O-021 Occupational Exposure to Diesel Exhaust and the Risk of Acute Myocardial Infarction

Introduction Numerous studies have found an association between exposure to ambient air pollution and ischemic heart disease, but only few studies have investigated if occupational exposure to diesel exhaust is associated with cardiovascular disease. The aim of this study was to determine if exposure to diesel exhaust affects the risk of first-time acute myocardial infarction (AMI). Methods The study was designed as a register-based follow-up study of the entire Danish working population with estimates on occupational exposure to diesel exhaust based on a quantitative job exposure matrix (1976-2018) and national data on ischemic heart disease throughout the follow-up period (1996-2018). The incidence risk ratio (IRR) for the association between incident AMI and cumulative exposure to diesel exhaust was assessed using Poisson regression with adjustments for demographics, comorbidities, and socio-economic factors as well as other occupational exposures such as noise, physically demanding work, job strain and outdoor air pollution. Results In the follow-up period, there were 35,517 cases of fatal and non-fatal first-time AMIs among 903,415 individuals. The IRR for the highest exposed (≥75th percentile) was 1.09 (95%CI:1.05-1.13), whereas the second highest exposed (≥50th percentile) had an IRR of 1.04 (95%CI:1.01-1.08). Discussion The results are in accordance with other epidemiological and mechanistic studies of the impact of diesel exposure on cardiovascular disease. Conclusion There is an association between cumulative occupational diesel exposure and increased risk of AMI, which should be included in the risk assessment of diesel exhaust.