Ambient air pollution is the leading cause of environmental mortality and morbidity worldwide. However, the individual contributions to acute mortality of traffic-related air pollutants such as nitrogen dioxide (NO₂) and fine particulate matter (PM_2.5) are still debated. We conducted a time-stratified case-crossover study for a population located around Zurich airport in Switzerland, including 24,886 adult cardiovascular deaths from the Swiss National Cohort. We estimated the risk of cause-specific cardiovascular mortality associated with daily NO₂ and PM_2.5 concentrations at home using distributed lag models up to 7 days preceding death, adjusted for daily temperature, precipitation, acute night-time aircraft noise, firework celebrations, and holidays. Cardiovascular mortality was associated with NO₂, whereas the association with PM_2.5 disappeared upon adjustment for NO₂. The strongest association was observed between NO₂ and ischemic stroke mortality (odds ratio = 1.55 per 10 μg/m³, 95% confidence intervals = 1.20–2.00). Cause-specific mortality analyses showed differences in terms of delayed effect: odds ratios were highest at 1–3 days after exposure for most outcomes but at lags of 3–5 days for heart failure. Individual vulnerabilities to NO₂ associated cardiovascular mortality also varied by cause of death, possibly highlighting the role of different behaviours and risk factors in the most susceptible groups. The risk of cardiovascular mortality was also increased on firework days and after public holidays, independent from NO₂ and PM_2.5 concentrations. This study confirms the association between ambient NO₂, as a marker for primary emissions, and acute cardiovascular mortality in a specific setting around a major airport. Future research should clarify the role of additional air pollutants including ultra-fine particles on cardiovascular diseases to inform most efficient control measures.

环境空气污染是全球环境死亡率和发病率的主要原因。然而，与交通相关的空气污染物，如二氧化氮 (NO ₂ ) 和细颗粒物 (PM _2.5 )对急性死亡率的个人贡献仍存在争议。我们对位于瑞士苏黎世机场周围的人群进行了一项时间分层病例交叉研究，其中包括来自瑞士国家队列的 24,886 名成人心血管死亡病例。我们估计了与每日 NO ₂和 PM _2.5相关的特定原因心血管死亡风险使用分布式滞后模型计算家中浓度，直至死亡前 7 天，根据每日温度、降水、急性夜间飞机噪音、烟花庆祝活动和假期进行调整。心血管疾病的死亡率与NO相关的₂，而用PM的关联_2.5消失时调整NO ₂。在 NO ₂和缺血性卒中死亡率之间观察到最强的关联（比值比 = 1.55/10 μg/m ³，95% 置信区间 = 1.20–2.00）。原因特异性死亡率分析显示延迟效应方面存在差异：大多数结果的比值比在暴露后 1-3 天时最高，但心力衰竭滞后 3-5 天。NO _{2 的}个人漏洞相关的心血管死亡率也因死因而异，这可能突出了不同行为和危险因素在最易感人群中的作用。在烟花日和公共假期之后，心血管死亡风险也增加，这与 NO ₂和 PM _2.5浓度无关。这项研究证实环境NO之间的关联₂，作为用于主排放的标记，并且在周围的主要机场特定设置急性心血管死亡率。未来的研究应阐明包括超细颗粒物在内的其他空气污染物对心血管疾病的作用，以提供最有效的控制措施。