Long-Term Exposure to Ambient Air Pollution and Myocardial Infarction: A Systematic Review and Meta-Analysis

Abstract

Background and Objective: An increasing number of epidemiological original studies suggested that long-term exposure to particulate matter (PM2.5 and PM10) could be associated with the risk of myocardial infarction (MI), but the results were inconsistent. We aimed to synthesized available cohort studies to identify the association between ambient air pollution (PM2.5 and PM10) and MI risk by a meta-analysis.Methods: PubMed and Embase were searched through September 2019 to identify studies that met predetermined inclusion criteria. Reference lists from retrieved articles were also reviewed. A random-effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (CI).Results: Twenty-seven cohort studies involving 6,764,987 participants and 94,540 patients with MI were included in this systematic review. The pooled results showed that higher levels of ambient air pollution (PM2.5 and PM10) exposure were significantly associated with the risk of MI. The pooled relative risk (RR) for each 10-μg/m3 increment in PM2.5 and PM10 were 1.18 (95% CI: 1.11–1.26), and 1.03 (95% CI: 1.00–1.05), respectively. Exclusion of any single study did not materially alter the combined risk estimate.Conclusions: Integrated evidence from cohort studies supports the hypothesis that long-term exposure to PM2.5 and PM10 is a risk factor for MI.

Synergistic Effects of Particle Radioactivity (Gross β Activity) and Particulate Matter ≤2.5 μm Aerodynamic Diameter on Cardiovascular Disease Mortality

“…Both results are also comparable with what has been recently published in reviews and meta‐analyses. 50 , 51 The 10% increase in total mortality for PM 2.5 is also similar to what was previously found using the same DID method 46 and among Medicare beneficiaries in the United States. 52 …”

Ambient Air Pollution in Relation to SARS-CoV-2 Infection, Antibody Response, and COVID-19 Disease: A Cohort Study in Catalonia, Spain (COVICAT Study)

“…Air pollution could also be related to COVID-19 disease through its contribution to chronic conditions that increase susceptibility to more severe COVID-19 disease (Williamson et al 2020). Long-term exposure to air pollution has been linked to incident diabetes (Zou et al 2021), as well as cardiovascular (Yang et al 2020) and chronic respiratory (Park et al 2021) and neurodegenerative disease (Power et al 2016). Owing to sample size limitations, we were not able to quantify the mediating role of these conditions in the air pollution-COVID-19 disease relationship.…”

Impact of Short-Term Exposure to Nitrogen Dioxide (NO2) and Ozone (O3) on Hospital Admissions for Non-ST-Segment Elevation Acute Coronary Syndrome

“…Moreover, Cesaroni et al demonstrated a 12% and 13% escalation, respectively, in the risk of acute coronary diseases due to chronic exposure to PM 10 and PM 2.5 [ 37 ]. The scientific literature consistently highlights a more detrimental impact of PM 2.5 compared to PM 10 on human health [ 20 , 33 ], attributed to its larger surface area facilitating increased absorption of chemical constituents and its extended persistence in ambient air, enhancing its capability to reach pulmonary alveoli [ 20 , 38 ].…”

“…Subsequent investigations consistently highlight that exposure to air pollutants, whether over short or long periods, significantly contributes to negative outcomes in cardio-respiratory conditions [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Earlier epidemiological discoveries specifically emphasize the heightened detrimental effects of PM on CVD compared to other airborne pollutants, especially in cases of increased exposure to PM 2.5 [ 10 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”