Ischemic Heart Disease and Ambient Air Pollution of Particulate Matter 2.5 in 51 Counties in the U.S.

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Abstract
Objective.: Ischemic heart disease (IHD) is one of the most common health threats to the adult population of the U.S. and other countries. The objective of this study was to examine the association between exposure to elevated annual average levels of Particulate matter 2.5 (PM2.5) air quality index (AQI) and IHD in the general population. Methods.: We combined data from the Behavioral Risk Factor Surveillance System and the U.S Environmental Protection Agency air quality database. We analyzed the data using SUDAAN software to adjust the effects of sampling bias, weights, and design effects. Results.: The prevalence of IHD was 9.6% among respondents who were exposed to an annual average level of PM2.5 AQI >60 compared with 5.9% among respondents exposed to an annual average PM2.5 AQI ≤60. The respondents with higher levels of PM2.5 AQI exposure were more likely to have IHD (adjusted odds ratio 5 1.72, 95% confidence interval 1.11, 2.66) than respondents with lower levels of exposure after adjusting for age, gender, race/ethnicity, education, smoking, body mass index, diabetes, hypertension, and hypercholesterolemia. Conclusions.: Our study suggested that exposure to relatively higher levels of average annual PM2.5 AQI may increase the likelihood of IHD. In addition to encouraging health-related behavioral changes to reduce IHD, efforts should also focus on implementing appropriate measures to reduce exposure to unhealthy AQI levels.