Long term exposure to ambient air pollution and incidence of acute coronary events: prospective cohort study and meta-analysis in 11 European cohorts from the ESCAPE Project

TY - JOUR

T1 - Long term exposure to ambient air pollution and incidence of acute coronary events

T2 - prospective cohort study and meta-analysis in 11 European cohorts from the ESCAPE Project

AU - Cesaroni, Giulia

AU - Forastiere, Francesco

AU - Stafoggia, Massimo

AU - Andersen, Zorana Jovanovic

AU - Badaloni, Chiara

AU - Beelen, Rob

AU - Caracciolo, Barbara

AU - de Faire, Ulf

AU - Erbel, Raimund

AU - Eriksen, Kirsten T

AU - Fratiglioni, Laura

AU - Galassi, Claudia

AU - Hampel, Regina

AU - Heier, Margit

AU - Hennig, Frauke

AU - Hilding, Agneta

AU - Hoffmann, Barbara

AU - Houthuijs, Danny

AU - Jöckel, Karl-Heinz

AU - Korek, Michal

AU - Lanki, Timo

AU - Leander, Karin

AU - Magnusson, Patrik K E

AU - Migliore, Enrica

AU - Ostenson, Caes-Göran

AU - Overvad, Kim

AU - Pedersen, Nancy L

AU - J, Juha Pekkanen

AU - Penell, Johanna

AU - Pershagen, Göran

AU - Pyko, Andrei

AU - Raaschou-Nielsen, Ole

AU - Ranzi, Andrea

AU - Ricceri, Fulvio

AU - Sacerdote, Carlotta

AU - Salomaa, Veikko

AU - Swart, Wim

AU - Turunen, Anu W

AU - Vineis, Paolo

AU - Weinmayr, Gudrun

AU - Wolf, Kathrin

AU - de Hoogh, Kees

AU - Hoek, Gerard

AU - Brunekreef, Bert

AU - Peters, Annette

PY - 2014/1/21

Y1 - 2014/1/21

N2 - Objectives: To study the effect of long term exposure to airborne pollutants on the incidence of acute coronary events in 11 cohorts participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Design: Prospective cohort studies and meta-analysis of the results. Setting: Cohorts in Finland, Sweden, Denmark, Germany, and Italy. Participants: 100 166 people were enrolled from 1997 to 2007 and followed for an average of 11.5 years. Participants were free from previous coronary events at baseline. Main outcome measures: Modelled concentrations of particulate matter <2.5 μm (PM 2.5), 2.5-10 μm (PMcoarse), and <10 μm (PM 10) in aerodynamic diameter, soot (PM2.5 absorbance), nitrogen oxides, and traffic exposure at the home address based on measurements of air pollution conducted in 2008-12. Cohort specific hazard ratios for incidence of acute coronary events (myocardial infarction and unstable angina) per fixed increments of the pollutants with adjustment for sociodemographic and lifestyle risk factors, and pooled random effects meta-analytic hazard ratios. Results: 5157 participants experienced incident events. A 5 μg/m3 increase in estimated annual mean PM2.5 was associated with a 13% increased risk of coronary events (hazard ratio 1.13, 95% confidence interval 0.98 to 1.30), and a 10 μg/m3 increase in estimated annual mean PM10 was associated with a 12% increased risk of coronary events (1.12, 1.01 to 1.25) with no evidence of heterogeneity between cohorts. Positive associations were detected below the current annual European limit value of 25 μg/m3 for PM2.5 (1.18, 1.01 to 1.39, for 5 μg/m 3 increase in PM2.5) and below 40 μg/m3 for PM10 (1.12, 1.00 to 1.27, for 10 μg/m3 increase in PM10). Positive but non-significant associations were found with other pollutants. Conclusions: Long term exposure to particulate matter is associated with incidence of coronary events, and this association persists at levels of exposure below the current European limit values.

AB - Objectives: To study the effect of long term exposure to airborne pollutants on the incidence of acute coronary events in 11 cohorts participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Design: Prospective cohort studies and meta-analysis of the results. Setting: Cohorts in Finland, Sweden, Denmark, Germany, and Italy. Participants: 100 166 people were enrolled from 1997 to 2007 and followed for an average of 11.5 years. Participants were free from previous coronary events at baseline. Main outcome measures: Modelled concentrations of particulate matter <2.5 μm (PM 2.5), 2.5-10 μm (PMcoarse), and <10 μm (PM 10) in aerodynamic diameter, soot (PM2.5 absorbance), nitrogen oxides, and traffic exposure at the home address based on measurements of air pollution conducted in 2008-12. Cohort specific hazard ratios for incidence of acute coronary events (myocardial infarction and unstable angina) per fixed increments of the pollutants with adjustment for sociodemographic and lifestyle risk factors, and pooled random effects meta-analytic hazard ratios. Results: 5157 participants experienced incident events. A 5 μg/m3 increase in estimated annual mean PM2.5 was associated with a 13% increased risk of coronary events (hazard ratio 1.13, 95% confidence interval 0.98 to 1.30), and a 10 μg/m3 increase in estimated annual mean PM10 was associated with a 12% increased risk of coronary events (1.12, 1.01 to 1.25) with no evidence of heterogeneity between cohorts. Positive associations were detected below the current annual European limit value of 25 μg/m3 for PM2.5 (1.18, 1.01 to 1.39, for 5 μg/m 3 increase in PM2.5) and below 40 μg/m3 for PM10 (1.12, 1.00 to 1.27, for 10 μg/m3 increase in PM10). Positive but non-significant associations were found with other pollutants. Conclusions: Long term exposure to particulate matter is associated with incidence of coronary events, and this association persists at levels of exposure below the current European limit values.

U2 - 10.1136/bmj.f7412

DO - 10.1136/bmj.f7412

M3 - Journal article

C2 - 24452269

SN - 0959-8146

VL - 348

SP - 1

EP - 16

JO - The BMJ

JF - The BMJ

M1 - f7412

ER -