Long-term exposure to traffic-related air pollution and the risk of coronary heart disease hospitalization and mortality

Environ Health Perspect. 2011 Apr;119(4):501-7. doi: 10.1289/ehp.1002511. Epub 2010 Nov 16.


Background: Epidemiologic studies have demonstrated that exposure to road traffic is associated with adverse cardiovascular outcomes.

Objectives: We aimed to identify specific traffic-related air pollutants that are associated with the risk of coronary heart disease (CHD) morbidity and mortality to support evidence-based environmental policy making.

Methods: This population-based cohort study included a 5-year exposure period and a 4-year follow-up period. All residents 45-85 years of age who resided in Metropolitan Vancouver during the exposure period and without known CHD at baseline were included in this study (n=452,735). Individual exposures to traffic-related air pollutants including black carbon, fine particles [aerodynamic diameter ≤ 2.5 µm (PM(2.5))], nitrogen dioxide (NO(2)), and nitric oxide were estimated at residences of the subjects using land-use regression models and integrating changes in residences during the exposure period. CHD hospitalizations and deaths during the follow-up period were identified from provincial hospitalization and death registration records.

Results: An interquartile range elevation in the average concentration of black carbon (0.94 × 10(-5)/m filter absorbance, equivalent to approximately 0.8 µg/m(3) elemental carbon) was associated with a 3% increase in CHD hospitalization (95% confidence interval, 1-5%) and a 6% increase in CHD mortality (3-9%) after adjusting for age, sex, preexisting comorbidity, neighborhood socioeconomic status, and copollutants (PM(2.5) and NO(2)). There were clear linear exposure-response relationships between black carbon and coronary events.

Conclusions: Long-term exposure to traffic-related fine particulate air pollution, indicated by black carbon, may partly explain the observed associations between exposure to road traffic and adverse cardiovascular outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Air Pollutants / analysis*
  • Air Pollution / statistics & numerical data*
  • Coronary Disease / epidemiology*
  • Coronary Disease / mortality
  • Environmental Exposure / analysis
  • Environmental Exposure / statistics & numerical data*
  • Environmental Monitoring
  • Epidemiological Monitoring
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Nitrogen Dioxide / analysis
  • Nitrogen Oxides / analysis
  • Particulate Matter / analysis
  • Risk Assessment
  • Soot / analysis
  • Transportation / statistics & numerical data


  • Air Pollutants
  • Nitrogen Oxides
  • Particulate Matter
  • Soot
  • Nitrogen Dioxide