Long-term exposure to ambient air pollution and incidence of cerebrovascular events: Results from 11 European cohorts within the ESCAPE project

Massimo Stafoggia*, Giulia Cesaroni, Annette Peters, Zorana J. Andersen, Chiara Badaloni, Rob Beelen, Barbara Caracciolo, Josef Cyrys, Ulf de Faire, Kees de Hoogh, Kirsten T. Eriksen, Laura Fratiglioni, Claudia Galassi, Bruna Gigante, Aki S. Havulinna, Frauke Hennig, Agneta Hilding, Gerard Hoek, Barbara Hoffmann, Danny HouthuijsMichal Korek, Timo Lanki, Karin Leander, Patrik K. Magnusson, Christa Meisinger, Enrica Migliore, Kim Overvad, Claes Göran Östenson, Nancy L. Pedersen, Juha Pekkanen, Johanna Penell, Goran Pershagen, Noreen Pundt, Andrei Pyko, Ole Raaschou-Nielsen, Andrea Ranzi, Fulvio Ricceri, Carlotta Sacerdote, Wim J.R. Swart, Anu W. Turunen, Paolo Vineis, Christian Weimar, Gudrun Weinmayr, Kathrin Wolf, Bert Brunekreef, Francesco Forastiere

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    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.

    OriginalsprogEngelsk
    Sider (fra-til)919-925
    Antal sider7
    TidsskriftEnvironmental Health Perspectives
    Vol/bind122
    Udgave nummer9
    DOI
    StatusUdgivet - sep. 2014

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