BACKGROUND: In China, the associations between long-term fine particulate matter with aerodynamic diameter ≤2.5 μm (PM OBJECTIVES: This study aimed to investigate the associations of long-term exposure to PM METHODS: This nationwide prospective cohort study was conducted in 101,906 adults from the China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) Project who were free of cardiovascular disease at baseline. Participants were followed up from 2003 to 2019. Annual residential exposures to PM RESULTS: During a median follow-up of 11.08 years (1,230,732 person-years), 3,500 incident cases of coronary heart disease, including 1,771 AMI events, and 1,321 coronary heart disease deaths, including 808 AMI deaths, were recorded. Per IQR increase in EC, OC, nitrate, and sulfate exposure, HRs for coronary heart disease incidence were 1.10 (95% CI: 1.01-1.19), 1.60 (95% CI: 1.31-1.95), 1.43 (95% CI: 1.06-1.95), and 0.93 (95% CI: 0.82-1.06), respectively. Similar positive associations for EC, OC, and nitrate were observed for coronary heart disease mortality and AMI outcomes, whereas the health impacts of sulfate were weaker and less consistent across outcomes. Concentration-response curves indicated an overall increasing coronary heart disease risk for OC, EC, and nitrate exposure with a plateau or slight attenuation in the higher exposure range of EC and OC, whereas sulfate exposure showed nonlinear associations without a sustained increase in risk. CONCLUSIONS: Long-term exposure to specific PM
Published in JACC, this large-scale study from China is notable for linking specific components of PM2.5 air pollution to increased risks of coronary heart disease and acute myocardial infarction, suggesting a need for more targeted pollution control measures.
Wang et al. (Wed,) studied this question.