Long-term exposure to air pollution and incidence of cardiovascular events in women

Miller, Kristin A.; Siscovick, David S.; Sheppard, Lianne; Shepherd, Kristen; Sullivan, Jeffrey H.; Anderson, Garnet L.; Kaufman, Joel D.

doi:10.1056/nejmoa054409

Cited by 1,854Air Quality and Health ImpactsIndoor Air Quality and Microbial ExposureEnvironmental Justice and Health Disparities

Long-term exposure to air pollution and incidence of cardiovascular events in women

Miller, Kristin A., Siscovick, David S., Sheppard, Lianne, Shepherd, Kristen, Sullivan, Jeffrey H., Anderson, Garnet L., Kaufman, Joel D.·2007·New England Journal of Medicine

DOI 10.1056/nejmoa054409

Open this paper in CoChat — free account

Abstract

BACKGROUND: Fine particulate air pollution has been linked to cardiovascular disease, but previous studies have assessed only mortality and differences in exposure between cities. We examined the association of long-term exposure to particulate matter of less than 2.5 microm in aerodynamic diameter (PM2.5) with cardiovascular events. METHODS: We studied 65,893 postmenopausal women without previous cardiovascular disease in 36 U.S. metropolitan areas from 1994 to 1998, with a median follow-up of 6 years. We assessed the women's exposure to air pollutants using the monitor located nearest to each woman's residence. Hazard ratios were estimated for the first cardiovascular event, adjusting for age, race or ethnic group, smoking status, educational level, household income, body-mass index, and presence or absence of diabetes, hypertension, or hypercholesterolemia. RESULTS: A total of 1816 women had one or more fatal or nonfatal cardiovascular events, as confirmed by a review of medical records, including death from coronary heart disease or cerebrovascular disease, coronary revascularization, myocardial infarction, and stroke. In 2000, levels of PM2.5 exposure varied from 3.4 to 28.3 microg per cubic meter (mean, 13.5). Each increase of 10 microg per cubic meter was associated with a 24% increase in the risk of a cardiovascular event (hazard ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41) and a 76% increase in the risk of death from cardiovascular disease (hazard ratio, 1.76; 95% CI, 1.25 to 2.47). For cardiovascular events, the between-city effect appeared to be smaller than the within-city effect. The risk of cerebrovascular events was also associated with increased levels of PM2.5 (hazard ratio, 1.35; 95% CI, 1.08 to 1.68). CONCLUSIONS: Long-term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women. Exposure differences within cities are associated with the risk of cardiovascular disease.

Integrity signals

Registry

Crossref · 10.1056/nejmoa054409

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Studies have reported broadly similar effect sizes for ambient particulate matter by smoking status.
“Studies124,159,160 have reported broadly similar effect sizes for ambient particulate matter by smoking status (never, former, and current smokers).”
From A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010 (2012) · cites this paper as [124]

Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution
Pope III, C. A. (2002) · JAMA · doi:10.1001/jama.287.9.1132 · Cited by 8,447 · see citing works
An association between air pollution and mortality in six U.S. cities
Dockery, D. W., Pope, C. A., Xu, X., Spengler, J. D., Ware, J. H., Fay, M. E., Ferris, B. G., & Speizer, F. E. (1993) · New England Journal of Medicine · doi:10.1056/nejm199312093292401 · Cited by 8,018 · see citing works
Health Effects of Fine Particulate Air Pollution: Lines that Connect
Pope, C. A., & Dockery, D. W. (2006) · Journal of the Air & Waste Management Association · doi:10.1080/10473289.2006.10464485 · Cited by 6,678 · see citing works
Particulate Air Pollution as a Predictor of Mortality in a Prospective Study of U.S. Adults
Pope, C. A., Thun, M. J., Namboodiri, M. M., Dockery, D. W., Evans, J. S., Speizer, F. E., & Heath, C. W. (1995) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm/151.3_pt_1.669 · Cited by 2,909 · see citing works
Cardiovascular Mortality and Long-Term Exposure to Particulate Air Pollution: Epidemiological Evidence of General Pathophysiological Pathways of Disease
Pope, C. A., Burnett, R. T., Thurston, G. D., Thun, M. J., Calle, E. E., Krewski, D., & Godleski, J. J. (2004) · Circulation · doi:10.1161/01.cir.0000108927.80044.7f · Cited by 2,592 · see citing works
Design of the Women’s Health Initiative Clinical Trial and Observational Study
The Women’s Health Initiative Study Group (1998) · Controlled Clinical Trials · doi:10.1016/s0197-2456(97)00078-0 · Cited by 2,580 · see citing works
Air Pollution and Cardiovascular Disease
Brook, R. D., Franklin, B. A., Cascio, W. E., Hong, Y., Howard, G., D, M. L. M., Luepker, R. V., Mittleman, M. A., Samet, J. M., Smith, S. C., et al. (2004) · Circulation · doi:10.1161/01.cir.0000128587.30041.c8 · Cited by 2,417 · see citing works
Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study
Hoek, G., Brunekreef, B., Bausch-Goldbohm, S., Fischer, P. H., & van den Brandt, P. A. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11280-3 · Cited by 1,547 · see citing works
Spatial analysis of air pollution and mortality in Los Angeles
Jerrett, M., Burnett, R. T., Ma, R., Pope, C. A., Krewski, D., Newbold, K. B., Thurston, G., Shi, Y., Finkelstein, N., Calle, E. E., et al. (2005) · Epidemiology · doi:10.1097/01.ede.0000181630.15826.7d · Cited by 985 · see citing works
Ambient Air Pollution and Atherosclerosis in Los Angeles
Künzli, N., Jerrett, M., Mack, W. J., Beckerman, B., LABREE, L. D., Gilliland, F. D., Thomas, D., Peters, J. M., & Hodis, H. N. (2004) · Environmental Health Perspectives · doi:10.1289/ehp.7523 · Cited by 809 · see citing works
Outcomes ascertainment and adjudication methods in the women's health initiative
Curb, J. D., McTiernan, A., Heckbert, S. R., Kooperberg, C. L., Stanford, J. L., Nevitt, M. C., Johnson, K., Proulx-Burns, L., Pastore, L. M., Criqui, M. H., et al. (2003) · Annals of Epidemiology · doi:10.1016/s1047-2797(03)00048-6 · Cited by 700 · see citing works
The National Morbidity, Mortality, and Air Pollution Study. Part II: Morbidity and mortality from air pollution in the United States.
Samet, J. M., Zeger, S. L., Dominici, F., Curriero, F. C., Coursac, I., Dockery, D. W., Schwartz, J. D., & Zanobetti, A. (2000) · PubMed · Cited by 698 · see citing works
The women's health initiative observational study: baseline characteristics of participants and reliability of baseline measures
Langer, R. D., White, E., Lewis, C. E., Kotchen, J. M., Hendrix, S. L., & Trevisan, M. (2003) · Annals of Epidemiology · doi:10.1016/s1047-2797(03)00047-4 · Cited by 630 · see citing works
Particulate air pollution induces progression of atherosclerosis
Suwa, T., Hogg, J. C., Quinlan, K. B., Ohgami, A., Vincent, R., & van Eeden, S. F. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)01715-1 · Cited by 611 · see citing works
Long-Term Inhalable Particles and Other Air Pollutants Related to Mortality in Nonsmokers
Abbey, D. E., Nishino, N., McDonnell, W. F., Burchette, R. J., Knutsen, S. F., Beeson, W. L., & YANG, J. X. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.2.9806020 · Cited by 593 · see citing works
Environmental Cardiology
Bhatnagar, A. (2006) · Circulation Research · doi:10.1161/01.res.0000243586.99701.cf · Cited by 453 · see citing works
Ambient Particles and Health: Lines that Divide
Vedal, S. (1997) · Journal of the Air & Waste Management Association · doi:10.1080/10473289.1997.10463922 · Cited by 406 · see citing works
Air Pollution and Hospital Admissions for Ischemic and Hemorrhagic Stroke Among Medicare Beneficiaries
Wellenius, G. A., Schwartz, J. D., & Mittleman, M. A. (2005) · Stroke · doi:10.1161/01.str.0000189687.78760.47 · Cited by 362 · see citing works
Comparison of Self-Report, Hospital Discharge Codes, and Adjudication of Cardiovascular Events in the Women's Health Initiative
Heckbert, S. R., Kooperberg, C. L., Safford, M. M., Psaty, B. M., Hsia, J. A., McTiernan, A., Gaziano, J. M., Frishman, W. H., & Curb, J. D. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh314 · Cited by 268 · see citing works
Assessment of Deaths Attributable to Air Pollution: Should We Use Risk Estimates based on Time Series or on Cohort Studies?
Künzli, N. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.11.1050 · Cited by 241 · see citing works
The Association between Fatal Coronary Heart Disease and Ambient Particulate Air Pollution: Are Females at Greater Risk?
Chen, L. H., Knutsen, S. F., Shavlik, D. J., Beeson, W. L., Petersen, F. F., Ghamsary, M. G., & Abbey, D. E. (2005) · Environmental Health Perspectives · doi:10.1289/ehp.8190 · Cited by 218 · see citing works
Stroke Mortality Associated With Living Near Main Roads in England and Wales
Maheswaran, R., & Elliott, P. (2003) · Stroke · doi:10.1161/01.str.0000101750.77547.11 · Cited by 152 · see citing works
A Critical Review of the Evidence on Particulate Air Pollution and Mortality
Moolgavkar, S. H., & Luebeck, E. G. (1996) · Epidemiology · doi:10.1097/00001648-199607000-00014 · Cited by 138 · see citing works
Inappropriate use of daily mortality analyses to estimate longer-term mortality effects of air pollution
McMichael, A. J. (1998) · International Journal of Epidemiology · doi:10.1093/ije/27.3.450 · Cited by 125 · see citing works
Outdoor Air Pollution and Stroke in Sheffield, United Kingdom
Maheswaran, R., Haining, R., Brindley, P., et al. (2004) · Stroke · doi:10.1161/01.str.0000151363.71221.12 · Cited by 121 · see citing works
Showdown Over Clean Air Science
Kaiser, J. (1997) · Science · doi:10.1126/science.277.5325.466 · Cited by 56 · see citing works
Flexible Modeling of Exposure-Response Relationship between Long-Term Average Levels of Particulate Air Pollution and Mortality in the American Cancer Society Study
Abrahamowicz, M., Schopflocher, T., Leffondré, K., et al. (2003) · Journal of Toxicology and Environmental Health · doi:10.1080/15287390306426 · Cited by 53 · see citing works

Flagged first, then by citations

Sorted by citations

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805 · see citing works
Particulate Matter Air Pollution and Cardiovascular Disease: An Update to the Scientific Statement From the American Heart Association
Brook, R. D., Rajagopalan, S., Pope, C. A., Brook, J. R., Bhatnagar, A., Diez-Roux, A. V., Holguin, F., Hong, Y., Luepker, R. V., Mittleman, M. A., et al. (2010) · Circulation · doi:10.1161/cir.0b013e3181dbece1 · Cited by 6,548 · see citing works
Self-citation
Long-term ozone exposure and mortality
Jerrett, M., Burnett, R. T., Pope, C. A., Ito, K., Thurston, G., Krewski, D., Shi, Y., Calle, E., & Thun, M. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0803894 · Cited by 1,602 · see citing works
Air Pollution and Cardiovascular Disease
Rajagopalan, S., Al-Kindi, S. G., & Brook, R. D. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.07.099 · Cited by 1,299 · see citing works
Long-term exposure to PM and all-cause and cause-specific mortality: A systematic review and meta-analysis
Chen, J., & Hoek, G. (2020) · Environment International · doi:10.1016/j.envint.2020.105974 · Cited by 1,042 · see citing works
Chronic exposure to fine particles and mortality: an extended follow-up of the Harvard Six Cities study from 1974 to 2009
Lepeule, J., Laden, F., Dockery, D., & Schwartz, J. (2012) · Environmental Health Perspectives · doi:10.1289/ehp.1104660 · Cited by 983 · see citing works
Factors Influencing the Decline in Stroke Mortality: A Statement From the American Heart Association/American Stroke Association
Lackland, D. T., Roccella, E. J., Deutsch, A. F., Fornage, M., George, M. G., Howard, G., Kissela, B. M., Kittner, S. J., Lichtman, J. H., Lisabeth, L. D., et al. (2014) · Stroke · doi:10.1161/01.str.0000437068.30550.cf · Cited by 815 · see citing works
Short term exposure to air pollution and stroke: systematic review and meta-analysis
Shah, A. S. V., Lee, K. K., McAllister, D. A., Hunter, A., Nair, H., Whiteley, W., Langrish, J. P., Newby, D. E., & Mills, N. L. (2015) · BMJ · doi:10.1136/bmj.h1295 · Cited by 870 · see citing works
Cardiovascular effects of air pollution.
Bourdrel, T., Bind, M.-A., Béjot, Y., Morel, O., & Argacha, J.-F. (2017) · Archives of Cardiovascular Diseases · doi:10.1016/j.acvd.2017.05.003 · Cited by 783 · see citing works
Environmental factors in cardiovascular disease
Cosselman, K. E., Navas-Acien, A., & Kaufman, J. D. (2015) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2015.152 · Cited by 613 · see citing works
Self-citation
Burden of Cause-Specific Mortality Associated With PM <sub>2.5</sub> Air Pollution in the United States
Bowe, B., Xie, Y., Yan, Y., & Al-Aly, Z. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.15834 · Cited by 367 · see citing works
A Method to Estimate the Chronic Health Impact of Air Pollutants in U.S. Residences
Logue, J. M., Price, P. N., Sherman, M. H., & Singer, B. C. (2012) · Environmental Health Perspectives · doi:10.1289/ehp.1104035 · Cited by 251 · see citing works
Exposure to particulate air pollution and risk of deep vein thrombosis
Baccarelli, A., Martinelli, I., Zanobetti, A., Grillo, P., Hou, L.-F., Bertazzi, P. A., Mannucci, P. M., & Schwartz, J. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.9.920 · Cited by 230 · see citing works
Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review
Chow, C. K., Lock, K., Teo, K., Subramanian, S., McKee, M., & Yusuf, S. (2009) · International Journal of Epidemiology · doi:10.1093/ije/dyn258 · Cited by 160 · see citing works
Short-term exposure to air pollution and inflammation-sensitive biomarkers
Steinvil, A., Kordova-Biezuner, L., Shapira, I., Berliner, S., & Rogowski, O. (2008) · Environmental Research · doi:10.1016/j.envres.2007.08.006 · Cited by 120 · see citing works
Associations of ozone and PM2. 5 concentrations with Parkinson's disease among participants in the agricultural health study
Kirrane, E. F., Bowman, C., Davis, J. A., Hoppin, J. A., Blair, A., Chen, H., Patel, M. M., Sandler, D. P., Tanner, C. M., Vinikoor-Imler, L., et al. (2015) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000000451 · Cited by 100 · see citing works
Investigations on meteorological conditions for elevated PM2.5 in Fairbanks, Alaska
Tran, H. N. Q., & Mölders, N. (2011) · Atmospheric Research · doi:10.1016/j.atmosres.2010.08.028 · Cited by 98 · see citing works
Within- and between-group regression for improving the robustness of causal claims in cross-sectional analysis
Genser, B., Teles, C. A., Barreto, M. L., & Fischer, J. E. (2015) · Environmental Health · doi:10.1186/s12940-015-0047-2 · Cited by 23 · see citing works
Emergency visits and hospital admissions in aged people living close to a gas-fired power plant
Di Ciaula, A. (2012) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2011.09.013 · Cited by 17 · see citing works
Caracterización fisico-química de los aerosoles atmosféricos en el Mediterráneo Occidental
Pey Betrán, J. (2023) · doi:10.5821/dissertation-2117-94310 · Cited by 3 · see citing works

It's an ill wind: The effect of fine particulate air pollution on respiratory hospitalizations
Ward, C. J. (2015) · Canadian Journal of Economics/Revue canadienne d économique · doi:10.1111/caje.12177 · Cited by 35 · see citing works
Protecting Human Health From Air Pollution
Dominici, F., Peng, R. D., Barr, C. D., & Bell, M. L. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181cc86e8 · Cited by 487 · see citing works
Assess the Performance against ETS and PM1 and Evaluate the Users’ Experiences of Comfort of Nasal Filters
Almuhaidib, I. (2020) · doi:10.33915/etd.7699 · Cited by 1 · see citing works
Particulate Air Pollution and Health: Emerging Issues and Research Needs Related to the Development of Air Quality Standards
Hessel, P. A., Goldsmith, J. R., Wichmann, H., et al. (1997) · Canadian Respiratory Journal · doi:10.1155/1997/903051 · Cited by 2 · see citing works
Acute Effects of Air Pollution on Influenza-like Illness in Nanjing, China
Huang, L. (2016) · ISEE Conference Abstracts · doi:10.1289/isee.2016.3535 · Cited by 1 · see citing works

Authors: Miller, K. A., Siscovick, D. S., Sheppard, L., Shepherd, K., Sullivan, J. H., Anderson, G. L., & Kaufman, J. D.
Affiliations: University of Washington (US)
ORCID: Siscovick, David S.
Sheppard, Lianne
Sullivan, Jeffrey H.
Anderson, Garnet L.
Kaufman, Joel D.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2007-02
Volume: 356
Issue: 5
Pages: 447-458
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmoa054409
OpenAlex: W2098189516
Cited by: 1,854
References: 27
Citations by year: 2026: 33 · 2025: 49 · 2024: 66 · 2023: 63 · 2022: 91 · 2021: 104 · 2020: 121 · 2019: 111 · 2018: 110 · 2017: 113 · 2016: 99 · 2015: 114 · 2014: 101 · 2013: 122 · 2012: 105
FWCI: 85.54
Type: journal article
Language: en
Open access: closed
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5t32es007262-15)
National Institute of Environmental Health Sciences (P30 ES-07033, T32-ES07262, K24ES013195, K23ES011139, P30ES007033)
Topics: Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Social Sciences › Sociology and Political Science › Environmental Justice and Health Disparities
Keywords: PM2.5, air pollution, cardiovascular disease, cardiovascular events, cardiovascular mortality, cerebrovascular disease, stroke, myocardial infarction, coronary artery disease, postmenopausal women, long-term exposure, coronary revascularization
MeSH terms: Aged, Air Pollution, Cerebrovascular Disorders, Environmental Exposure, Female, Humans, Middle Aged, Risk Factors, Urban Population, Cohort Studies, Incidence, Proportional Hazards Models, Myocardial Ischemia, Postmenopause, Particulate Matter

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Long-term exposure to air pollution and incidence of cardiovascular events in women

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks