Abstract

Background:

Increased respiration during physical activity may increase air pollution dose, which may attenuate the benefits of physical activity on cardiovascular disease (CVD) risk and overall mortality.

Objectives:

We aimed to examine the multiplicative interaction between long-term ambient residential exposure to fine particulate matter $<2.5\text{\hspace{0.17em}microns}$ (${\mathrm{PM}}_{2.5}$) and physical activity in the association with CVD risk and overall mortality.

Methods:

We followed 104,990 female participants of the U.S.-based prospective Nurses’ Health Study from 1988 to 2008. We used Cox proportional hazards models to assess the independent associations of 24-months moving average residential ${\mathrm{PM}}_{2.5}$ exposure and physical activity updated every 4 y and the multiplicative interaction of the two on CVD (myocardial infarction and stroke) risk and overall mortality, after adjusting for demographics and CVD risk factors.

Results:

During 20 years of follow-up, we documented 6,074 incident CVD cases and 9,827 deaths. In fully adjusted models, ${\mathrm{PM}}_{2.5}$ exposure was associated with modest increased risks of CVD [hazard ratio (HR) for fifth quintile $\ge 16.5{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$ compared to first quintile $<10.7{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$: 1.09, 95% confidence interval (CI): 0.99, 1.20; $p_{\text{trend}}=0.05$] and overall mortality (HR fifth compared to first quintile: 1.10, 95% CI: 1.02, 1.19; $p_{\text{trend}}=0.07$). Higher overall physical activity was associated with substantially lower risk of CVD [HR fourth quartile, which was $\ge 24.4\text{\hspace{0.17em}metabolic}$ equivalent of task (MET)-h/wk, compared to first quartile ($<3.7\text{MET-h}/\mathrm{wk}$): 0.61, 95% CI: 0.57, 0.66; $p_{trend}<0.0001$] and overall mortality (HR fourth compared to first quartile: 0.40, 95% CI: 0.37, 0.42; $p_{trend}<0.0001$). We observed no statistically significant interactions between ${\mathrm{PM}}_{2.5}$ exposure and physical activity (overall, walking, vigorous activity) in association with CVD risk and overall mortality.

Discussion:

In this study of U.S. women, we observed no multiplicative interaction between long-term ${\mathrm{PM}}_{2.5}$ exposure and physical activity; higher physical activity was strongly associated with lower CVD risk and overall mortality at all levels of ${\mathrm{PM}}_{2.5}$ exposure. https://doi.org/10.1289/EHP7402

中文翻译：

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美国女性长期接触细颗粒物与体力活动、心血管疾病风险和总体死亡率之间的相互作用

摘要

背景：

身体活动期间呼吸增加可能会增加空气污染剂量，这可能会削弱身体活动对心血管疾病 (CVD) 风险和总体死亡率的益处。

目标：

我们的目的是检查长期环境住宅暴露于细颗粒物之间的乘法相互作用$<2.5\text{\hspace{0.17em}微米}$(${\mathrm{下午}}_{2.5}$) 和体力活动与 CVD 风险和总体死亡率的关系。

方法：

我们跟踪了 1988 年至 2008 年美国前瞻性护士健康研究的 104,990 名女性参与者。我们使用 Cox 比例风险模型来评估 24 个月移动平均住宅的独立关联${\mathrm{下午}}_{2.5}$在调整人口统计学和 CVD 风险因素后，暴露和身体活动每 4 年更新一次，以及两者对 CVD（心肌梗塞和中风）风险和总体死亡率的乘法相互作用。

结果：

在 20 年的随访期间，我们记录了 6,074 例 CVD 病例和 9,827 例死亡病例。在完全调整的模型中，${\mathrm{下午}}_{2.5}$暴露与 CVD 风险的适度增加有关[第五个五分位数的风险比 (HR)$\ge 16.5{\mathrm{\mu }\mathrm{G}/\mathrm{米}}^{\mathrm{3个}}$与第一个五分位数相比$<10.7{\mathrm{\mu }\mathrm{G}/\mathrm{米}}^{\mathrm{3个}}$：1.09，95%置信区间（CI）：0.99，1.20；$p_{\text{趋势}}=0.05$] 和总死亡率（与第一五分位数相比，HR 第五：1.10，95% CI：1.02，1.19；$p_{\text{趋势}}=0.07$). 更高的整体身体活动与显着降低的 CVD 风险相关 [HR 第四四分位数，即$\ge 24.4\text{\hspace{0.17em}新陈代谢}$相当于任务 (MET)-h/wk，与第一四分位数 ($<3.7\text{甲硫氨酸}/\mathrm{周}$): 0.61, 95% CI: 0.57, 0.66;$p_{吨r\mathrm{电子}nd}<0.0001$] 和总体死亡率（与第一四分位数相比，HR 第四：0.40，95% CI：0.37，0.42；$p_{吨r\mathrm{电子}nd}<0.0001$). 我们观察到两者之间没有统计学上显着的相互作用${\mathrm{下午}}_{2.5}$暴露和身体活动（总体、步行、剧烈活动）与 CVD 风险和总体死亡率相关。

讨论：

在这项针对美国女性的研究中，我们没有观察到长期${\mathrm{下午}}_{2.5}$暴露和身体活动；较高的体力活动与较低的 CVD 风险和总体死亡率密切相关${\mathrm{下午}}_{2.5}$接触。https://doi.org/10.1289/EHP7402