1. ^aDepartment of Health Evaluation Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
2. ^bDepartment of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
3. ^cDivision of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
4. ^dDepartment of Epidemiology and Health Promotion, KTL-National Public Health Institute, Helsinki, Finland

Correspondence: Dr. Duanping Liao, Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, A210, 600 Centerview Dr., Hershey, PA 17033, USA. Tel.: +1-717-531-4149; Fax: +1-717-531-5779; E-mail: DLiao@psu.edu

Received 30 October 2003; Accepted 17 August 2004; Published online 10 November 2004.

Abstract

To elucidate the health effects of air pollution, the short-term association of criteria pollutants (particles <10 m in diameter [PM₁₀], O₃, CO, NO₂, and SO₂) with hemostatic and inflammatory markers were examined using a population-based sample of 10,208 middle-age males and females of the biracial cohort of Atherosclerosis Risk in Communities (ARIC) study. For each participant, we calculated the following pollutant exposures 1–3 days prior to the randomly allocated cohort examination date: PM₁₀, CO, NO₂, and SO₂ as 24-h averages, and O₃ as an 8-h average of the hourly measures. The hemostatic/inflammatory factors included fibrinogen, factor VIII-C, von Willebrand factor (vWF), albumin, and white blood cell count (WBC). Linear regression models were used to adjust for cardiovascular disease (CVD) risk factors, demographic and socioeconomic variables, and relevant meteorological variables. One standard deviation (SD) increment of PM₁₀ (12.8 g/m³) was significantly (P<0.05) associated with 3.93% higher of vWF among diabetics and 0.006 g/dl lower of serum albumin among persons with a history of CVD. One SD increment of CO (0.60 p.p.m.) was significantly (P<0.01) associated with 0.018 g/dl lower of serum albumin. Significant curvilinear associations, indicative of threshold effects, for PM₁₀ with factor VIII-C, O₃ with fibrinogen and vWF, and SO₂ with factor VIII-C, WBC, and serum albumin were found. This population-based study suggest that the hemostasis/inmflammation markers analyzed, which are linked to higher risk of CHD, are associated adversely with environmentally relevant ambient pollutants, with the strongest associations in the upper range of the pollutant distributions, and in persons with a positive history of diabetes and CHD.