Potential Link Between Indoor Air Quality and Coronary Artery Disease in Amsterdam, a Field Study

Several studies have established a link between outdoor air quality and cardiovascular disease (CVD), with air pollution causing millions of premature deaths annually according to the WHO. However, a similar link has not been clearly established for indoor air quality (IAQ), despite the fact that people spend much of their time indoors. In this prospective observational study, we monitored PM2.5 and PM10 (particulate matter) levels for several weeks in the homes of 49 patients referred for coronary CT angiography (CCTA) at two outpatient cardiology clinics in Amsterdam and compared these IAQ measurements with patients’ CCTA results. The CCTA outcomes included CAD-RADS scoring, vessel involvement, and the presence of obstructive disease. Patients were recruited from two Amsterdam neighborhoods with contrasting socioeconomic profiles, Amsterdam Zuid (N = 24) and Amsterdam Nieuw-West (N = 25). We found no strong systematic difference in indoor air quality between the two recruitment sites, but observed substantial within-neighborhood variability, suggesting that household-level factors may play an important role in indoor air quality. No significant associations were found between residential indoor PM levels and CAD or obstructive CAD. We conclude that the small sample size (49 individuals) and short IAQ monitoring period (a few weeks) substantially limit our ability to assess the relationship between long-term exposure and coronary artery disease.