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Fine particulate air pollution and premature atrial contractions: The REasons for Geographic And Racial Differences in Stroke study


Several reports have suggested that particulate matter (PM) exposure increases the risk for atrial arrhythmias. However, data from large-scale epidemiologic studies supporting this hypothesis are lacking. We examined the association of PM <2.5 μm in diameter (PM2.5) concentration with premature atrial contractions (PACs) in 26,609 (mean age=65±9.4 years; 55% female; 41% black) participants from the REGARDS (REasons for Geographic And Racial Differences in Stroke) study. Estimates of short- (2 weeks) and long-term (1 year) PM2.5 exposure were computed before each participant’s baseline visit using geographic information system data on the individual level at the coordinates of study participants’ residences. PACs were identified from baseline electrocardiograms. A total of 2140 (8.2%) participants had evidence of PACs on the baseline electrocardiogram. Short-term PM2.5 (per 10 μg/m3) exposure was not associated with PACs (OR=1.09, 95% CI=0.98, 1.23). Increases in long-term PM2.5 (per 10 μg/m3) were associated with PACs (OR=1.40, 95% CI=1.10, 1.78). Interactions were not detected for short- and long-term PM2.5 exposure by age, sex, or race. Long- but not short-term PM2.5 exposure is associated with PACs. This suggests a role for long-term PM2.5 exposure in initiating supraventricular arrhythmias that are triggered by PACs.

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We thank the other investigators, the staff, and the participants of the REGARDS study for their valuable contributions. A full list of participating REGARDS investigators and institutions can be found at This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service, as well as from the NASA Applied Sciences Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke, National Institutes of Health, or NASA.

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Correspondence to Wesley T O'Neal.

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O'Neal, W., Soliman, E., Efird, J. et al. Fine particulate air pollution and premature atrial contractions: The REasons for Geographic And Racial Differences in Stroke study. J Expo Sci Environ Epidemiol 27, 271–275 (2017).

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