Introduction Particulate air pollution has been associated with increased risk of cardiovascular diseases. At Copenhagen Airport high numbers of particles have been measured especially on the apron were employees are working.

Aim To investigate whether occupational exposure to air pollution at Copenhagen Airport is associated with the risk of ischaemic heart disease, stroke and acute coronary syndrome.

Method This study was based on Copenhagen Airport Cohort consisting of men in unskilled work with employment at Copenhagen Airport and other firms in the Greater Copenhagen area during the period 1990–2012. The exposure was assessed from proportion of time spent on the apron each calendar year (apron years) and included in the analyses as cumulated apron years. The cohort was followed in the National Patient Register for the ischaemic heart disease, stroke and acute coronary syndrome. Poisson regression adjusted for age, calendar year and educational level was used.

Results The cohort comprised 6 515 persons in the exposed group and 61 617 in the reference group. The reference group had higher incidence of ischaemic heart disease compared to the exposed group (IRR = 1.24; 95% CI; 1.08–1.42). When including exposure categorically we found no associations between cumulative apron years and the risk of ischaemic heart disease, stroke or acute coronary syndrome, ischaemic heart disease: (0.1–2.9 apron years) IRR = 1.03; 1.04–1.63, (≥7 apron years) IRR = 1.08;0.83–1.52). For stroke and acute coronary syndrome the risk estimates were similar.

Conclusion In this large cohort study we found no associations between cumulative occupational exposure to air pollution and incidence of ischaemic heart disease, stroke or acute coronary syndrome.