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

TitleLong-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts.
Publication TypeJournal Article
Year of Publication2014
AuthorsBeelen R, Stafoggia M, Raaschou-Nielsen O, Andersen ZJovanovic, Xun WW, Katsouyanni K, Dimakopoulou K, Brunekreef B, Weinmayr G, Hoffmann B, Wolf K, Samoli E, Houthuijs D, Nieuwenhuijsen M, Oudin A, Forsberg B, Olsson D, Salomaa V, Lanki T, Yli-Tuomi T, Oftedal B, Aamodt G, Nafstad P, de Faire U, Pedersen NL, Ostenson C-G, Fratiglioni L, Penell J, Korek M, Pyko A, Eriksen KThorup, Tjønneland A, Becker T, Eeftens M, Bots M, Meliefste K, Wang M, Bueno-de-Mesquita B, Sugiri D, Krämer U, Heinrich J, de Hoogh K, Key T, Peters A, Cyrys J, Concin H, Nagel G, Ineichen A, Schaffner E, Probst-Hensch N, Dratva J, Ducret-Stich R, Vilier A, Clavel-Chapelon F, Stempfelet M, Grioni S, Krogh V, Tsai M-Y, Marcon A, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Tamayo I, Amiano P, Dorronsoro M, Katsoulis M, Trichopoulou A, Vineis P, Hoek G
JournalEpidemiology
Volume25
Issue3
Pagination368-78
Date Published2014 May
ISSN1531-5487
KeywordsAdolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Air Pollutants, Air Pollution, Cardiovascular Diseases, Cause of Death, Cohort Studies, Databases, Factual, Environmental Exposure, Europe, Female, Humans, Incidence, Male, Middle Aged, Nitric Oxide, Particulate Matter, Proportional Hazards Models, Sex Distribution, Time Factors, Young Adult
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); 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 PM2.5, 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.

DOI10.1097/EDE.0000000000000076
Alternate JournalEpidemiology
PubMed ID24589872
Grant ListG0801056 / / Medical Research Council / United Kingdom
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