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dc.contributor.authorMedina-Ramón, Mercedes
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorMelly, Steven J.
dc.contributor.authorMittleman, Murray A.
dc.contributor.authorSchwartz, Joel
dc.date2022-08-11T08:10:39.000
dc.date.accessioned2022-08-23T17:15:34Z
dc.date.available2022-08-23T17:15:34Z
dc.date.issued2008-04-17
dc.date.submitted2010-05-27
dc.identifier.citationEnviron Health Perspect. 2008 Apr;116(4):481-5. <a href="http://dx.doi.org/10.1289/ehp.10918">Link to article on publisher's site</a>
dc.identifier.issn0091-6765 (Linking)
dc.identifier.doi10.1289/ehp.10918
dc.identifier.pmid18414630
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47198
dc.description.abstractBACKGROUND: Although patients with heart failure (HF) have been identified as particularly susceptible to the acute effects of air pollution, the effects of long-term exposure to air pollution on patients with this increasingly prevalent disease are largely unknown. OBJECTIVE: This study was designed to examine the mortality risk associated with residential exposure to traffic-related air pollution among HF patients. METHODS: A total of 1,389 patients hospitalized with acute HF in greater Worcester, Massachusetts, during 2000 were followed for survival through December 2005. We used daily traffic within 100 and 300 m of residence as well as the distance from residence to major roadways and to bus routes as proxies for residential exposure to traffic-related air pollution. We assessed mortality risks for each exposure variable using Cox proportional hazards models adjusted for prognostic factors. RESULTS: After the 5-year follow-up, only 334 (24%) subjects were still alive. An interquartile range increase in daily traffic within 100 m of home was associated with a mortality hazard ratio (HR) of 1.15 [95% confidence interval (CI), 1.05-1.25], whereas for traffic within 300 m this association was 1.09 (95% CI, 1.01-1.19). The mortality risk decreased with increasing distance to bus routes (HR = 0.88; 95% CI, 0.81-0.96) and was larger for those living within 100 m of a major roadway or 50 m of a bus route (HR = 1.30; 95% CI, 1.13-1.49). Adjustment for area-based income and educational level slightly attenuated these associations. CONCLUSIONS: Residential exposure to traffic-related air pollution increases the mortality risk after hospitalization with acute HF. Reducing exposure to traffic-related emissions may improve the long-term prognosis of HF patients.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=18414630&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1289/ehp.10918
dc.subjectAged
dc.subjectAir Pollutants
dc.subjectAir Pollution
dc.subjectEnvironmental Exposure
dc.subjectFemale
dc.subjectHeart Failure
dc.subjectHumans
dc.subjectInsurance Claim Review
dc.subjectMale
dc.subject*Motor Vehicles
dc.subjectPrognosis
dc.subjectProportional Hazards Models
dc.subjectResidence Characteristics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleResidential exposure to traffic-related air pollution and survival after heart failure
dc.typeJournal Article
dc.source.journaltitleEnvironmental health perspectives
dc.source.volume116
dc.source.issue4
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1344&amp;context=qhs_pp&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/343
dc.identifier.contextkey1333096
refterms.dateFOA2022-08-23T17:15:35Z
html.description.abstract<p>BACKGROUND: Although patients with heart failure (HF) have been identified as particularly susceptible to the acute effects of air pollution, the effects of long-term exposure to air pollution on patients with this increasingly prevalent disease are largely unknown.</p> <p>OBJECTIVE: This study was designed to examine the mortality risk associated with residential exposure to traffic-related air pollution among HF patients.</p> <p>METHODS: A total of 1,389 patients hospitalized with acute HF in greater Worcester, Massachusetts, during 2000 were followed for survival through December 2005. We used daily traffic within 100 and 300 m of residence as well as the distance from residence to major roadways and to bus routes as proxies for residential exposure to traffic-related air pollution. We assessed mortality risks for each exposure variable using Cox proportional hazards models adjusted for prognostic factors.</p> <p>RESULTS: After the 5-year follow-up, only 334 (24%) subjects were still alive. An interquartile range increase in daily traffic within 100 m of home was associated with a mortality hazard ratio (HR) of 1.15 [95% confidence interval (CI), 1.05-1.25], whereas for traffic within 300 m this association was 1.09 (95% CI, 1.01-1.19). The mortality risk decreased with increasing distance to bus routes (HR = 0.88; 95% CI, 0.81-0.96) and was larger for those living within 100 m of a major roadway or 50 m of a bus route (HR = 1.30; 95% CI, 1.13-1.49). Adjustment for area-based income and educational level slightly attenuated these associations.</p> <p>CONCLUSIONS: Residential exposure to traffic-related air pollution increases the mortality risk after hospitalization with acute HF. Reducing exposure to traffic-related emissions may improve the long-term prognosis of HF patients.</p>
dc.identifier.submissionpathqhs_pp/343
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages481-5


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