Objectives The aim of this study is to investigate the effect of occupational exposure to radon and respirable quartz (RQ) on the risk of acute myocardial infarction.

Methods This individually matched case-control-study is nested into the Wismut cohort of former uranium miners. Acute myocardial infarction (AMI) was ascertained from hospital discharge diagnoses coded in ICD-10 and validated according to WHO criteria (1979) by patient records. Exposure to RQ, radon, long-lived radionuclides, Gamma-radiation, and arsenic was estimated by a corresponding job-exposure-matrix. Information on silicosis was included in the dataset to reduce a possible Healthy-worker-effect. To exclude effects of possible exposures before hire in uranium mining, a second analysis was performed limited to miners born after 1930. Conditional logistic regression was used for risk modelling.

Results In total, 467 cases of AMI and 467 controls, matched by year of birth, were ascertained. The analysis of the full dataset shows only a weak increase of AMI-risk with increasing exposure to RQ. But the second analysis, based on 126 matched pairs, revealed a positive dose-response relationship with RQ. The odds ratio for the highest quintile (>15 mg/m³·year) was 4.91 (95%CI: 1.43–16.8). Including RQ as a linear term yields OR=1.05 per mg/m³·year. The analysis of the cumulative radon exposure produced similar findings.

Conclusions This study shows elevated risk of AMI due to radon and RQ exposure. Because of the high correlation between both exposures, a differentiation between the corresponding effects is not possible.