Long-term exposure to air pollution and cardiovascular mortality: An analysis of 22 European cohorts

Rob Beelen, Massimo Stafogguiia, Ole Raaschou-Nielsen, Zorana Jovanovic Andersen, Wei W. Xun, Klea Katsouyanni, Konstantina Dimakopoulou, Bert Brunekreef, Gudrun Weinmayr, Barbara Hoffmann, Kathrin Wolf, Evangelia Samoli, Danny Houthuijs, Mark Nieuwenhuijsen, Anna Oudin, Bertil Forsberg, David Olsson, Veikko Salomaa, Timo Lanki, Tarja Yli-TuomiBente Oftedal, Geir Aamodt, Per Nafstad, Ulf De Faire, Nancy L. Pedersen, Claes Göran Östenson, Laura Fratiglioni, Johanna Penell, Michal Korek, Andrei Pyko, Kirsten Thorup Eriksen, Anne Tjønneland, Thomas Becker, Marloes Eeftens, Michiel Bots, Kees Meliefste, Meng Wang, Bas Bueno-De-Mesquita, Dorothea Sugiri, Ursula Krämer, Joachim Heinrich, Kees De Hoogh, Timothy Key, Annette Peters, Josef Cyrys, Hans Concin, Gabriele Nagel, Alex Ineichen, Emmanuel Schaffner, Nicole Probst-Hensch, Julia Dratva, Regina Ducret-Stich, Alice Vilier, Françoise Clavel-Chapelon, Morgane Stempfelet, Sara Grioni, Vittorio Krogh, Ming Yi Tsai, Alessandro Marcon, Fulvio Ricceri, Carlotta Sacerdote, Claudia Galassi, Enrica Migliore, Andrea Ranzi, Giulia Cesaroni, Chiara Badaloni, Francesco Forastiere, Ibon Tamayo, Pilar Amiano, Miren Dorronsoro, Michail Katsoulis, Antonia Trichopoulou, Paolo Vineis, Gerard Hoek

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM 2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.

Original languageEnglish
Pages (from-to)368-378
Number of pages11
JournalEpidemiology
Volume25
Issue number3
DOIs
Publication statusPublished - 2014

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Air Pollution
Cerebrovascular Disorders
Mortality
Air Pollutants
Cardiovascular Diseases
Cause of Death
Nitrogen Dioxide
Proportional Hazards Models
Multicenter Studies
Myocardial Ischemia
Meta-Analysis
Cohort Studies
Myocardial Infarction
Confidence Intervals
Population

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)

Cite this

Beelen, R., Stafogguiia, M., Raaschou-Nielsen, O., Andersen, Z. J., Xun, W. W., Katsouyanni, K., ... Hoek, G. (2014). Long-term exposure to air pollution and cardiovascular mortality: An analysis of 22 European cohorts. Epidemiology, 25(3), 368-378. https://doi.org/10.1097/EDE.0000000000000076

Long-term exposure to air pollution and cardiovascular mortality : An analysis of 22 European cohorts. / Beelen, Rob; Stafogguiia, Massimo; Raaschou-Nielsen, Ole; Andersen, Zorana Jovanovic; Xun, Wei W.; Katsouyanni, Klea; Dimakopoulou, Konstantina; Brunekreef, Bert; Weinmayr, Gudrun; Hoffmann, Barbara; Wolf, Kathrin; Samoli, Evangelia; Houthuijs, Danny; Nieuwenhuijsen, Mark; Oudin, Anna; Forsberg, Bertil; Olsson, David; Salomaa, Veikko; Lanki, Timo; Yli-Tuomi, Tarja; Oftedal, Bente; Aamodt, Geir; Nafstad, Per; De Faire, Ulf; Pedersen, Nancy L.; Östenson, Claes Göran; Fratiglioni, Laura; Penell, Johanna; Korek, Michal; Pyko, Andrei; Eriksen, Kirsten Thorup; Tjønneland, Anne; Becker, Thomas; Eeftens, Marloes; Bots, Michiel; Meliefste, Kees; Wang, Meng; Bueno-De-Mesquita, Bas; Sugiri, Dorothea; Krämer, Ursula; Heinrich, Joachim; De Hoogh, Kees; Key, Timothy; Peters, Annette; Cyrys, Josef; Concin, Hans; Nagel, Gabriele; Ineichen, Alex; Schaffner, Emmanuel; Probst-Hensch, Nicole; Dratva, Julia; Ducret-Stich, Regina; Vilier, Alice; Clavel-Chapelon, Françoise; Stempfelet, Morgane; Grioni, Sara; Krogh, Vittorio; Tsai, Ming Yi; Marcon, Alessandro; Ricceri, Fulvio; Sacerdote, Carlotta; Galassi, Claudia; Migliore, Enrica; Ranzi, Andrea; Cesaroni, Giulia; Badaloni, Chiara; Forastiere, Francesco; Tamayo, Ibon; Amiano, Pilar; Dorronsoro, Miren; Katsoulis, Michail; Trichopoulou, Antonia; Vineis, Paolo; Hoek, Gerard.

In: Epidemiology, Vol. 25, No. 3, 2014, p. 368-378.

Research output: Contribution to journalArticle

Beelen, R, Stafogguiia, M, Raaschou-Nielsen, O, Andersen, ZJ, Xun, WW, Katsouyanni, K, Dimakopoulou, K, Brunekreef, B, Weinmayr, G, Hoffmann, B, Wolf, K, Samoli, E, Houthuijs, D, Nieuwenhuijsen, M, Oudin, A, Forsberg, B, Olsson, D, Salomaa, V, Lanki, T, Yli-Tuomi, T, Oftedal, B, Aamodt, G, Nafstad, P, De Faire, U, Pedersen, NL, Östenson, CG, Fratiglioni, L, Penell, J, Korek, M, Pyko, A, Eriksen, KT, Tjønneland, A, Becker, T, Eeftens, M, Bots, M, Meliefste, K, Wang, M, Bueno-De-Mesquita, B, Sugiri, D, Krämer, U, Heinrich, J, De Hoogh, K, Key, T, Peters, A, Cyrys, J, Concin, H, Nagel, G, Ineichen, A, Schaffner, E, Probst-Hensch, N, Dratva, J, Ducret-Stich, R, Vilier, A, Clavel-Chapelon, F, Stempfelet, M, Grioni, S, Krogh, V, Tsai, MY, Marcon, A, Ricceri, F, Sacerdote, C, Galassi, C, Migliore, E, Ranzi, A, Cesaroni, G, Badaloni, C, Forastiere, F, Tamayo, I, Amiano, P, Dorronsoro, M, Katsoulis, M, Trichopoulou, A, Vineis, P & Hoek, G 2014, 'Long-term exposure to air pollution and cardiovascular mortality: An analysis of 22 European cohorts', Epidemiology, vol. 25, no. 3, pp. 368-378. https://doi.org/10.1097/EDE.0000000000000076
Beelen R, Stafogguiia M, Raaschou-Nielsen O, Andersen ZJ, Xun WW, Katsouyanni K et al. Long-term exposure to air pollution and cardiovascular mortality: An analysis of 22 European cohorts. Epidemiology. 2014;25(3):368-378. https://doi.org/10.1097/EDE.0000000000000076
Beelen, Rob ; Stafogguiia, Massimo ; Raaschou-Nielsen, Ole ; Andersen, Zorana Jovanovic ; Xun, Wei W. ; Katsouyanni, Klea ; Dimakopoulou, Konstantina ; Brunekreef, Bert ; Weinmayr, Gudrun ; Hoffmann, Barbara ; Wolf, Kathrin ; Samoli, Evangelia ; Houthuijs, Danny ; Nieuwenhuijsen, Mark ; Oudin, Anna ; Forsberg, Bertil ; Olsson, David ; Salomaa, Veikko ; Lanki, Timo ; Yli-Tuomi, Tarja ; Oftedal, Bente ; Aamodt, Geir ; Nafstad, Per ; De Faire, Ulf ; Pedersen, Nancy L. ; Östenson, Claes Göran ; Fratiglioni, Laura ; Penell, Johanna ; Korek, Michal ; Pyko, Andrei ; Eriksen, Kirsten Thorup ; Tjønneland, Anne ; Becker, Thomas ; Eeftens, Marloes ; Bots, Michiel ; Meliefste, Kees ; Wang, Meng ; Bueno-De-Mesquita, Bas ; Sugiri, Dorothea ; Krämer, Ursula ; Heinrich, Joachim ; De Hoogh, Kees ; Key, Timothy ; Peters, Annette ; Cyrys, Josef ; Concin, Hans ; Nagel, Gabriele ; Ineichen, Alex ; Schaffner, Emmanuel ; Probst-Hensch, Nicole ; Dratva, Julia ; Ducret-Stich, Regina ; Vilier, Alice ; Clavel-Chapelon, Françoise ; Stempfelet, Morgane ; Grioni, Sara ; Krogh, Vittorio ; Tsai, Ming Yi ; Marcon, Alessandro ; Ricceri, Fulvio ; Sacerdote, Carlotta ; Galassi, Claudia ; Migliore, Enrica ; Ranzi, Andrea ; Cesaroni, Giulia ; Badaloni, Chiara ; Forastiere, Francesco ; Tamayo, Ibon ; Amiano, Pilar ; Dorronsoro, Miren ; Katsoulis, Michail ; Trichopoulou, Antonia ; Vineis, Paolo ; Hoek, Gerard. / Long-term exposure to air pollution and cardiovascular mortality : An analysis of 22 European cohorts. In: Epidemiology. 2014 ; Vol. 25, No. 3. pp. 368-378.
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title = "Long-term exposure to air pollution and cardiovascular mortality: An analysis of 22 European cohorts",
abstract = "Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM 2.5, the hazard ratio was 1.21 (95{\%} confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.",
author = "Rob Beelen and Massimo Stafogguiia and Ole Raaschou-Nielsen and Andersen, {Zorana Jovanovic} and Xun, {Wei W.} and Klea Katsouyanni and Konstantina Dimakopoulou and Bert Brunekreef and Gudrun Weinmayr and Barbara Hoffmann and Kathrin Wolf and Evangelia Samoli and Danny Houthuijs and Mark Nieuwenhuijsen and Anna Oudin and Bertil Forsberg and David Olsson and Veikko Salomaa and Timo Lanki and Tarja Yli-Tuomi and Bente Oftedal and Geir Aamodt and Per Nafstad and {De Faire}, Ulf and Pedersen, {Nancy L.} and {\"O}stenson, {Claes G{\"o}ran} and Laura Fratiglioni and Johanna Penell and Michal Korek and Andrei Pyko and Eriksen, {Kirsten Thorup} and Anne Tj{\o}nneland and Thomas Becker and Marloes Eeftens and Michiel Bots and Kees Meliefste and Meng Wang and Bas Bueno-De-Mesquita and Dorothea Sugiri and Ursula Kr{\"a}mer and Joachim Heinrich and {De Hoogh}, Kees and Timothy Key and Annette Peters and Josef Cyrys and Hans Concin and Gabriele Nagel and Alex Ineichen and Emmanuel Schaffner and Nicole Probst-Hensch and Julia Dratva and Regina Ducret-Stich and Alice Vilier and Fran{\cc}oise Clavel-Chapelon and Morgane Stempfelet and Sara Grioni and Vittorio Krogh and Tsai, {Ming Yi} and Alessandro Marcon and Fulvio Ricceri and Carlotta Sacerdote and Claudia Galassi and Enrica Migliore and Andrea Ranzi and Giulia Cesaroni and Chiara Badaloni and Francesco Forastiere and Ibon Tamayo and Pilar Amiano and Miren Dorronsoro and Michail Katsoulis and Antonia Trichopoulou and Paolo Vineis and Gerard Hoek",
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TY - JOUR

T1 - Long-term exposure to air pollution and cardiovascular mortality

T2 - An analysis of 22 European cohorts

AU - Beelen, Rob

AU - Stafogguiia, Massimo

AU - Raaschou-Nielsen, Ole

AU - Andersen, Zorana Jovanovic

AU - Xun, Wei W.

AU - Katsouyanni, Klea

AU - Dimakopoulou, Konstantina

AU - Brunekreef, Bert

AU - Weinmayr, Gudrun

AU - Hoffmann, Barbara

AU - Wolf, Kathrin

AU - Samoli, Evangelia

AU - Houthuijs, Danny

AU - Nieuwenhuijsen, Mark

AU - Oudin, Anna

AU - Forsberg, Bertil

AU - Olsson, David

AU - Salomaa, Veikko

AU - Lanki, Timo

AU - Yli-Tuomi, Tarja

AU - Oftedal, Bente

AU - Aamodt, Geir

AU - Nafstad, Per

AU - De Faire, Ulf

AU - Pedersen, Nancy L.

AU - Östenson, Claes Göran

AU - Fratiglioni, Laura

AU - Penell, Johanna

AU - Korek, Michal

AU - Pyko, Andrei

AU - Eriksen, Kirsten Thorup

AU - Tjønneland, Anne

AU - Becker, Thomas

AU - Eeftens, Marloes

AU - Bots, Michiel

AU - Meliefste, Kees

AU - Wang, Meng

AU - Bueno-De-Mesquita, Bas

AU - Sugiri, Dorothea

AU - Krämer, Ursula

AU - Heinrich, Joachim

AU - De Hoogh, Kees

AU - Key, Timothy

AU - Peters, Annette

AU - Cyrys, Josef

AU - Concin, Hans

AU - Nagel, Gabriele

AU - Ineichen, Alex

AU - Schaffner, Emmanuel

AU - Probst-Hensch, Nicole

AU - Dratva, Julia

AU - Ducret-Stich, Regina

AU - Vilier, Alice

AU - Clavel-Chapelon, Françoise

AU - Stempfelet, Morgane

AU - Grioni, Sara

AU - Krogh, Vittorio

AU - Tsai, Ming Yi

AU - Marcon, Alessandro

AU - Ricceri, Fulvio

AU - Sacerdote, Carlotta

AU - Galassi, Claudia

AU - Migliore, Enrica

AU - Ranzi, Andrea

AU - Cesaroni, Giulia

AU - Badaloni, Chiara

AU - Forastiere, Francesco

AU - Tamayo, Ibon

AU - Amiano, Pilar

AU - Dorronsoro, Miren

AU - Katsoulis, Michail

AU - Trichopoulou, Antonia

AU - Vineis, Paolo

AU - Hoek, Gerard

PY - 2014

Y1 - 2014

N2 - Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM 2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.

AB - Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2 and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5 absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM 2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association.

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