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 Jovanovic

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 - Ostenson, Claes-Göran

AU - Pedersen, Nancy L

AU - Pekkanen, Juha

AU - Penell, Johanna

AU - Pershagen, Göran

AU - Pundt, Noreen

AU - Pyko, Andrei

AU - Raaschou-Nielsen, Ole

AU - Ranzi, Andrea

AU - Ricceri, Fulvio

AU - Sacerdote, Carlotta

AU - Swart, Wim J

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] below 2.5 µm in diameter), coarse PM (PM between 2.5 and 10 µm), PM10 (PM below 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: 99,446 subjects were included, 3,086 of whom developed stroke. A 5-μg/m(3) increase in annual PM2.5 exposure was associated with 19% increased risk of incident stroke (hazard ratio [HR] = 1.19, 95% confidence interval [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 co-exposure. The association with PM2.5 was apparent among those aged 60+ years (HR = 1.40, 95% CI: 1.05, 1.87), among never-smokers (HR = 1.74, 95% CI: 1.06, 2.88), and among subjects with PM2.5 exposure below 25 μg/m(3) (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] below 2.5 µm in diameter), coarse PM (PM between 2.5 and 10 µm), PM10 (PM below 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: 99,446 subjects were included, 3,086 of whom developed stroke. A 5-μg/m(3) increase in annual PM2.5 exposure was associated with 19% increased risk of incident stroke (hazard ratio [HR] = 1.19, 95% confidence interval [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 co-exposure. The association with PM2.5 was apparent among those aged 60+ years (HR = 1.40, 95% CI: 1.05, 1.87), among never-smokers (HR = 1.74, 95% CI: 1.06, 2.88), and among subjects with PM2.5 exposure below 25 μg/m(3) (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.

U2 - 10.1289/ehp.1307301

DO - 10.1289/ehp.1307301

M3 - Journal article

C2 - 24835336

VL - 122

SP - 919

EP - 925

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 9

ER -