Air Pollution and Atherosclerosis: A Cross-Sectional Analysis of Four European Cohort Studies in the ESCAPE Study

Laura Perez, Kathrin Wolf, Frauke Hennig, Johanna Penell, Xavier Basagaña, Inmaculada Aguilera, David Agis, Rob Beelen, Bert Brunekreef, Josef Cyrys, Kateryna B Fuks, Martin Adam, Damiano Baldassare, Marta Cirach, Roberto Elosua, Julia Dratva, Regina Hampel, Wolfgang Koenig, Jaume Marrugat, Ulf De FaireGöran Pershagen, Nicole M Probst-Hensch, Audrey de Nazelle, Mark J Nieuwenhuijsen, Wolfgang Rathmann, Marcela Rivera, Jochen Seissler, Christian Schindler, Joachim Thierry, Barbara Hoffmann, Annette Peters, Nino Künzli

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    BACKGROUND: In four European cohorts, we investigated the cross-sectional association between long-term exposure to air pollution and intima-media thickness of the common carotid artery (CIMT), a pre-clinical marker of atherosclerosis.

    METHODS: Individually assigned levels of NO2, NOx, PM2.5, absorbance of PM2.5 (PM2.5abs), PM10, PMcoarse, and two indicators of residential proximity to highly trafficked roads were obtained under a standard exposure protocol (European Study of Cohorts for Air Pollution effects-ESCAPE study) in the Stockholm area (Sweden), the Ausburg and Ruhr area (Germany) and the Girona area (Spain). We used linear regression and meta-analyses to examine the association between long-term exposure to air pollution and CIMT.

    RESULTS: The meta-analysis with 9183 individuals resulted in an estimated increase in CIMT (geometric mean) of 0.72% (95% Confidence Interval [CI]: -0.65%, 2.10%) per 5 µg/m(3) increase in PM2.5 and 0.42% (95% CI: -0.46%, 1.30%) per 10(-5)/m increase in PM2.5abs. Living in proximity to high traffic was also positively but not significantly associated with CIMT. Meta-analytic estimates for other pollutants were inconsistent. Results were similar across different adjustment sets and sensitivity analyses. In an extended meta-analysis for PM2.5 with three other previously published studies, a 0.78% (95% CI: -0.18%, 1.75%) increase in CIMT was estimated for a 5 µg/m(3) contrast in PM2.5.

    CONCLUSIONS: Using a standardized exposure and analytical protocol in four European cohorts, cross-sectional associations between CIMT and the eight ESCAPE markers of long-term residential air pollution exposure did not reach statistical significance. The additional meta-analysis of CIMT and PM2.5 across all published studies also was positive but not significant.

    Original languageEnglish
    Pages (from-to)597-605
    Number of pages9
    JournalEnvironmental Health Perspectives
    Volume123
    Issue number6
    DOIs
    Publication statusPublished - 27 Jan 2015

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