Abstract
Prior work has reported acute associations between ST-elevation myocardial infarction (STEMI) and short-term increases in airborne particulate matter. Subsequently, the association between STEMI and hourly measures of Delta-C (marker of woodsmoke) and black carbon (marker of traffic pollution) measured at a central site in Rochester, NY, were examined, but no association was found. Therefore, land use regression estimates of Delta-C and black carbon concentrations at each patient’s residence were developed for 246 STEMI patients treated at the University of Rochester Medical Center during the winters of 2008–2012. Using case-crossover methods, the rate of STEMI associated with increased Delta-C and BC concentration on the same and previous 3 days was estimated after adjusting for 3-day mean temperature and relative humidity. Non-statistically significant increased rates of STEMI associated with interquartile range increases in concentrations of BC in the previous 2 days (1.10 μg/m3; OR = 1.12; 95% CI 0.93, 1.35) and Delta-C in the previous 3 days (0.43 μg/m3; OR = 1.16; 95% CI 0.96, 1.40) were found. Significantly increased rates of STEMI associated with interquartile range increases in concentrations of BC (1.23 μg/m3; OR = 1.04; 95% CI = 0.87, 1.24) or Delta-C (0.40 μg/m3; OR = 0.94; 95% CI = 0.85, 1.09) on the same day were not observed likely due, in part, to temporal misalignment. Therefore, sophisticated spatial-temporal models will be needed to minimize exposure error and bias by better predicting concentrations at individual locations for individual hours, especially for outcomes with short-term responses to air pollution (< 24 h).
Highlights
Short-term increases in ambient particulate matter (PM) concentrations over hours and days have been associated with various manifestations of cardiovascular disease, including myocardial infarction (MI) (Mustafic et al 2012; Gardner et al 2014)
Evans et al (2017) examined whether increased hourly concentrations of source-specific PM2.5, including Delta-C (Wang et al 2011a) and black carbon (Suglia et al 2008), measured at a single, central, monitoring station in Rochester in the previous 1, 12, 24, 48, 72, and 96 h were associated with an increased rate of STelevation myocardial infarction (STEMI)
In a case-crossover study examining the triggering of STelevation myocardial infarction by short-term increases in daily ambient black carbon and Delta-C concentrations estimated at each study subject’s residence using a land use regression
Summary
Short-term increases in ambient particulate matter (PM) concentrations over hours and days have been associated with various manifestations of cardiovascular disease, including myocardial infarction (MI) (Mustafic et al 2012; Gardner et al 2014). All study subjects’ pollutant concentrations were taken from the same monitoring station no matter how far they lived from it, resulting in exposure error and likely effect underestimation (Evans et al 2017) This exposure error may be fairly substantial for Delta-C and black carbon, which have greater spatial variability in concentration than PM2.5 (Larson et al 2007; Su et al 2007; Wang et al 2011b). Wang et al (2011b) measured BC at a number of locations in Rochester and concluded that one central monitoring site may not adequately represent the actual residential wood combustion particle exposure over the whole urban area This exposure error could induce substantial attenuation of the estimated associations between STEMI and these pollutants. Use of central site measured concentrations alone may not be sufficient to observe air pollution-mediated health effects if they do exist
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