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 Houthuijs; Michal Korek; Timo Lanki; Karin Leander; Patrik K. Magnusson; Christa Meisinger; Enrica Migliore; Kim Overvad; Claes-Goran Ostenson; 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

doi:10.1289/ehp.1307301

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-Goran Ostenson, 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 for this work

Research output: Contribution to journal › Article › Academic › peer-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 m in diameter], coarse PM (PM between 2.5 and 10 m), PM10 (PM <10 mu m), 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 mu g/m(3) 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 g/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.

Original language	English
Pages (from-to)	919-925
Number of pages	7
Journal	Environmental Health Perspectives
Volume	122
Issue number	9
DOIs	https://doi.org/10.1289/ehp.1307301
Publication status	Published - Sept 2014

Funding

The European Community's Seventh Framework Program (FP7/ 2007-2011) provided funding for this work (grant 211250). For the Finnish part, additional funding came from the Academy of Finland (project number 129317). The four Swedish cohorts [SNAC-K (Swedish National Study on Aging and Care in Kungsholmen), SALT (Screening Across the Lifespan Twin study), 60y (60-year-olds study), SDPP (Stockholm Diabetes Prevention Program study)] were partially funded by the Swedish Environmental Protection Agency, the Swedish Council for Working Life and Social Research, and the Swedish Heart-Lung Foundation. The SALT cohort received additional support from the U.S. National Institutes of Health (grant AG-08724). The 60y cohort received additional support from the Stockholm County Council and the Swedish Research Council (longitudinal research and 0593). The SDPP cohort received additional support from the Stockholm County Council, the Swedish Research Council, the Swedish Diabetes Association, and the Novo Nordisk Scandinavia. The Heinz Nixdorf Foundation, the German Ministry of Education and Science, the German Aerospace Center (Deutsches Zentrum fur Luft-und Raumfahrt), and the German Research Foundation (DFG HO 3314/2-1 and JO170/ 8-1), Bonn, Germany, also provided support for this study. The KORA (German Cooperative Health Research in the Region of Augsburg) research platform and the MONICA (Multinational MONItoring of trends and determinants in CArdiovascular diseases) Augsburg studies were initiated and financed by the Helmholtz Zentrum Munchen, German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria. The SIDRIA (International Study on Asthma and Allergies in Childhood in Turin and Rome) cohort study was partially funded by the Italian Ministry of Health.

Keywords

USE REGRESSION-MODELS
ACUTE ISCHEMIC-STROKE
PARTICULATE MATTER
PM2.5 ABSORBENCY
MORTALITY
AREAS
RISK
NO2
METAANALYSIS
PMCOARSE

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1289/ehp.1307301

ehp.1307301Final published version, 263 KB

Cite this

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., ... Forastiere, F. (2014). Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events: Results from 11 European Cohorts within the ESCAPE Project. Environmental Health Perspectives, 122(9), 919-925. https://doi.org/10.1289/ehp.1307301

@article{9ed9b6563b5740059b371f616b990649,

title = "Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events: Results from 11 European Cohorts within the ESCAPE Project",

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 m in diameter], coarse PM (PM between 2.5 and 10 m), PM10 (PM <10 mu m), 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 mu g/m(3) 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 g/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.",

keywords = "USE REGRESSION-MODELS, ACUTE ISCHEMIC-STROKE, PARTICULATE MATTER, PM2.5 ABSORBENCY, MORTALITY, AREAS, RISK, NO2, METAANALYSIS, PMCOARSE",

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

year = "2014",

month = sep,

doi = "10.1289/ehp.1307301",

language = "English",

volume = "122",

pages = "919--925",

journal = "Environmental Health Perspectives",

issn = "0091-6765",

publisher = "Public Health Services, US Dept of Health and Human Services",

number = "9",

}

Stafoggia, M, Cesaroni, G, Peters, A, Andersen, ZJ, Badaloni, C, Beelen, R, Caracciolo, B, Cyrys, J, de Faire, U, de Hoogh, K, Eriksen, KT, Fratiglioni, L, Galassi, C, Gigante, B, Havulinna, AS, Hennig, F, Hilding, A, Hoek, G, Hoffmann, B, Houthuijs, D, Korek, M, Lanki, T, Leander, K, Magnusson, PK, Meisinger, C, Migliore, E, Overvad, K, Ostenson, C-G, Pedersen, NL, Pekkanen, J, Penell, J, Pershagen, G, Pundt, N, Pyko, A, Raaschou-Nielsen, O, Ranzi, A, Ricceri, F, Sacerdote, C, Swart, WJR, Turunen, AW, Vineis, P, Weimar, C, Weinmayr, G, Wolf, K, Brunekreef, B & Forastiere, F 2014, 'Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events: Results from 11 European Cohorts within the ESCAPE Project', Environmental Health Perspectives, vol. 122, no. 9, pp. 919-925. https://doi.org/10.1289/ehp.1307301

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 J.

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-Goran

AU - Pedersen, Nancy L.

AU - Pekkanen, Juha

AU - Penell, Johanna

AU - Pershagen, Goran

AU - Pundt, Noreen

AU - Pyko, Andrei

AU - Raaschou-Nielsen, Ole

AU - Ranzi, Andrea

AU - Ricceri, Fulvio

AU - Sacerdote, Carlotta

AU - Swart, Wim J. R.

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) = 2.5 m in diameter], coarse PM (PM between 2.5 and 10 m), PM10 (PM <10 mu m), 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 mu g/m(3) 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 g/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) = 2.5 m in diameter], coarse PM (PM between 2.5 and 10 m), PM10 (PM <10 mu m), 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 mu g/m(3) 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 g/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.

KW - USE REGRESSION-MODELS

KW - ACUTE ISCHEMIC-STROKE

KW - PARTICULATE MATTER

KW - PM2.5 ABSORBENCY

KW - MORTALITY

KW - AREAS

KW - RISK

KW - NO2

KW - METAANALYSIS

KW - PMCOARSE

U2 - 10.1289/ehp.1307301

DO - 10.1289/ehp.1307301

M3 - Article

SN - 0091-6765

VL - 122

SP - 919

EP - 925

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

IS - 9

ER -

Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events: Results from 11 European Cohorts within the ESCAPE Project

Abstract

Funding

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this