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dc.contributor.authorMedina-Ramón, Mercedes
dc.contributor.authorGoldberg, Robert
dc.contributor.authorMelly, Steven John
dc.contributor.authorMittleman, Murray A.
dc.contributor.authorSchwartz, Joel David
dc.date.accessioned2011-05-15T21:52:41Z
dc.date.issued2008
dc.identifier.citationMedina-Ramón, Mercedes, Robert Goldberg, Steven Melly, Murray A. Mittleman, and Joel Schwartz. 2008. Residential Exposure to Traffic-Related Air Pollution and Survival after Heart Failure. Environmental Health Perspectives 116(4): 481-485.en_US
dc.identifier.issn0091-6765en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4889508
dc.description.abstractBackground: Although patients with heart failure (HF) have been identified as particularly susceptible to the acute effects of air pollution, the effects of long-term exposure to air pollution on patients with this increasingly prevalent disease are largely unknown. Objective: This study was designed to examine the mortality risk associated with residential exposure to traffic-related air pollution among HF patients. Methods: A total of 1,389 patients hospitalized with acute HF in greater Worcester, Massachusetts, during 2000 were followed for survival through December 2005. We used daily traffic within 100 and 300 m of residence as well as the distance from residence to major roadways and to bus routes as proxies for residential exposure to traffic-related air pollution. We assessed mortality risks for each exposure variable using Cox proportional hazards models adjusted for prognostic factors. Results: After the 5-year follow-up, only 334 (24%) subjects were still alive. An interquartile range increase in daily traffic within 100 m of home was associated with a mortality hazard ratio (HR) of 1.15 [95% confidence interval (CI), 1.05–1.25], whereas for traffic within 300 m this association was 1.09 (95% CI, 1.01–1.19). The mortality risk decreased with increasing distance to bus routes (HR = 0.88; 95% CI, 0.81–0.96) and was larger for those living within 100 m of a major roadway or 50 m of a bus route (HR = 1.30; 95% CI, 1.13–1.49). Adjustment for area-based income and educational level slightly attenuated these associations. Conclusions: Residential exposure to traffic-related air pollution increases the mortality risk after hospitalization with acute HF. Reducing exposure to traffic-related emissions may improve the long-term prognosis of HF patients.en_US
dc.language.isoen_USen_US
dc.publisherNational Institute of Environmental Health Sciencesen_US
dc.relation.isversionofdoi:10.1289/ehp.10918en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2290984/pdf/en_US
dash.licenseLAA
dc.subjectair pollutionen_US
dc.subjectepidemiologyen_US
dc.subjectfollow-up studiesen_US
dc.subjectheart failureen_US
dc.subjectsurvivalen_US
dc.titleResidential Exposure to Traffic-Related Air Pollution and Survival after Heart Failureen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalEnvironmental Health Perspectivesen_US
dash.depositing.authorMelly, Steven John
dc.date.available2011-05-15T21:52:41Z
dash.affiliation.otherSPH^Exposure Epidemiology and Risk Programen_US
dash.affiliation.otherSPH^Epidemiologyen_US
dash.affiliation.otherHMS^Medicine- Beth Israel-Deaconessen_US
dash.affiliation.otherHMS^Medicine-Brigham and Women's Hospitalen_US
dash.affiliation.otherSPH^Exposure Epidemiology and Risk Programen_US
dc.identifier.doi10.1289/ehp.10918*
dash.contributor.affiliatedMelly, Steven
dash.contributor.affiliatedMittleman, Murray
dash.contributor.affiliatedSchwartz, Joel


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