monrad, Maria ; Sajadieh, Ahmad ; Christensen, Jeppe Schultz ; Ketzel, Matthias ; Raaschou-Nielsen, Ole ; Tjønneland, Anne ; Overvad, Kim ; Loft, Steffen ; Sørensen, Mette

Environmental Health Perspectives, 2017, Vol.125(3), p.422-427 [Peer Reviewed Journal]

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  • Title:
    Long-Term Exposure to Traffic-Related Air Pollution and Risk of Incident Atrial Fibrillation: A Cohort Study
  • Author/Creator: Monrad, Maria ; Sajadieh, Ahmad ; Christensen, Jeppe Schultz ; Ketzel, Matthias ; Raaschou-Nielsen, Ole ; Tjønneland, Anne ; Overvad, Kim ; Loft, Steffen ; Sørensen, Mette
  • Subjects: Research
  • Is Part Of: Environmental Health Perspectives, 2017, Vol.125(3), p.422-427
  • Description: Background: Atrial fibrillation is the most common sustained arrhythmia and is associated with cardiovascular morbidity and mortality. The few studies conducted on short-term effects of air pollution on episodes of atrial fibrillation indicate a positive association, though not consistently. Objectives: The aim of this study was to evaluate the long-term impact of traffic-related air pollution on incidence of atrial fibrillation in the general population. Methods: In the Danish Diet, Cancer, and Health cohort of 57,053 people 50–64 years old at enrollment in 1993–1997, we identified 2,700 cases of first-ever hospital admission for atrial fibrillation from enrollment to end of follow-up in 2011. For all cohort members, exposure to traffic-related air pollution assessed as nitrogen dioxide (NO 2 ) and nitrogen oxides (NO x ) was estimated at all present and past residential addresses from 1984 to 2011 using a validated dispersion model. We used Cox proportional hazard model to estimate associations between long-term residential exposure to NO 2 and NO x and risk of atrial fibrillation, after adjusting for lifestyle and socioeconomic position. Results: A 10 μg/m 3 higher 10-year time-weighted mean exposure to NO 2 preceding diagnosis was associated with an 8% higher risk of atrial fibrillation [incidence rate ratio: 1.08; 95% confidence interval (CI): 1.01, 1.14] in adjusted analysis. Though weaker, similar results were obtained for long-term residential exposure to NO x . We found no clear tendencies regarding effect modification of the association between NO 2 and atrial fibrillation by sex, smoking, hypertension or myocardial infarction. Conclusion: We found long-term residential traffic-related air pollution to be associated with higher risk of atrial fibrillation. Accordingly, the present findings lend further support to the demand for abatement of air pollution. Citation: Monrad M, Sajadieh A, Christensen JS, Ketzel M, Raaschou-Nielsen O, Tjønneland A, Overvad K, Loft S, Sørensen M. 2017. Long-term exposure to traffic-related air pollution and risk of incident atrial fibrillation: a cohort study. Environ Health Perspect 125:422–427; http://dx.doi.org/10.1289/EHP392
  • Identifier: ISSN: 0091-6765 ; E-ISSN: 1552-9924 ; DOI: 10.1289/EHP392 ; PMCID: 5332191 ; PMID: 27472911