Environmental exposure and cardiovascular disease prevalence in West End Louisville: Is there an association?

Objectives: The World Health Organization estimates that 800,000 premature deaths each year may be attributed to air pollution. Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality in Western countries and exposure to air pollution is associated with increased CVD prevalence. The objectives of this study were to: 1. Determine CVD prevalence in West End Louisville residents (WEL) and East End Louisville residents (EEL), 2. Determine 1,3 butadiene, carbon tetrachloride, and acrylonitrile levels in WEL and EEL, 3. Determine the association between CVD prevalence and 1,3 butadiene, carbon tetrachloride, and acrylonitrile levels in WEL and EEL. Methods: In 2004, a cross-sectional health survey was conducted comparing WEL with EEL health indicators. Subjects were randomly selected from a list of telephone numbers generated for the WEL and EEL residents. There were 306 respondents from zip codes 40211 and 40216, the higher exposed zip codes. There were 302 respondents from zip codes 40213, 40214, 40218, 40219, the lower exposed (or unexposed) zip codes. There were 24,365 and 23,187 eligible subjects in WEL and EEL, respectively. The survey response rate was 26% on the American Association of Public Opinion Research (AAPOR) RR4 scale. An exposure model was developed to assess air pollution exposure among Louisville Metro residents. Results: CVD prevalence among WEL respondents was 45 percent compared to 37 percent among EEL respondents (p=.002). Also, WEL diabetes prevalence was 20 percent compared to 13 percent in EEL (p = .011). African-Americans had significantly higher relative CVD odds than Whites (OR: 1.86, CI: 1.24, 2.79). Smoking and education was a not predictor of prevalent CVD. 1,3 butadiene was not a significant predictor of CVD, but WEL residents were likely exposed at higher 1,3 butadiene levels than EEL residents.