ArticleBMJ (Clinical research ed.)2011
The effects of hourly differences in air pollution on the risk of myocardial infarction: case crossover analysis of the MINAP database.
Article in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
69 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Epidemiological and mechanistic links between PMFrontiers in endocrinology · 2025Pooled it
- Association between PM10 exposure and risk of myocardial infarction in adults: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Long-Term Exposure to Ambient Air Pollution and Myocardial Infarction: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity.Environmental health : a global access science source · 2020Pooled it
- Association between PMBMC public health · 2020Pooled it
- Who is more affected by ozone pollution? A systematic review and meta-analysis.American journal of epidemiology · 2014Pooled it
- Evidence on vulnerability and susceptibility to health risks associated with short-term exposure to particulate matter: a systematic review and meta-analysis.American journal of epidemiology · 2013Pooled it
- Cardiovascular effects of ozone in healthy subjects with and without deletion of glutathione-S-transferase M1.Inhalation toxicology · 2015Trial
- Plasma nitrite is an indicator of acute changes in ambient air pollutant concentrations.Inhalation toxicology · 2014Trial
- Exposure to wood smoke increases arterial stiffness and decreases heart rate variability in humans.Particle and fibre toxicology · 2013Trial
- Modeling the Exposome in Murine Cardiovascular Disease.JACC. Basic to translational science · 2026Review
- Nationwide Study of the Association between Temperature Variability and Sleep Apnea, and the Modifying Role of Air Pollution, in a Moderate-to-Severe Risk OSA Population.Environment & health (Washington, D.C.) · 2026Article
- Spatiotemporal patterns of excess mortality attributable to prolonged cold spells in China, 2020-2023.BMC public health · 2026Article
- Daily changes in fine particulate matter are associated with acute myocardial infarction hospitalizations: an individual-level time-stratified case-crossover study in Zhongshan, China.Frontiers in public health · 2026Article
- Association Between Air Pollution and Monday Peak Mortality From Acute Myocardial Infarction.JACC. Advances · 2026Article
- Tree canopy cover and injurious pedestrian falls: a location-based case-control study.American journal of epidemiology · 2025Article
- Climate warming may undermine sleep duration and quality in repeated-measure study of 23 million records.Nature communications · 2025Article
- Copper-enriched automotive brake wear particles perturb human alveolar cellular homeostasis.Particle and fibre toxicology · 2025Article
- Associations of Personal Hourly Exposures to Air Temperature and Pollution with Resting Heart Rate in Chronic Obstructive Pulmonary Disease.Environmental science & technology · 2024Article
- Acute effects of ambient nitrogen dioxide pollution on outpatient visits for neurological diseases in Xinxiang, China.BMC public health · 2024Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
7 authors.
Funding
Abstract
objectivesTo investigate associations between air pollution levels and myocardial infarction (MI) on short timescales, with data at an hourly temporal resolution.
designTime stratified case crossover study linking clinical data from the Myocardial Ischaemia National Audit Project (MINAP) with PM(10), ozone, CO, NO(2), and SO(2) data from the UK National Air Quality Archive. Pollution effects were investigated with delays (lags) of 1-6, 7-12, 13-18, 19-24, and 25-72 hours in both single and multi-pollutant models, adjusted for ambient temperature, relative humidity, circulating levels of influenza and respiratory syncytial virus, day of week, holidays, and residual seasonality within calendar month strata.
settingPopulation based study in 15 conurbations in England and Wales. SUBJECTS: 79,288 diagnoses of myocardial infarction recorded over the period 2003-6.
main outcome measuresExcess risk of myocardial infarction per 10 µg/m(3) increase in pollutant level.
resultsIn single pollutant models, PM(10) and NO(2) levels were associated with a very short term increase in risk of myocardial infarction 1-6 hours later (excess risks 1.2% (95% confidence interval 0.3 to 2.1) and 1.1% (0.3 to 1.8) respectively per 10 μg/m(3) increase); the effects persisted in multi-pollutant models, though with only weak evidence of an independent PM(10) effect (P = 0.05). The immediate risk increases were followed by reductions in risk at longer lags: we found no evidence of any net excess risk associated with the five pollutants studied over a 72 hour period after exposure.
conclusionsHigher levels of PM(10) and NO(2), which are typically markers of traffic related pollution, seem to be associated with transiently increased risk of myocardial infarction 1-6 hours after exposure, but later reductions in risk suggest that air pollution may be associated with bringing events forward in time ("short-term displacement") rather than increasing overall risk. The well established effect of air pollution on cardiorespiratory mortality may not be mediated through increasing the acute risk of myocardial infarction, but through another mechanism.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.