Investigation of factors which might indicate susceptibility to particulate air pollution
G J Prescott, R J Lee, G R Cohen, R A Elton, A J Lee, F G R Fowkes, R M Agius
Department of
Community Health Sciences, University of Edinburgh, UK
Correspondence to: Dr R M Agius, Department of Community Health Sciences, The Medical School, Teviot Place, Edinburgh EH8 9AG, UK Raymond.Agius{at}ed.ac.uk
Accepted 27 August
1999
OBJECTIVES
To
determine whether previous symptoms or recognised risk factors of
cardiovascular ill health, are associated with an increased likelihood
of adverse health effects related to particulate air pollution.
METHODSCardiovascular
event rates were studied relative to urban concentrations of
particulate air pollution and baseline risk factors. The Edinburgh
artery study consisted of a cohort of 1592 subjects aged 55-74 and was
followed up to the end of March 1998 for a median of 10 years resulting
in about 5 million person-days of observation. Baseline measurements
included plasma fibrinogen and blood and plasma viscosity. A nested
case-control approach was used to investigate a possible interaction
between effects of these selected baseline risk factors and particulate
air pollution, on subsequent event rates.
RESULTSDuring the
follow up period there were 343 fatal and non-fatal myocardial
infarctions or strokes. Trends in adverse cardiovascular outcomes
related to pollution were identified among subjects belonging to the
highest baseline quintile of plasma fibrinogen. Evidence for
interactions between concentrations of particulate pollution and
fibrinogen was not established at conventional levels of significance.
CONCLUSIONSPeople
with high concentrations of plasma fibrinogen might be more susceptible
to adverse cardiovascular effects of particulate air pollution, but
limitations of power mean that evidence relating to such an interaction
is not conclusive. A range of cardiopulmonary risk factors warrant
investigation in relation to possible susceptibility to air pollution.
Keywords: particulate pollution; fibrinogen; susceptibility
© 2000 by Occupational and Environmental Medicine
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