Emergency Hospital Admissions for Cardiovascular Diseases and Ambient Levels of Carbon Monoxide

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Abstract
Background— Evidence on risk of cardiovascular disease (CVD) hospitalization associated with short-term exposure to outdoor carbon monoxide (CO), an air pollutant primarily generated by traffic, is inconsistent across studies. Uncertainties remain on the degree to which associations are attributable to other traffic pollutants and whether effects persist at low levels. Methods and Results— We conducted a multisite time-series study to estimate risk of CVD hospitalization associated with short-term CO exposure in 126 US urban counties during 1999–2005 for >9.3 million Medicare enrollees aged ≥65 years. We considered models with adjustment by other traffic-related pollutants: NO2, fine particulate matter (with aerodynamic diameter ≤2.5 μm), and elemental carbon. We found a positive and statistically significant association between same-day CO and increased risk of hospitalization for multiple CVD outcomes (ischemic heart disease, heart rhythm disturbances, heart failure, cerebrovascular disease, total CVD)....