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Long-term exposure to air pollution and cardiovascular mortality : An analysis of 22 European cohorts

Beelen, Rob; Stafogguiia, Massimo; Raaschou-Nielsen, Ole; Andersen, Zorana Jovanovic; Xun, Wei W.; Katsouyanni, Klea; Dimakopoulou, Konstantina; Brunekreef, Bert; Weinmayr, Gudrun and Hoffmann, Barbara, et al. (2014) In Epidemiology 25(3). p.368-378
Abstract

Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx);... (More)

Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM 2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association. Copyright © 2014 by Lippincott Williams & Wilkins.

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Epidemiology
volume
25
issue
3
pages
11 pages
publisher
Wolters Kluwer Health/LWW
external identifiers
  • scopus:84898037753
ISSN
1044-3983
DOI
10.1097/EDE.0000000000000076
language
English
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no
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a2743edb-657d-48eb-b08a-731174d01863
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2016-09-27 08:50:32
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2017-06-04 04:52:47
@article{a2743edb-657d-48eb-b08a-731174d01863,
  abstract     = {<p>Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO<sub>2</sub> and NO<sub>x</sub>); particles with diameters of less than 2.5 μm (PM<sub>2.5</sub>), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM<sub>2.5</sub> absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM <sub>2.5</sub>, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association. Copyright © 2014 by Lippincott Williams &amp; Wilkins.</p>},
  author       = {Beelen, Rob and Stafogguiia, Massimo and Raaschou-Nielsen, Ole and Andersen, Zorana Jovanovic and Xun, Wei W. and Katsouyanni, Klea and Dimakopoulou, Konstantina and Brunekreef, Bert and Weinmayr, Gudrun and Hoffmann, Barbara and Wolf, Kathrin and Samoli, Evangelia and Houthuijs, Danny and Nieuwenhuijsen, Mark and Oudin, Anna and Forsberg, Bertil and Olsson, David and Salomaa, Veikko and Lanki, Timo and Yli-Tuomi, Tarja and Oftedal, Bente and Aamodt, Geir and Nafstad, Per and De Faire, Ulf and Pedersen, Nancy L. and Östenson, Claes Göran and Fratiglioni, Laura and Penell, Johanna and Korek, Michal and Pyko, Andrei and Eriksen, Kirsten Thorup and Tjønneland, Anne and Becker, Thomas and Eeftens, Marloes and Bots, Michiel and Meliefste, Kees and Wang, Meng and Bueno-De-Mesquita, Bas and Sugiri, Dorothea and Krämer, Ursula and Heinrich, Joachim and De Hoogh, Kees and Key, Timothy and Peters, Annette and Cyrys, Josef and Concin, Hans and Nagel, Gabriele and Ineichen, Alex and Schaffner, Emmanuel and Probst-Hensch, Nicole and Dratva, Julia and Ducret-Stich, Regina and Vilier, Alice and Clavel-Chapelon, Françoise and Stempfelet, Morgane and Grioni, Sara and Krogh, Vittorio and Tsai, Ming Yi and Marcon, Alessandro and Ricceri, Fulvio and Sacerdote, Carlotta and Galassi, Claudia and Migliore, Enrica and Ranzi, Andrea and Cesaroni, Giulia and Badaloni, Chiara and Forastiere, Francesco and Tamayo, Ibon and Amiano, Pilar and Dorronsoro, Miren and Katsoulis, Michail and Trichopoulou, Antonia and Vineis, Paolo and Hoek, Gerard},
  issn         = {1044-3983},
  language     = {eng},
  number       = {3},
  pages        = {368--378},
  publisher    = {Wolters Kluwer Health/LWW},
  series       = {Epidemiology},
  title        = {Long-term exposure to air pollution and cardiovascular mortality : An analysis of 22 European cohorts},
  url          = {http://dx.doi.org/10.1097/EDE.0000000000000076},
  volume       = {25},
  year         = {2014},
}