Abstract
Fine particulate matter (PM2.5) in air pollution, primarily from combustion sources, is recognized as an important risk factor for cardiovascular events but studies of workplace PM2.5 exposure are rare. We conducted a prospective study of exposure to PM2.5 and incidence of ischemic heart disease (IHD) in a cohort of 11,966 US aluminum workers. Incident IHD was identified from medical claims data from 1998 to 2008. Quantitative metrics were developed for recent exposure (within the last year) and cumulative exposure; however, we emphasize recent exposure in the absence of interpretable work histories before follow-up. IHD was modestly associated with recent PM2.5 overall. In analysis restricted to recent exposures estimated with the highest confidence, the hazard ratio (HR) increased to 1.78 (95% CI: 1.02, 3.11) in the second quartile and remained elevated. When the analysis was stratified by work process, the HR rose monotonically to 1.5 in both smelter and fabrication facilities, though exposure was almost an order of magnitude higher in smelters. The differential exposure–response may be due to differences in exposure composition or healthy worker survivor effect. These results are consistent with the air pollution and cigarette smoke literature; recent exposure to PM2.5 in the workplace appears to increase the risk of IHD incidence.
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Acknowledgements
This work was supported by National Institutes of Health, Institute of Aging (R01 AG026291-01) and Center for Disease Control and Prevention, National Institute of Occupational Safety and Health (R01OH009939-01) and by Alcoa.
NIA Data Sharing: As an alternative to providing a de-identified data set to the public domain, we allow access for the purpose of re-analyses or appropriate “follow-on” analyses by any qualified investigator willing to sign a contractual covenant with the host Institution limiting use of data to a specific agreed upon purpose and observing the same restrictions as are limited in our contract with Alcoa, such as 60-day manuscript review for compliance purposes.
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Drs Costello, Brown, Noth and Eisen do not have any conflicts of interest to declare. Ms Cantley and Ms Tessier-Sherman receive salary support from Alcoa, Inc through contracts with Yale University. Dr Cullen receives salary support from Alcoa, Inc through contracts with Stanford University. Dr Hammond receives compensation as a member of the scientific advisory board for Alcoa, Inc and has also consulted on exposure assessment and received compensation.
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Costello, S., Brown, D., Noth, E. et al. Incident ischemic heart disease and recent occupational exposure to particulate matter in an aluminum cohort. J Expo Sci Environ Epidemiol 24, 82–88 (2014). https://doi.org/10.1038/jes.2013.47
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DOI: https://doi.org/10.1038/jes.2013.47
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