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Previous Volume 351:1721-1730 October 21, 2004 Number 17 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Stone, P. H. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background An association between exposure to vehicular traffic in urban areas and the exacerbation of cardiovascular disease has been suggested in previous studies. This study was designed to assess whether exposure to traffic can trigger myocardial infarction.

Methods We conducted a case–crossover study in which cases of myocardial infarction were identified with the use of data from the Cooperative Health Research in the Region of Augsburg Myocardial Infarction Registry in Augsburg, in southern Germany, for the period from February 1999 to July 2001. There were 691 subjects for whom the date and time of the myocardial infarction were known who had survived for at least 24 hours after the event, completed the registry's standardized interview, and provided information on factors that may have triggered the myocardial infarction. Data on subjects' activities during the four days preceding the onset of symptoms were collected with the use of patient diaries.

Results An association was found between exposure to traffic and the onset of a myocardial infarction within one hour afterward (odds ratio, 2.92; 95 percent confidence interval, 2.22 to 3.83; P<0.001). The time the subjects spent in cars, on public transportation, or on motorcycles or bicycles was consistently linked with an increase in the risk of myocardial infarction. Adjusting for the level of exercise on a bicycle or for getting up in the morning changed the estimated effect of exposure to traffic only slightly (odds ratio for myocardial infarction, 2.73; 95 percent confidence interval, 2.06 to 3.61; P<0.001). The subject's use of a car was the most common source of exposure to traffic; nevertheless, there was also an association between time spent on public transportation and the onset of a myocardial infarction one hour later.

Conclusions Transient exposure to traffic may increase the risk of myocardial infarction in susceptible persons.

Source Information

From the Institute of Epidemiology (A.P., S.K., M.H., I.T., H.E.W., H.L.) and the Institute for Health Economics (A.H.), GSF–National Research Center for Environment and Health, Neuherberg; and the Department of Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität, Munich (H.E.W.) — all in Germany.

Address reprint requests to Dr. Peters at the Institute of Epidemiology, GSF–National Research Center for Environment and Health, Ingolstädter Landstr. 1, 87564 Neuherberg, Germany, or at peters{at}gsf.de.

Full Text of this Article

Related Letters:

Traffic and Myocardial Infarction
Tosteson D. C., Greenbaum D. S., Lebwohl B., Stone P. H.
Extract | Full Text | PDF  
N Engl J Med 2005; 352:623-624, Feb 10, 2005. Correspondence

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