Gustavsson et al. (2001) addressed specific occupational and personal risk factors for MI
as part of the Stockholm Heart Epidemiology Programduring 1992–1993 formenand during
1992–1994 for women in living in Stockholm County, and free of previous MI (1335 cases
and 1658 controls). Cases surviving at least 28 days post infarction were identified using
hospital data, and referents were identified through a computerized population register and
matched on age, year of enrollment, and hospital service area. Participants completed mail
questionnaires to obtain lifetime occupational histories and other personal life-style factors,
with followup by telephone. Exposures were assessed using a job-exposure matrix designed
to assess the intensity of exposure to motor exhaust using estimated CO levels found in
various occupational categories. After adjusting for smoking, alcohol, body mass index,
diabetes, hypertension, and physical activity, there was an increase in risk of MI for
participants having medium exhaust cumulative exposure levels (154 cases and 136
controls; RR ¼ 1.32; 95% CI ¼ 1.01–1.73) and with high cumulative exhaust exposures
(155 cases and 137 controls; RR ¼ 1.21; 95% CI ¼ 0.91–1.59).