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Long-term ambient air pollution and venous thromboembolism in a population-based Swedish cohort
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
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2023 (English)In: Environmental Pollution, ISSN 0269-7491, E-ISSN 1873-6424, Vol. 331, article id 121841Article in journal (Refereed) Published
Abstract [en]

Air pollution is a major contributor to the global burden of disease and has been linked to several diseases and conditions, including cardiovascular disease. The biological mechanisms are related to inflammation and increased coagulability, factors that play an important role in the pathogenesis of venous thromboembolism (VTE, i.e., deep vein thrombosis or pulmonary embolism). This study investigates if long-term exposure to air pollution is associated with increased VTE incidence. The study followed 29 408 participants from the Malmö Diet and Cancer (MDC) cohort, which consists of adults aged 44–74 recruited in Malmö, Sweden between 1991 and 1996. For each participant, annual mean residential exposures to particulate matter <2.5 μg (PM2.5) and <10 μg (PM10), nitrogen oxides (NOx) and black carbon (BC) from 1990 up to 2016 were calculated. Associations with VTE were analysed using Cox proportional hazard models for air pollution in the year of the VTE event (lag0) and the mean of the prior 1–10 years (lag1-10). Annual air pollution exposures for the full follow-up period had the following means: 10.8 μg/m3 for PM2.5, 15.8 μg/m3 for PM10, 27.7 μg/m3 for NOx, and 0.96 μg/m3 for BC. The mean follow-up period was 19.5 years, with 1418 incident VTE events recorded during this period. Exposure to lag1-10 PM2.5 was associated with an increased risk of VTE (HR 1.17 (95%CI 1.01–1.37)) per interquartile range (IQR) of 1.2 μg/m3 increase in PM2.5 exposure. No significant associations were found between other pollutants or lag0 PM2.5 and incident VTE. When VTE was divided into specific diagnoses, associations with lag1-10 PM2.5 exposure were similarly positive for deep vein thrombosis but not for pulmonary embolism. Results persisted in sensitivity analyses and in multi-pollutant models. Long-term exposure to moderate concentrations of ambient PM2.5 was associated with increased risks of VTE in the general population in Sweden.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 331, article id 121841
Keywords [en]
Air pollution, Deep vein thromboembolism, Particulate matter, Survival analysis, Venous thromboembolism
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:umu:diva-209186DOI: 10.1016/j.envpol.2023.121841ISI: 001013282600001PubMedID: 37209899Scopus ID: 2-s2.0-85160406991OAI: oai:DiVA.org:umu-209186DiVA, id: diva2:1770909
Available from: 2023-06-20 Created: 2023-06-20 Last updated: 2023-09-05Bibliographically approved

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Oudin, Anna

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