PM has been positively associated with cardiovascular disease (CVD) incidence. Most evidence has come from cohorts and administrative databases. Cohorts typically have extensive information on potential confounders and residential-level exposures. Administrative databases are usually more representative but typically lack information on potential confounders and often only have exposures at coarser geographies (e.g., ZIP code). The weaknesses in both types of studies have been criticized for potentially jeopardizing the validity of their findings for regulatory purposes. We followed 101,870 participants from the US-based Nurses' Health Study (2000–2016) and linked residential-level PM and individual-level confounders, and ZIP code-level PM and confounders. We used time-varying Cox proportional hazards models to examine associations with CVD incidence. We specified basic models (adjusted for individual-level age, race and calendar year), individual-level confounder models, and ZIP code-level confounder models. Residential- and ZIP code-level PM were strongly correlated (Pearson = 0.88). For residential-level PM, the hazard ratio (HR, 95 % confidence interval) per 5 μg/m increase was 1.06 (1.01, 1.11) in the basic and 1.04 (0.99, 1.10) in the individual-level confounder model. For ZIP code-level PM, the HR per 5 μg/m was 1.04 (0.99, 1.08) in the basic and 1.02 (0.97, 1.08) in the ZIP code-level confounder model. We observed suggestive positive, but not statistically significant, associations between long-term PM and CVD incidence, regardless of the exposure or confounding model. Although differences were small, associations from models with individual-level confounders and residential-level PM were slightly stronger than associations from models with ZIP code-level confounders and PM.

中文翻译：

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细颗粒物与心血管疾病的关联；比较使用邮政编码级别和个人级别的细颗粒物和混杂因素的模型

PM 与心血管疾病 (CVD) 发病率呈正相关。大多数证据来自队列和管理数据库。群组通常拥有有关潜在混杂因素和住宅水平暴露的大量信息。管理数据库通常更具代表性，但通常缺乏有关潜在混杂因素的信息，并且通常只暴露较粗略的地理区域（例如邮政编码）。这两类研究的弱点都受到批评，因为可能会危及监管目的研究结果的有效性。我们跟踪了美国护士健康研究（2000-2016）的 101,870 名参与者，并将住宅级 PM 和个人级混杂因素以及邮政编码级 PM 和混杂因素联系起来。我们使用时变 Cox 比例风险模型来检查与 CVD 发病率的关联。我们指定了基本模型（根据个人级别的年龄、种族和日历年进行调整）、个人级别的混杂因素模型和邮政编码级别的混杂因素模型。住宅和邮政编码级别的 PM 密切相关（Pearson = 0.88）。对于住宅级 PM，每增加 5 μg/m 的风险比（HR，95% 置信区间）在基本模型中为 1.06（1.01，1.11），在个人级混杂因素模型中为 1.04（0.99，1.10）。对于邮政编码级 PM，基本模型中每 5 μg/m 的 HR 为 1.04（0.99，1.08），邮政编码级混杂因素模型中每 5 μg/m 的 HR 为 1.02（0.97，1.08）。我们观察到，长期 PM 和 CVD 发病率之间存在提示性正相关，但不具有统计显着性，无论暴露或混杂模型如何。尽管差异很小，但模型与个人级混杂因素和住宅级 PM 的关联略强于模型与邮政编码级混杂因素和 PM 的关联。