Long-Term Exposures to Air Pollution and the Risk of Atrial Fibrillation

Background: Atrial fibrillation (AF) is the most common heart rhythm disorder and is associated with substantial morbidity and mortality. Established risk factors explain only 50%-60% of AF cases, therefore identification of novel population-level risk factors is vital. Short-term exposures to air pollution have been associated with AF triggering, however, only a single study has examined associations between long-term exposures and AF incidence.Methods: We used information from the Women’s Health Initiative to explore the association between annual average exposures to PM10, PM2.5, NO2, SO2, O3, and risk of incident AF. Exposures were estimated at each address from nationwide spatiotemporal models and distance to road was calculated. Cases of AF were identified through linkage with Centers for Medicare & Medicaid Services data. Time-varying Cox proportional-hazards regression models were adjusted for known AF risk factors and splines were used to assess deviations of the exposure-response functions...