The association between chronic exposure to traffic-related air pollution and ischemic heart disease

J Toxicol Environ Health A. 2012;75(7):402-11. doi: 10.1080/15287394.2012.670899.


Increasing evidence links air pollution to the risk of cardiovascular disease. This study investigated the association between ischemic heart disease (IHD) prevalence and exposure to traffic-related air pollution (nitrogen dioxide [NO₂], fine particulate matter [PM₂.₅], and ozone [O₃]) in a population of susceptible subjects in Toronto. Local (NO₂) exposures were modeled using land use regression based on extensive field monitoring. Regional exposures (PM₂.₅, O₃) were modeled as confounders using inverse distance weighted interpolation based on government monitoring data. The study sample consisted of 2360 patients referred during 1992 to 1999 to a pulmonary clinic at the Toronto Western Hospital in Toronto, Ontario, Canada, to diagnose or manage a respiratory complaint. IHD status was determined by clinical database linkages (ICD-9-CM 412-414). The association between IHD and air pollutants was assessed with a modified Poisson regression resulting in relative risk estimates. Confounding was controlled with individual and neighborhood-level covariates. After adjusting for multiple covariates, NO₂ was significantly associated with increased IHD risk, relative risk (RR) = 1.33 (95% confidence interval [CI]: 1.2, 1.47). Subjects living near major roads and highways had a trend toward an elevated risk of IHD, RR = 1.08 (95% CI: 0.99, 1.18). Regional PM₂.₅ and O₃ were not associated with risk of IHD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • Cohort Studies
  • Cross-Sectional Studies
  • Environmental Monitoring
  • Epidemiological Monitoring
  • Female
  • Humans
  • Inhalation Exposure / adverse effects*
  • Inhalation Exposure / analysis
  • Male
  • Middle Aged
  • Models, Theoretical
  • Myocardial Ischemia / chemically induced*
  • Myocardial Ischemia / epidemiology
  • Nitrogen Dioxide / analysis
  • Nitrogen Dioxide / toxicity*
  • Ontario / epidemiology
  • Oxidants, Photochemical / analysis
  • Oxidants, Photochemical / toxicity*
  • Ozone / analysis
  • Ozone / toxicity*
  • Particulate Matter / analysis
  • Particulate Matter / toxicity*
  • Poisson Distribution
  • Prevalence
  • Regression Analysis
  • Risk


  • Oxidants, Photochemical
  • Particulate Matter
  • Ozone
  • Nitrogen Dioxide