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BMJ 2009; 338 doi: (Published 17 March 2009) Cite this as: BMJ 2009;338:b1078

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Air pollution from ozone implicated in respiratory deaths

Scientists have long suspected that exposure to the air pollutant ozone might cause harm, but it has been hard to prove. A study from the US now reports the most convincing evidence to date—among nearly half a million US citizens, incremental increases in local ozone concentrations were associated with small but significant increases in the risk of death from respiratory causes (relative risk 1.040, 95% CI 1.010 to 1.067 for each increment of 10 parts per billion).

The link between ozone and respiratory deaths was independent of the harm caused by small particle pollution, and it survived adjustment for 20 potentially confounding factors such as poverty and smoking. It is also biologically plausible, say the authors. We already know ozone can inflame airways and cause asthma. Ozone was not associated with excess deaths overall, or deaths from cardiovascular disease.

The authors analysed data from an established cohort of adults living in 96 metropolitan areas across 50 states. The cohort was recruited in 1982 and followed for 18 years. There were 118 777 deaths. The Environmental Protection Agency’s pollution monitors provided hourly readings for ozone concentration and enough data on small particle pollution to confirm a significant association between small particles and deaths from cardiovascular disease (1.206, 1.150 to 1.264).

New diagnostic test for a lethal genetic cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy causes potentially lethal arrhythmias and is one cause of sudden death in young people. About 40% of cases have a genetic component, and reliable diagnostic tests are urgently needed to help evaluate young people with warning arrhythmias and the relatives of people known to have the disease. Researchers from the US hope their recently developed technique will fit the bill. The test uses immunohistochemical analysis of an endomyocardial biopsy to look for a signal from one of the proteins seen at junctions between cells. In samples …

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