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Am J Epidemiol 2003; 157:501-509.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Exposure to Ambient Fine Particulate Matter and Primary Cardiac Arrest among Persons With and Without Clinically Recognized Heart Disease

J. Sullivan1,, N. Ishikawa2, L. Sheppard2, D. Siscovick3,4, H. Checkoway1 and J. Kaufman3,4

1 Department of Environmental Health, School of Public Health, University of Washington, Seattle, WA.
2 Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA.
3 Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA.
4 Department of Medicine, School of Medicine, University of Washington, Seattle, WA.

The authors studied the association between incidence of primary cardiac arrest and daily measures of fine particulate matter (<=2.5 µm) using a case-crossover study of 1,206 Washington State out-of-hospital cardiac arrests (1985–1994) among persons with (n = 774) and without (n = 432) clinically recognized heart disease. The authors compared particulate matter levels on the day of the cardiac event and the 2 days preceding the event with levels from matched reference days. The estimated relative risk for a 13.8-µg/m3 increase in fine particulate matter (nephelometry: 0.54 x 10–1 km–1 bsp) on the day prior to cardiac arrest was 0.94 (95% confidence interval: 0.88, 1.02). Pollutant levels measured on the same day as the event and on the 2 days preceding the event demonstrated similar results. No increased risk was found among all cases with preexisting cardiac disease (odds ratio = 0.97, 95% confidence interval: 0.89, 1.07); however, an unexpected association appeared between current smokers with preexisting heart disease and increased particulate matter levels 2 days prior to the event (odds ratio = 1.29, 95% confidence interval: 1.06, 1.55). This association was not present in the 0- or 1-day lag analyses or in persons with other diseases. There was no consistent association between increased levels of fine particulate matter and risk of primary cardiac arrest.

air pollutants; air pollution; heart arrest; heart diseases; environmental exposure

Abbreviations: Abbreviations: CI, confidence interval; PM1.0, particulate matter <=1.0 µm in aerodynamic diameter; PM2.5, particulate matter <=2.5 µm in aerodynamic diameter; PM10, particulate matter <=10 µm in aerodynamic diameter.


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