European Heart Journal Advance Access originally published online on August 7, 2006
European Heart Journal 2006 27(19):2275-2284; doi:10.1093/eurheartj/ehl162
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Impact of urban atmospheric pollution on coronary disease
Laboratoire Environnement et Prédiction de la Santé des Populations—TIMC, Faculté de Médecine, Domaine de la Merci, 38700 La Tronche Cedex, France
Received 27 January 2006; revised 4 July 2006; accepted 6 July 2006; online publish-ahead-of-print 7 August 2006.
* Corresponding author: Service de Médecine et Santé au travail—RCH, Hopital A Michallon, BP 217, 38043 Grenoble Cedex 9, France. Tel: +33 4 76 76 52 27; fax: +33 4 76 76 89 10. E-mail address: rdegaudemaris{at}chu-grenoble.fr
See page 2269 for the editorial comment on this article (doi:10.1093/eurheartj/ehl221)
Recent epidemiological findings have suggested that urban atmospheric pollution may have adverse effects on the cardiovascular system as well as on the respiratory system. We carried out an exhaustive search of published studies investigating links between coronary heart disease and urban atmospheric pollution. The review was conducted on cited articles published between 1994 and 2005 and whose main objective was to measure the risk of ischaemic heart diseases related to urban pollution. Of the 236 references identified, 46 epidemiological studies were selected for analysis on the basis of pre-defined criteria. The studies were analysed according to short-term effects (time series and case-crossover designs) and long-term effects (case–control and cohort studies). A link between coronary heart disease and at least one of the pollutants studied (PM10, O3, NOx, CO, SO2) emerged in 40 publications. Particulate matter, nitrogen oxides, and carbon monoxide were the pollutants most often linked with coronary heart disease. The association was inconstant for O3. Although the mean mortality or morbidity risk related to urban atmospheric pollution is low compared with that associated with other better-known risk factors, its impact on health is nevertheless major because of the large number of people who are exposed. This exhaustive review supports the possibility that urban pollution is indeed an environmental cardiovascular risk factor and should be considered as such by the cardiologists.
Key Words: Air pollution • Myocardial infarction • Cardiovascular diseases • Particles • Nitrogen oxides • Ozone • Review
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