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

Rob Beelen; Massimo Stafoggia; Ole Raaschou-Nielsen; Zorana Jovanovic Andersen; Wei W Xun; Klea Katsouyanni; Konstantina Dimakopoulou; Bert Brunekreef; Gudrun Weinmayr; Barbara Hoffmann; Kathrin Wolf; Evangelia Samoli; Danny Houthuijs; Mark Nieuwenhuijsen; Anna Oudin; Bertil Forsberg; David Olsson; Veikko Salomaa; Timo Lanki; Tarja Yli-Tuomi; Bente Oftedal; Geir Aamodt; Per Nafstad; Ulf De Faire; Nancy L Pedersen; Claes-Göran Östenson; Laura Fratiglioni; Johanna Penell; Michal Korek; Andrei Pyko; Kirsten Thorup Eriksen; Anne Tjønneland; Thomas Becker; Marloes Eeftens; Michiel Bots; Kees Meliefste; Meng Wang; Bas Bueno-de-Mesquita; Dorothea Sugiri; Ursula Krämer; Joachim Heinrich; Kees de Hoogh; Timothy Key; Annette Peters; Josef Cyrys; Hans Concin; Gabriele Nagel; Alex Ineichen; Emmanuel Schaffner; Nicole Probst-Hensch; Julia Dratva; Regina Ducret-Stich; Alice Vilier; Françoise Clavel-Chapelon; Morgane Stempfelet; Sara Grioni; Vittorio Krogh; Ming-Yi Tsai; Alessandro Marcon; Fulvio Ricceri; Carlotta Sacerdote; Claudia Galassi; Enrica Migliore; Andrea Ranzi; Giulia Cesaroni; Chiara Badaloni; Francesco Forastiere; Ibon Tamayo; Pilar Amiano; Miren Dorronsoro; Michail Katsoulis; Antonia Trichopoulou; Paolo Vineis; Gerard Hoek

doi:10.1097/EDE.0000000000000076

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

Rob Beelen, Massimo Stafoggia, Ole Raaschou-Nielsen, Zorana Jovanovic Andersen, Wei W Xun, Klea Katsouyanni, Konstantina Dimakopoulou, Bert Brunekreef, Gudrun Weinmayr, Barbara Hoffmann, Kathrin Wolf, Evangelia Samoli, Danny Houthuijs, Mark Nieuwenhuijsen, Anna Oudin, Bertil Forsberg, David Olsson, Veikko Salomaa, Timo Lanki, Tarja Yli-TuomiBente Oftedal, Geir Aamodt, Per Nafstad, Ulf De Faire, Nancy L Pedersen, Claes-Göran Östenson, Laura Fratiglioni, Johanna Penell, Michal Korek, Andrei Pyko, Kirsten Thorup Eriksen, Anne Tjønneland, Thomas Becker, Marloes Eeftens, Michiel Bots, Kees Meliefste, Meng Wang, Bas Bueno-de-Mesquita, Dorothea Sugiri, Ursula Krämer, Joachim Heinrich, Kees de Hoogh, Timothy Key, Annette Peters, Josef Cyrys, Hans Concin, Gabriele Nagel, Alex Ineichen, Emmanuel Schaffner, Nicole Probst-Hensch, Julia Dratva, Regina Ducret-Stich, Alice Vilier, Françoise Clavel-Chapelon, Morgane Stempfelet, Sara Grioni, Vittorio Krogh, Ming-Yi Tsai, Alessandro Marcon, Fulvio Ricceri, Carlotta Sacerdote, Claudia Galassi, Enrica Migliore, Andrea Ranzi, Giulia Cesaroni, Chiara Badaloni, Francesco Forastiere, Ibon Tamayo, Pilar Amiano, Miren Dorronsoro, Michail Katsoulis, Antonia Trichopoulou, Paolo Vineis, Gerard Hoek

Center of Epidemiology and Screening

171 Citations (Scopus)

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.

Original language	English
Journal	Epidemiology (Cambridge, Mass.)
Volume	25
Issue number	3
Pages (from-to)	368-78
Number of pages	11
ISSN	1044-3983
DOIs	https://doi.org/10.1097/EDE.0000000000000076
Publication status	Published - 1 Jul 2014

Keywords

Adolescent
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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/EDE.0000000000000076

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Beelen, R., Stafoggia, M., Raaschou-Nielsen, O., Andersen, Z. J., Xun, W. W., 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., ... Hoek, G. (2014). Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts. Epidemiology (Cambridge, Mass.), 25(3), 368-78. https://doi.org/10.1097/EDE.0000000000000076

Beelen, R, Stafoggia, M, Raaschou-Nielsen, O, Andersen, ZJ, 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, Östenson, C-G, Fratiglioni, L, Penell, J, Korek, M, Pyko, A, Eriksen, KT, 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 2014, 'Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts', Epidemiology (Cambridge, Mass.), vol. 25, no. 3, pp. 368-78. https://doi.org/10.1097/EDE.0000000000000076

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title = "Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts",

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.",

keywords = "Adolescent, 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",

author = "Rob Beelen and Massimo Stafoggia and Ole Raaschou-Nielsen and Andersen, {Zorana Jovanovic} and Xun, {Wei W} and Klea Katsouyanni and Konstantina Dimakopoulou and Bert Brunekreef and Gudrun Weinmayr and Barbara Hoffmann and Kathrin Wolf and Evangelia Samoli and Danny Houthuijs and Mark Nieuwenhuijsen and Anna Oudin and Bertil Forsberg and David Olsson and Veikko Salomaa and Timo Lanki and Tarja Yli-Tuomi and Bente Oftedal and Geir Aamodt and Per Nafstad and {De Faire}, Ulf and Pedersen, {Nancy L} and Claes-G{\"o}ran {\"O}stenson and Laura Fratiglioni and Johanna Penell and Michal Korek and Andrei Pyko and Eriksen, {Kirsten Thorup} and Anne Tj{\o}nneland and Thomas Becker and Marloes Eeftens and Michiel Bots and Kees Meliefste and Meng Wang and Bas Bueno-de-Mesquita and Dorothea Sugiri and Ursula Kr{\"a}mer and Joachim Heinrich and {de Hoogh}, Kees and Timothy Key and Annette Peters and Josef Cyrys and Hans Concin and Gabriele Nagel and Alex Ineichen and Emmanuel Schaffner and Nicole Probst-Hensch and Julia Dratva and Regina Ducret-Stich and Alice Vilier and Fran{\c c}oise Clavel-Chapelon and Morgane Stempfelet and Sara Grioni and Vittorio Krogh and Ming-Yi Tsai and Alessandro Marcon and Fulvio Ricceri and Carlotta Sacerdote and Claudia Galassi and Enrica Migliore and Andrea Ranzi and Giulia Cesaroni and Chiara Badaloni and Francesco Forastiere and Ibon Tamayo and Pilar Amiano and Miren Dorronsoro and Michail Katsoulis and Antonia Trichopoulou and Paolo Vineis and Gerard Hoek",

year = "2014",

month = jul,

day = "1",

doi = "10.1097/EDE.0000000000000076",

language = "English",

volume = "25",

pages = "368--78",

journal = "Epidemiology",

issn = "1044-3983",

publisher = "Lippincott Williams & Wilkins",

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TY - JOUR

T1 - Long-term exposure to air pollution and cardiovascular mortality

T2 - an analysis of 22 European cohorts

AU - Beelen, Rob

AU - Stafoggia, Massimo

AU - Raaschou-Nielsen, Ole

AU - Andersen, Zorana Jovanovic

AU - Xun, Wei W

AU - Katsouyanni, Klea

AU - Dimakopoulou, Konstantina

AU - Brunekreef, Bert

AU - Weinmayr, Gudrun

AU - Hoffmann, Barbara

AU - Wolf, Kathrin

AU - Samoli, Evangelia

AU - Houthuijs, Danny

AU - Nieuwenhuijsen, Mark

AU - Oudin, Anna

AU - Forsberg, Bertil

AU - Olsson, David

AU - Salomaa, Veikko

AU - Lanki, Timo

AU - Yli-Tuomi, Tarja

AU - Oftedal, Bente

AU - Aamodt, Geir

AU - Nafstad, Per

AU - De Faire, Ulf

AU - Pedersen, Nancy L

AU - Östenson, Claes-Göran

AU - Fratiglioni, Laura

AU - Penell, Johanna

AU - Korek, Michal

AU - Pyko, Andrei

AU - Eriksen, Kirsten Thorup

AU - Tjønneland, Anne

AU - Becker, Thomas

AU - Eeftens, Marloes

AU - Bots, Michiel

AU - Meliefste, Kees

AU - Wang, Meng

AU - Bueno-de-Mesquita, Bas

AU - Sugiri, Dorothea

AU - Krämer, Ursula

AU - Heinrich, Joachim

AU - de Hoogh, Kees

AU - Key, Timothy

AU - Peters, Annette

AU - Cyrys, Josef

AU - Concin, Hans

AU - Nagel, Gabriele

AU - Ineichen, Alex

AU - Schaffner, Emmanuel

AU - Probst-Hensch, Nicole

AU - Dratva, Julia

AU - Ducret-Stich, Regina

AU - Vilier, Alice

AU - Clavel-Chapelon, Françoise

AU - Stempfelet, Morgane

AU - Grioni, Sara

AU - Krogh, Vittorio

AU - Tsai, Ming-Yi

AU - Marcon, Alessandro

AU - Ricceri, Fulvio

AU - Sacerdote, Carlotta

AU - Galassi, Claudia

AU - Migliore, Enrica

AU - Ranzi, Andrea

AU - Cesaroni, Giulia

AU - Badaloni, Chiara

AU - Forastiere, Francesco

AU - Tamayo, Ibon

AU - Amiano, Pilar

AU - Dorronsoro, Miren

AU - Katsoulis, Michail

AU - Trichopoulou, Antonia

AU - Vineis, Paolo

AU - Hoek, Gerard

PY - 2014/7/1

Y1 - 2014/7/1

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Age Distribution

KW - Aged

KW - Aged, 80 and over

KW - Air Pollutants

KW - Air Pollution

KW - Cardiovascular Diseases

KW - Cause of Death

KW - Cohort Studies

KW - Databases, Factual

KW - Environmental Exposure

KW - Europe

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Nitric Oxide

KW - Particulate Matter

KW - Proportional Hazards Models

KW - Sex Distribution

KW - Time Factors

KW - Young Adult

U2 - 10.1097/EDE.0000000000000076

DO - 10.1097/EDE.0000000000000076

M3 - Journal article

C2 - 24589872

SN - 1044-3983

VL - 25

SP - 368

EP - 378

JO - Epidemiology

JF - Epidemiology

IS - 3

ER -

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

Abstract

Keywords

UN SDGs

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