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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.
BMJ:Br. Med. J. 348:f7412 (2014)
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.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Use Regression-models; Cardiovascular-disease; Particulate Matter; Heart-disease; Pm2.5 Absorbency; Risk-factors; Mortality; Women; Association; Health
Language
english
Publication Year
2014
HGF-reported in Year
2014
ISSN (print) / ISBN
1756-1833
e-ISSN
0959-535X
Journal
BMJ: British Medical Journal
Quellenangaben
Volume: 348,
Article Number: f7412
Publisher
BMJ Publishing Group
Publishing Place
London
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
POF-Topic(s)
30202 - Environmental Health
Research field(s)
Genetics and Epidemiology
PSP Element(s)
G-504000-001
G-504000-006
G-504000-006
PubMed ID
24452269
WOS ID
WOS:000330296900002
Scopus ID
84893149456
Erfassungsdatum
2014-02-16