Air pollution exposure may induce procoagulant effects, and chronic exposure may be linked to greater risk of venous thromboembolism (VTE). We tested the hypothesis that air pollution is associated with increased VTE risk in the prospective Multi-Ethnic Study of Atherosclerosis (MESA), which has well-characterized air pollution measures and information on potential confounding factors. We included 6,651 participants recruited in 2000-2002 (baseline age range: 45-84 yrs; 53% female). Air pollution was assessed with a validated spatio-temporal model that incorporates cohort-specific monitoring. Four indices of air pollution updated each fortnight over follow-up were averaged to estimate participant-level chronic exposure: fine particulate matter ≤2.5 micrometers in aerodynamic diameter (PM2.5), oxides of nitrogen (NOx), nitrogen dioxide (NO2), and ozone (O3). Mean±SD PM2.5 was 13.5±3.0 µg/m3, NO2 17.9±8.2 ppb, NOx 36.1±19.6 ppb, and O3 22.2±3.7 ppb. Incident VTE was identified using hospitalization discharge codes through 2018. A total of 248 VTE events accrued over a median follow-up of 16.7 years. After adjustment for baseline demographics, health behaviors and body mass index, the hazard ratio (95% CI) for incident VTE associated per 3.6 µg/m3 higher PM2.5 was 1.39 (1.04-1.86); per 13.3 ppb higher NO2 concentration was 2.74 (1.57-4.77); and per 30 ppb higher NOx was 2.21 (1.42-3.44). O3 was not related. In this prospective community-based cohort with individual-level estimation of chronic air pollution exposure, higher average ambient concentrations of PM2.5, NO2 and NOX were associated with greater risk of developing VTE. Findings add to accumulating evidence of adverse health effects attributed to air pollution exposure.

中文翻译：

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空气污染与静脉血栓栓塞风险增加有关：动脉粥样硬化的多种族研究。


空气污染暴露可能会诱发促凝血作用，而长期暴露可能与静脉血栓栓塞 （VTE） 的风险增加有关。我们在前瞻性动脉粥样硬化多种族研究 （MESA） 中检验了空气污染与 VTE 风险增加相关的假设，该研究具有明确表征的空气污染措施和有关潜在混杂因素的信息。我们纳入了 2000-2002 年招募的 6,651 名参与者（基线年龄范围：45-84 岁;53% 为女性）。空气污染使用经过验证的时空模型进行评估，该模型结合了队列特异性监测。在随访期间每两周更新一次的四个空气污染指数被平均，以估计参与者级别的慢性暴露：细颗粒物 ≤空气动力学直径 （PM2.5） 为 2.5 微米）、氮氧化物 （NOx）、二氧化氮 （NO2） 和臭氧 （O3）。平均±SD PM2.5 为 13.5±3.0 μg/m3，NO2 为 17.9±8.2 ppb，NOx 为 36.1±19.6 ppb，O3 为 22.2±3.7 ppb。到 2018 年，使用住院出院代码确定事件 VTE。在中位随访 16.7 年期间，共累积了 248 例 VTE 事件。在调整基线人口统计学、健康行为和体重指数后，PM2.5 每升高 3.6 μg/m3 相关的新发 VTE 风险比 （95% CI） 为 1.39 （1.04-1.86）;每 13.3 ppb 较高的 NO2 浓度为 2.74 （1.57-4.77）;每 30 ppb 高出 NOx 为 2.21 （1.42-3.44）。O3 无关。在这个基于社区的前瞻性队列中，对慢性空气污染暴露进行个体层面的估计，PM2.5、NO2 和 NOX 的平均环境浓度较高与发生 VTE 的风险增加相关。研究结果增加了空气污染暴露对健康产生不利影响的积累证据。