TY - JOUR
T1 - Long-term exposure to ambient air pollution and incidence of cerebrovascular events
T2 - Results from 11 European cohorts within the ESCAPE project
AU - Stafoggia, Massimo
AU - Cesaroni, Giulia
AU - Peters, Annette
AU - Andersen, Zorana J.
AU - Badaloni, Chiara
AU - Beelen, Rob
AU - Caracciolo, Barbara
AU - Cyrys, Josef
AU - de Faire, Ulf
AU - de Hoogh, Kees
AU - Eriksen, Kirsten T.
AU - Fratiglioni, Laura
AU - Galassi, Claudia
AU - Gigante, Bruna
AU - Havulinna, Aki S.
AU - Hennig, Frauke
AU - Hilding, Agneta
AU - Hoek, Gerard
AU - Hoffmann, Barbara
AU - Houthuijs, Danny
AU - Korek, Michal
AU - Lanki, Timo
AU - Leander, Karin
AU - Magnusson, Patrik K.
AU - Meisinger, Christa
AU - Migliore, Enrica
AU - Overvad, Kim
AU - Östenson, Claes Göran
AU - Pedersen, Nancy L.
AU - Pekkanen, Juha
AU - Penell, Johanna
AU - Pershagen, Goran
AU - Pundt, Noreen
AU - Pyko, Andrei
AU - Raaschou-Nielsen, Ole
AU - Ranzi, Andrea
AU - Ricceri, Fulvio
AU - Sacerdote, Carlotta
AU - Swart, Wim J.R.
AU - Turunen, Anu W.
AU - Vineis, Paolo
AU - Weimar, Christian
AU - Weinmayr, Gudrun
AU - Wolf, Kathrin
AU - Brunekreef, Bert
AU - Forastiere, Francesco
PY - 2014/9
Y1 - 2014/9
N2 - Background: Few studies have investigated effects of air pollution on the incidence of cerebrovascular events. Objectives: We assessed the association between long-term exposure to multiple air pollutants and the incidence of stroke in European cohorts. Methods: Data from 11 cohorts were collected, and occurrence of a first stroke was evaluated. Individual air pollution exposures were predicted from land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE). The exposures were: PM2.5 [particulate matter (PM) ≤ 2.5 μm in diameter], coarse PM (PM between 2.5 and 10 μm), PM10 (PM ≤ 10 μm), PM2.5 absorbance, nitrogen oxides, and two traffic indicators. Cohort-specific analyses were conducted using Cox proportional hazards models. Random-effects meta-analysis was used for pooled effect estimation. Results: A total of 99,446 study participants were included, 3,086 of whom developed stroke. A 5-μg/m3 increase in annual PM2.5 exposure was associated with 19% increased risk of incident stroke [hazard ratio (HR) = 1.19, 95% CI: 0.88, 1.62]. Similar findings were obtained for PM10. The results were robust to adjustment for an extensive list of cardiovascular risk factors and noise coexposure. The association with PM2.5 was apparent among those ≥ 60 years of age (HR = 1.40, 95% CI: 1.05, 1.87), among neversmokers (HR = 1.74, 95% CI: 1.06, 2.88), and among participants with PM2.5 exposure < 25 μg/m3 (HR = 1.33, 95% CI: 1.01, 1.77). Conclusions: We found suggestive evidence of an association between fine particles and incidence of cerebrovascular events in Europe, even at lower concentrations than set by the current air quality limit value.
AB - Background: Few studies have investigated effects of air pollution on the incidence of cerebrovascular events. Objectives: We assessed the association between long-term exposure to multiple air pollutants and the incidence of stroke in European cohorts. Methods: Data from 11 cohorts were collected, and occurrence of a first stroke was evaluated. Individual air pollution exposures were predicted from land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE). The exposures were: PM2.5 [particulate matter (PM) ≤ 2.5 μm in diameter], coarse PM (PM between 2.5 and 10 μm), PM10 (PM ≤ 10 μm), PM2.5 absorbance, nitrogen oxides, and two traffic indicators. Cohort-specific analyses were conducted using Cox proportional hazards models. Random-effects meta-analysis was used for pooled effect estimation. Results: A total of 99,446 study participants were included, 3,086 of whom developed stroke. A 5-μg/m3 increase in annual PM2.5 exposure was associated with 19% increased risk of incident stroke [hazard ratio (HR) = 1.19, 95% CI: 0.88, 1.62]. Similar findings were obtained for PM10. The results were robust to adjustment for an extensive list of cardiovascular risk factors and noise coexposure. The association with PM2.5 was apparent among those ≥ 60 years of age (HR = 1.40, 95% CI: 1.05, 1.87), among neversmokers (HR = 1.74, 95% CI: 1.06, 2.88), and among participants with PM2.5 exposure < 25 μg/m3 (HR = 1.33, 95% CI: 1.01, 1.77). Conclusions: We found suggestive evidence of an association between fine particles and incidence of cerebrovascular events in Europe, even at lower concentrations than set by the current air quality limit value.
UR - https://www.scopus.com/pages/publications/84906874008
U2 - 10.1289/ehp.1307301
DO - 10.1289/ehp.1307301
M3 - Article
SN - 0091-6765
VL - 122
SP - 919
EP - 925
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
IS - 9
ER -
