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Stafoggia, M.* ; Cesaroni, G.* ; Peters, A. ; Andersen, Z.J.* ; Badaloni, C.* ; Beelen, R.* ; Caracciolo, B.* ; Cyrys, J. ; de Faire, U.* ; de Hoogh, K.* ; Eriksen, K.T.* ; Fratiglioni, L.* ; Galassi, C.* ; Gigante, B.* ; Havulinna, A.S.* ; Hennig, F.* ; Hilding, A.* ; Hoek, G.* ; Hoffmann, B.* ; Houthuijs, D.* ; Korek, M.* ; Lanki, T.* ; Leander, K.* ; Magnusson, P.K.* ; Meisinger, C. ; Migliore, E.* ; Overvad, K.* ; Ostenson, C.G.* ; Pedersen, N.L.* ; Pekkanen, J.* ; Penell, J.* ; Pershagen, G.* ; Pundt, N.* ; Pyko, A.* ; Raaschou-Nielsen, O.* ; Ranzi, A.* ; Ricceri, F.* ; Sacerdote, C.* ; Swart, W.J.* ; Turunen, A.W.* ; Vineis, P.* ; Weimar, C.* ; Weinmayr, G.* ; Wolf, K. ; Brunekreef, B.* ; Forastiere, F.*

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

Environ. Health Perspect. 122, 919-925 (2014)
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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.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Use Regression-models; Acute Ischemic-stroke; Particulate Matter; Pm2.5 Absorbency; Mortality; Areas; Risk; No2; Metaanalysis; Pmcoarse
ISSN (print) / ISBN 0091-6765
e-ISSN 1552-9924
Quellenangaben Volume: 122, Issue: 9, Pages: 919-925 Article Number: , Supplement: ,
Publisher Research Triangle Park
Publishing Place NC [u.a.]
Non-patent literature Publications
Reviewing status Peer reviewed