Introduction Atrial fibrillation is a common heart rhythm disorder affecting 1–3% of the adult population. Despite being such a prevalent disorder, the knowledge about risk factors preceding the disease is very limited, especially regarding work related factors. The aim of the present study was to estimate the association between the exposure to exhaust fumes, combustion products or soot in the work environment and the risk of atrial fibrillation.

Method Data from the Swedish Work, Lipids and Fibrinogen (WOLF) study was used. The study includes working men and women in the counties of Stockholm, Västernorrland and Jämtland (n = 10416). The baseline data collection was carried out 1992–1998. Atrial fibrillation cases were identified by the Swedish national hospital discharge register.

Results During a median follow-up time of 13.6 years, 252 incident cases with atrial fibrillation were identified. In total, 1249 (12.5%) people reported exposure to exhaust fumes, combustion products or soot at baseline. The age and sex adjusted hazard ratio (HR) for atrial fibrillation was 1.01 (95% CI: 0.70–1.46) for the exposed group compared with the unexposed group. Further adjustment for socio-economic status, lifestyle factors, job strain, waist circumference and hypertension did not alter the estimated HR in any substantial way (HR 0.99, 95% CI: 0.66–1.48). However, when combining the exposure with smoking status, an increased risk for atrial fibrillation was observed among those exposed both to smoking and exhaust fumes, combustion products or soot compared to non-smokers who were not exposed (HR 1.83, 95% CI: 1.07–3.12).

Exposure-Smoking status   HR*   95% CI

Non exposed-Non-smoker   1      –

Non exposed-Smoker     1.09   0.78-1.52

Exposed-Non-smoker     0.69   0.40-1.19

Exposed-Smoker       1.83   1.07-3.12

*Adjusted for SES, life-style, job strain, waist circumference and hypertension

Conclusion Preliminary results indicate that exposure to exhaust fumes, combustion products or soot in combination with smoking is associated with an increased risk of atrial fibrillation.