Long‐Term Particulate Matter Exposure and Incidence of Arrhythmias: A Cohort Study

BACKGROUND: Studies have shown that short‐term exposure to air pollution is associated with cardiac arrhythmia hospitalization and mortality. However, the relationship between long‐term particulate matter air pollution and arrhythmias is still unclear. We evaluate the prospective association between particulate matter (PM) air pollution and the risk of incident arrhythmia and its subtypes. METHODS AND RESULTS: Participants were drawn from a prospective cohort study of 178 780 men and women who attended regular health screening exams in Seoul and Suwon, South Korea, from 2002 to 2016. Exposure to PM with an aerodynamic diameter of ≤10 and ≤2.5 μm (PM(10) and PM(2.5), respectively) was estimated using a land‐use regression model. The associations between long‐term PM air pollution and arrhythmia were examined using pooled logistic regression models with time‐varying exposure and covariables. In the fully adjusted model, the odds ratios (ORs) for any arrhythmia associated with a 10 μg/m(3) increase in 12‐, 36‐, and 60‐month PM(10) exposure were 1.15 (1.09, 1.21), 1.12 (1.06, 1.18), and 1.14 (1.08, 1.20), respectively. The ORs with a 10 μg/m(3) increase in 12‐ and 36‐month PM(2.5) exposure were 1.27 (1.15, 1.40) and 1.10 (0.99, 1.23). PM(10) was associated with increased risk of incident bradycardia and premature atrial contraction. PM(2.5) was associated with increased risk of incident bradycardia and right bundle‐branch block. CONCLUSIONS: In this large cohort study, long‐term exposure to outdoor PM air pollution was associated with increased risk of arrhythmia. Our findings indicate that PM air pollution may be a contributor to cardiac arrhythmia in the general population.