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. 2016 Mar;27(2):211-20.
doi: 10.1097/EDE.0000000000000421.

Long- and Short-term Exposure to Air Pollution and Inflammatory/Hemostatic Markers in Midlife Women

Rochelle Green  1 , Rachel Broadwin, Brian Malig, Rupa Basu, Ellen B Gold, Lihong Qi, Barbara Sternfeld, Joyce T Bromberger, Gail A Greendale, Howard M Kravitz, Kristin Tomey, Karen Matthews, Carol A Derby, Elizabeth A Jackson, Robin Green, Bart Ostro
Affiliations

Long- and Short-term Exposure to Air Pollution and Inflammatory/Hemostatic Markers in Midlife Women

Rochelle Green et al. Epidemiology. 2016 Mar.

Abstract

Background: Studies have reported associations between long-term air pollution exposures and cardiovascular mortality. The biological mechanisms connecting them remain uncertain.

Methods: We examined associations of fine particles (PM2.5) and ozone with serum markers of cardiovascular disease risk in a cohort of midlife women. We obtained information from women enrolled at six sites in the multi-ethnic, longitudinal Study of Women's Health Across the Nation, including repeated measurements of high-sensitivity C-reactive protein, fibrinogen, tissue-type plasminogen activator antigen, plasminogen activator inhibitor type 1, and factor VIIc (factor VII coagulant activity). We obtained residence-proximate PM2.5 and ozone monitoring data for a maximum five annual visits, calculating prior year, 6-month, 1-month, and 1-day exposures and their relations to serum markers using longitudinal mixed models.

Results: For the 2,086 women studied from 1999 to 2004, PM2.5 exposures were associated with all blood markers except factor VIIc after adjusting for age, race/ethnicity, education, site, body mass index, smoking, and recent alcohol use. Adjusted associations were strongest for prior year exposures for high-sensitivity C-reactive protein (21% increase per 10 μg/m³ PM2.5, 95% confidence interval [CI]: 6.6, 37), tissue-type plasminogen activator antigen (8.6%, 95% CI: 1.8, 16), and plasminogen activator inhibitor (35%, 95% CI: 19, 53). An association was also observed between year prior ozone exposure and factor VIIc (5.7% increase per 10 ppb ozone, 95% CI: 2.9, 8.5).

Conclusions: Our findings suggest that prior year exposures to PM2.5 and ozone are associated with adverse effects on inflammatory and hemostatic pathways for cardiovascular outcomes in midlife women.

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Figures

Figure 1
Figure 1
Associations between hemostatic markers and (A) PM2.5 alone (solid circles) and PM2.5 with ozone (open circles) in the model with a 10 μg/m3 change in PM2.5 and a 10 ppb change in ozone, and (B) ozone alone (solid circles) and ozone with PM2.5 (open circles). Bars around estimates represent 95% confidence intervals. The estimates for fibrinogen are not percent changes, but instead are unit changes per 10 unit change in air pollutant. Adjusting for time invariant variables: site, ethnicity, and education; and time variant variables: smoking status, age, body mass index and alcohol use in the last 24 hours. Factor VIIc, Factor VII coagulant activity hs-CRP, high sensitivity C-reactive protein PAI-1, plasminogen activator inhibitor Type 1 PM2.5, fine particles or particles less than 2.5 microns in diameter tPA-ag, tissue-type plasminogen activator antigen
Figure 1
Figure 1
Associations between hemostatic markers and (A) PM2.5 alone (solid circles) and PM2.5 with ozone (open circles) in the model with a 10 μg/m3 change in PM2.5 and a 10 ppb change in ozone, and (B) ozone alone (solid circles) and ozone with PM2.5 (open circles). Bars around estimates represent 95% confidence intervals. The estimates for fibrinogen are not percent changes, but instead are unit changes per 10 unit change in air pollutant. Adjusting for time invariant variables: site, ethnicity, and education; and time variant variables: smoking status, age, body mass index and alcohol use in the last 24 hours. Factor VIIc, Factor VII coagulant activity hs-CRP, high sensitivity C-reactive protein PAI-1, plasminogen activator inhibitor Type 1 PM2.5, fine particles or particles less than 2.5 microns in diameter tPA-ag, tissue-type plasminogen activator antigen
See this image and copyright information in PMC

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