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Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials
BACKGROUND: The putative effects of postmenopausal hormone therapy on the association between particulate matter (PM) air pollution and venous thromboembolism (VTE) have not been assessed in a randomized trial of hormone therapy, despite its widespread use among postmenopausal women. OBJECTIVE: In t...
Autores principales: | , , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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National Institute of Environmental Health Sciences
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059994/ https://www.ncbi.nlm.nih.gov/pubmed/21036692 http://dx.doi.org/10.1289/ehp.1002256 |
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author | Shih, Regina A. Griffin, Beth Ann Salkowski, Nicholas Jewell, Adria Eibner, Christine Bird, Chloe E. Liao, Duanping Cushman, Mary Margolis, Helene G. Eaton, Charles B. Whitsel, Eric A. |
author_facet | Shih, Regina A. Griffin, Beth Ann Salkowski, Nicholas Jewell, Adria Eibner, Christine Bird, Chloe E. Liao, Duanping Cushman, Mary Margolis, Helene G. Eaton, Charles B. Whitsel, Eric A. |
author_sort | Shih, Regina A. |
collection | PubMed |
description | BACKGROUND: The putative effects of postmenopausal hormone therapy on the association between particulate matter (PM) air pollution and venous thromboembolism (VTE) have not been assessed in a randomized trial of hormone therapy, despite its widespread use among postmenopausal women. OBJECTIVE: In this study, we examined whether hormone therapy modifies the association of PM with VTE risk. METHODS: Postmenopausal women 50–79 years of age (n = 26,450) who did not have a history of VTE and who were not taking anticoagulants were enrolled in the Women’s Health Initiative Hormone Therapy trials at 40 geographically diverse U.S. clinical centers. The women were randomized to treatment with estrogen versus placebo (E trial) or to estrogen plus progestin versus placebo (E + P trial). We used age-stratified Cox proportional hazard models to examine the association between time to incident, centrally adjudicated VTE, and daily mean PM concentrations spatially interpolated at geocoded addresses of the participants and averaged over 1, 7, 30, and 365 days. RESULTS: During the follow-up period (mean, 7.7 years), 508 participants (2.0%) had VTEs at a rate of 2.6 events per 1,000 person-years. Unadjusted and covariate-adjusted VTE risk was not associated with concentrations of PM < 2.5 μm (PM(2.5)) or < 10 μm (PM(10))] in aerodynamic diameter and PM × active treatment interactions were not statistically significant (p > 0.05) regardless of PM averaging period, either before or after combining data from both trials [e.g., combined trial-adjusted hazard ratios (95% confidence intervals) per 10 μg/m(3) increase in annual mean PM(2.5) and PM(10), were 0.93 (0.54–1.60) and 1.05 (0.72–1.53), respectively]. Findings were insensitive to alternative exposure metrics, outcome definitions, time scales, analytic methods, and censoring dates. CONCLUSIONS: In contrast to prior research, our findings provide little evidence of an association between short-term or long-term PM exposure and VTE, or clinically important modification by randomized exposure to exogenous estrogens among postmenopausal women. |
format | Text |
id | pubmed-3059994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | National Institute of Environmental Health Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-30599942011-03-21 Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials Shih, Regina A. Griffin, Beth Ann Salkowski, Nicholas Jewell, Adria Eibner, Christine Bird, Chloe E. Liao, Duanping Cushman, Mary Margolis, Helene G. Eaton, Charles B. Whitsel, Eric A. Environ Health Perspect Research BACKGROUND: The putative effects of postmenopausal hormone therapy on the association between particulate matter (PM) air pollution and venous thromboembolism (VTE) have not been assessed in a randomized trial of hormone therapy, despite its widespread use among postmenopausal women. OBJECTIVE: In this study, we examined whether hormone therapy modifies the association of PM with VTE risk. METHODS: Postmenopausal women 50–79 years of age (n = 26,450) who did not have a history of VTE and who were not taking anticoagulants were enrolled in the Women’s Health Initiative Hormone Therapy trials at 40 geographically diverse U.S. clinical centers. The women were randomized to treatment with estrogen versus placebo (E trial) or to estrogen plus progestin versus placebo (E + P trial). We used age-stratified Cox proportional hazard models to examine the association between time to incident, centrally adjudicated VTE, and daily mean PM concentrations spatially interpolated at geocoded addresses of the participants and averaged over 1, 7, 30, and 365 days. RESULTS: During the follow-up period (mean, 7.7 years), 508 participants (2.0%) had VTEs at a rate of 2.6 events per 1,000 person-years. Unadjusted and covariate-adjusted VTE risk was not associated with concentrations of PM < 2.5 μm (PM(2.5)) or < 10 μm (PM(10))] in aerodynamic diameter and PM × active treatment interactions were not statistically significant (p > 0.05) regardless of PM averaging period, either before or after combining data from both trials [e.g., combined trial-adjusted hazard ratios (95% confidence intervals) per 10 μg/m(3) increase in annual mean PM(2.5) and PM(10), were 0.93 (0.54–1.60) and 1.05 (0.72–1.53), respectively]. Findings were insensitive to alternative exposure metrics, outcome definitions, time scales, analytic methods, and censoring dates. CONCLUSIONS: In contrast to prior research, our findings provide little evidence of an association between short-term or long-term PM exposure and VTE, or clinically important modification by randomized exposure to exogenous estrogens among postmenopausal women. National Institute of Environmental Health Sciences 2011-03 2010-10-29 /pmc/articles/PMC3059994/ /pubmed/21036692 http://dx.doi.org/10.1289/ehp.1002256 Text en http://creativecommons.org/publicdomain/mark/1.0/ Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely. Use of materials published in EHP should be acknowledged (for example, ?Reproduced with permission from Environmental Health Perspectives?); pertinent reference information should be provided for the article from which the material was reproduced. Articles from EHP, especially the News section, may contain photographs or illustrations copyrighted by other commercial organizations or individuals that may not be used without obtaining prior approval from the holder of the copyright. |
spellingShingle | Research Shih, Regina A. Griffin, Beth Ann Salkowski, Nicholas Jewell, Adria Eibner, Christine Bird, Chloe E. Liao, Duanping Cushman, Mary Margolis, Helene G. Eaton, Charles B. Whitsel, Eric A. Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials |
title | Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials |
title_full | Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials |
title_fullStr | Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials |
title_full_unstemmed | Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials |
title_short | Ambient Particulate Matter Air Pollution and Venous Thromboembolism in the Women’s Health Initiative Hormone Therapy Trials |
title_sort | ambient particulate matter air pollution and venous thromboembolism in the women’s health initiative hormone therapy trials |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059994/ https://www.ncbi.nlm.nih.gov/pubmed/21036692 http://dx.doi.org/10.1289/ehp.1002256 |
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