Triggering of ST-elevation myocardial infarction by ambient wood smoke and other particulate and gaseous pollutants

• Published in: Journal of exposure science & environmental epidemiology Vol. 27; no. 2; pp. 198 - 206
• Main Authors: Evans, Kristin A, Hopke, Philip K, Utell, Mark J, Kane, Cathleen, Thurston, Sally W, Ling, Frederick S, Chalupa, David, Rich, David Q
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-03-2017; Nature Publishing Group
• Subjects: 692/499; 692/699/75/2/1674; Adult; Aged; Air Pollutants - adverse effects; Air Pollutants - analysis; Air pollution; Air Pollution - adverse effects; Air Pollution - analysis; Black carbon; Carbon monoxide; Carbon Monoxide - adverse effects; Carbon Monoxide - analysis; Cross-Over Studies; Databases, Factual; Development and progression; Electrocardiography; Environmental aspects; Environmental Monitoring; Epidemiology; Female; Gaseous pollutants; Health aspects; Heart attack; Hospitals, University; Humans; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial infarction; Myocardial Infarction - chemically induced; New York; original-article; Ozone - adverse effects; Ozone - analysis; Particulate emissions; Particulate matter; Particulate Matter - adverse effects; Pollutants; Risk factors; Seasonal variations (Diseases); Seasons; Smoke; Smoke - adverse effects; Vehicle Emissions; Wood; Wood - adverse effects; United States; STEMI; wood smoke; air pollution; fine particles; myocardial infarction
• ISSN: 1559-0631; 1559-064X
• DOI: 10.1038/jes.2016.15

We previously observed increased odds of ST-elevation myocardial infarctions (STEMIs) associated with increased ambient fine particulate matter (PM
2.5
) in the previous hour. However, data are lacking on the effects of specific PM sources. Using data from 362 patients, a case–crossover design, and conditional logistic regression, we estimated the relative odds of STEMI associated with increased Delta-C (wood smoke), black carbon (BC; traffic), PM
2.5
, and gaseous pollutants in the previous 1–72 h. We did not observe increased odds of STEMIs associated with increased Delta-C or BC. We did observe increased odds associated with each 7.1 
μ
g/m
3
increase in PM
2.5
(OR (95% CI): 1.17 (0.99, 1.39)) and each 19.9 p.p.b. increase in ozone (O
3
; 1.27 (1.00, 1.63)) in the previous hour, and each 0.22 p.p.m. increase in 48-h carbon monoxide (CO) concentrations (1.32 (1.00, 1.73]). Larger relative odds were associated with PM
2.5
in May–October, and O
3
and CO in November–April. Increased PM
2.5
, O
3
, and CO, but not wood smoke or BC, were associated with increased odds of STEMI, and effects may differ by season. Studies using spatially adjusted pollution estimates are needed, as well as studies further examining O
3
and CO effects on the risk of STEMI.