Traffic-related air pollution and cardiovascular mortality in central Taiwan

In this study, the relationship between cardiovascular mortality and traffic-related air pollutants (NO₂, CO, PM₁₀, and six volatile organic compounds (VOCs), propane, iso-butane, propylene, benzene, meta-, para-, and ortho-xylenes) was investigated. The concentrations of NO₂, PM₁₀ and CO from 1993 to 2006 were measured at a fixed-site air monitoring station, and VOC data from 2003 to 2006 were obtained from a photochemical assessment monitoring site in an urban area in central Taiwan. Outcome variables were data on mortality due to cardiovascular diseases (ICD-9-CM 410-411, 414, 430-437) from 1993 to 2006. Cardiovascular mortality averaged 1.5 cases, ranging between 0 and 9 cases per day. Daily air pollution levels ranged from 0.5 to 80.5 ppb for NO₂ and from 0.1 to 3.8 ppm for CO. From the subset of data from 2003 to 2006, daily average values ranged from 0.6 to 17.5 ppb for propane, 0.3 to 6.7 ppb for iso-butane, 0.3 to 6.7 ppb for propylene, 0.2 to 3.8 ppb for benzene, 0.3 to 26.0 ppb for m,p-xylene, and 0.02 to 7.6 ppb for o-xylene. Poisson generalized additive model was used to estimate the effects of elevated air pollutant levels on daily mortality, adjusting for meteorological conditions and temporal trends. Single-pollutant model showed that cardiovascular mortality was significantly associated with NO₂ lagged 2 days, and with propane, iso-butane, and benzene lagged 0 day. The relative risk for an interquartile range increase in air pollutant levels was 1.053 for NO₂, 1.064 for propane, 1.055 for iso-butane, and 1.055 for benzene. In conclusion, daily cardiovascular mortality showed association with data on acute exposure to traffic air pollutants in Taichung, which is an important factor to consider in studying cardiovascular mortality in urban environments.