Published Online
on June 8, 2009

A more recent version of this article appeared on June 23, 2009

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Submitted on November 15, 2008
Accepted on April 6, 2009

Living Near Major Traffic Roads and Risk of Deep Vein Thrombosis

Andrea Baccarelli MD^*, Ida Martinelli MD, PhD, Valeria Pegoraro BStat, Steven Melly MS, Paolo Grillo MD, Antonella Zanobetti PhD, Lifang Hou MD, Pier Alberto Bertazzi MD, Pier Mannuccio Mannucci MD, and Joel Schwartz PhD

From the Department of Environmental and Occupational Health (A.B., V.P., P.G., P.A.B.), and A. Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties (I.M., P.M.M.), Istituto di Ricovero e Cura a Carattere Scientifico Maggiore Policlinico Hospital, Mangiagalli and Regina Elena Foundation and University of Milan, Milan, Italy, Department of Environmental Health, Harvard School of Public Health, Boston, Mass (A.B., S.M., A.Z., J.S.), and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill (L.H.).

^* To whom correspondence should be addressed. E-mail: andrea.baccarelli{at}unimi.it.

Background—Particulate air pollution has been consistently linked to increased risk of arterial cardiovascular disease. Few data on air pollution exposure and risk of venous thrombosis are available. We investigated whether living near major traffic roads increases the risk of deep vein thrombosis (DVT), using distance from roads as a proxy for traffic exposure.

Methods and Results—From 1995 through 2005, we examined 663 patients with DVT of the lower limbs and 859 age-matched controls from cities with population >15 000 inhabitants in Lombardia Region, Italy. We assessed distance from residential addresses to the nearest major traffic road using geographic information system methodology. The risk of DVT was estimated from logistic regression models adjusting for multiple clinical and environmental covariates. The risk of DVT was increased (odds ratio=1.33; 95% confidence interval, 1.03 to 1.71; P=0.03 in age-adjusted models; odds ratio=1.47; 95% confidence interval, 1.10 to 1.96; P=0.008 in models adjusted for multiple covariates) for subjects living near a major traffic road (index distance of 3 meters, 10th centile of the distance distribution) compared with those living farther away (reference distance of 245 meters, 90th centile). The increase in DVT risk was approximately linear over the observed distance range (from 718 to 0 meters) and was not modified after adjusting for background levels of particulate matter (odds ratio=1.47; 95% confidence interval, 1.11 to 1.96; P=0.008 for 10th versus 90th distance centile in models adjusting for area levels of particulate matter <10 µm in aerodynamic diameter in the year before diagnosis).

Conclusions—Living near major traffic roads is associated with increased risk of DVT.

Key words: deep vein thrombosis • air pollution • risk factors • coagulation

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