Residential Proximity to Major Roadway and 10-Year All-Cause Mortality After Myocardial Infarction

Abstract

Background-The relationship between residential proximity to roadway and long-term survival after acute myocardial infarction (AMI) is unknown. We investigated the association between distance from residence and major roadway and 10-year all-cause mortality after AMI in the Determinants of Myocardial Infarction Onset Study (Onset Study), hypothesizing that living closer to a major roadway at the time of AMI would be associated with increased risk of mortality. Methods and Results-The Onset Study enrolled 3886 individuals hospitalized for AMI in 64 centers across the UnitedStates from 1989 to 1996. Institutionalized patients, those providing only post office boxes, and those whose addresses could not be geocoded were excluded, leaving 3547 patients eligible for analysis. Addresses were geocoded, and distance to the nearest major roadway was assigned. Cox regression was used to calculate hazard ratios, with adjustment for personal characteristics (age, sex, race, education, marital status, distance to nearest acute care hospital), clinical characteristics (smoking, body mass index, comorbidities, medications), and neighborhood-level characteristics derived from US Census block group data (household income, education, urbanicity). There were 1071 deaths after 10 years of follow-up. In the fully adjusted model, compared with living Ͼ1000 m, hazard ratios (95% confidence interval) for living Յ100 m were 1.27 (1.01-1.60), for 100 to Յ200 m were 1.19 (0.93-1.60), and for 200 to Յ1000 m were 1.13 (0.99 -1.30) (P trend ϭ0.016). Conclusions-In this multicenter study, living close to a major roadway at the time of AMI was associated with increased risk of all-cause 10-year mortality; this relationship persisted after adjustment for individual and neighborhood-level covariates. (Circulation. 2012;125:2197-2203.)

Residential Proximity to High-Traffic Roadways and Poststroke Mortality

“…The strongest associations were observed among individuals living <100m of a high traffic road in categorical analysis and remained consistent with a log-linear association. Our findings are also consistent with the results of previous studies that have shown that living close to a major road is associated with higher mortality rate [16–18]. …”

“…Studies in other susceptible populations have shown that living near a major roadway is associated with all-cause mortality [19], cardiopulmonary mortality [20], post-myocardial infarction mortality [18], and deep vein thrombosis [21]. Evidence also suggest that there may be chronic effects of living in a location with higher exposure to air pollution, and one study in women found that living in close proximity to a roadway was also associated with elevated incidence of stroke (Hazard Ratio (HR) 2.08 (95%CI: 1.25, 3.48) and death from cerebrovascular disease (HR 2.93 (95%CI: 1.03, 8.38) [22].…”

“…Our primary analysis was to examine the association between residential proximity to a road with >10,000 vehicles/day and survival time following stroke. Evidence suggests that exposure to traffic-related pollutants is highest within 100–300 meters from major road [14] and several studies have observed associations between living within this proximity of a major road and increased risk of cardiovascular disease and mortality[15–18]. Therefore, we evaluated associations for the following categories of residential proximity to a high traffic road: ≤100 meters (m), 100 to ≤200m, 200 to ≤400m or >400m.…”

Race/Ethnicity, Residential Segregation, and Exposure to Ambient Air Pollution: The Multi-Ethnic Study of Atherosclerosis (MESA)

“…also found individuals living closer to a major roadway were more likely to be of non-White race/ethnicity. 44 Living in census tracts with higher percentages of Hispanics was associated with higher exposures to PM 2.5 and NO X , independently of individual race/ethnicity. These findings were largely consistent with a few previous studies of racial/ethnic composition and air pollution exposure.…”

Relation of Long-Term Exposure to Air Pollution to Brachial Artery Flow-Mediated Dilation and Reactive Hyperemia

“…We also tested the natural logarithm of the proximity to a major roadway and brachial function because it is associated linearly with mortality. 12 Participants living further than 1,000 m from a major road in rural areas beyond background were excluded from the roadway analyses (530 participants, 10%).…”