Abstract
BackgroundExposure to traffic-related pollution is positively associated with cardiovascular diseases (CVD), but little is known about how different sources of traffic pollution (eg, gasoline-powered cars, diesel-engine vehicles) contribute to CVD. Therefore, we evaluated the association between exposure to different types of engine exhaust and CVD mortality.MethodsWe recruited 12,098 participants from REVEAL-HBV cohort in Taiwan. The CVD mortality in 2000–2014 was ascertained by the Taiwan Death Certificates. Traffic pollution sources (2005–2013) were based on information provided by the Directorate General of Highway in 2005. Exposure to PM2.5 was based on a land-use regression model. We applied Cox proportional hazard models to assess the association of traffic vehicle exposure and CVD mortality. A causal mediation analysis was applied to evaluate the mediation effect of PM2.5 on the relationship between traffic and CVD mortality.ResultsA total of 382 CVD mortalities were identified from 2000 to 2014. We found participants exposed to higher volumes of small car and truck exhausts had an increased CVD mortality. The adjusted hazard ratio (HR) was 1.10 for small cars (95% confidence interval [CI], 0.94–1.27; P-value = 0.23) and 1.24 for truck (95% CI, 1.03–1.51; P-value = 0.03) per one unit increment of the logarithm scale. The findings were still robust with further adjustment for different types of vehicles. A causal mediation analysis revealed PM2.5 had an over 60% mediation effect on traffic-CVD association.ConclusionsExposure to exhaust from trucks or gasoline-powered cars is positively associated with CVD mortality, and air pollution may play a role in this association.
Highlights
Cardiovascular disease (CVD) is the leading cause of death globally, and it is estimated that cardiovascular diseases (CVD) was responsible for more than 30% of global deaths in 2018.1 Epidemiological studies suggest long-term exposure to traffic pollution is positively associated with CVD risks.[2,3,4,5,6,7,8,9] In a landmark study conducted in the Netherlands, Hoek et al found long-term exposure to traffic-related air pollution is consistently associated with cardiopulmonary mortality.[7]
Male sex, higher body mass index (BMI), had ever smoked, and higher serum triglyceride levels were associated with higher CVD mortality (Table 1)
After adjusting for age and sex, we found a positive association between total vehicle exposure and cumulative CVD mortality
Summary
Cardiovascular disease (CVD) is the leading cause of death globally, and it is estimated that CVD was responsible for more than 30% of global deaths in 2018.1 Epidemiological studies suggest long-term exposure to traffic pollution is positively associated with CVD risks.[2,3,4,5,6,7,8,9] In a landmark study conducted in the Netherlands, Hoek et al found long-term exposure to traffic-related air pollution is consistently associated with cardiopulmonary mortality.[7]. Studies in occupational health settings found that workers chronically exposed to DEE had a higher risk of respiratory symptoms.[10,11,12] evidence in human randomized controlled trials indicated short-term exposure to DEE had adverse effects on inflammatory response,[13,14] cardiovascular functions,[15,16,17,18] endothelial functions,[19] ischemic and thrombotic responses,[20] and blood pressure.[21] previous epidemiological and animal studies suffer from several limitations, and the interpretation of these findings should be viewed with caution.[22] For instance, participants in most human controlled exposure studies were assigned much higher DEE exposure levels (200 to 300 μg=m3) than typical ambient levels.[15,17,18,19,20,21,23] The. Exposure to traffic-related pollution is positively associated with cardiovascular diseases (CVD), but little is known about how different sources of traffic pollution (eg, gasoline-powered cars, diesel-engine vehicles) contribute to CVD. We evaluated the association between exposure to different types of engine exhaust and CVD mortality
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