Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease: a pooled analysis of six European cohorts within the ELAPSE project.

Adult Air Pollution / adverse effects Coronary Disease / chemically induced Environmental Exposure / adverse effects Humans Incidence Multicenter Studies as Topic Stroke / epidemiology

Journal

The Lancet. Planetary health
ISSN: 2542-5196
Titre abrégé: Lancet Planet Health
Pays: Netherlands
ID NLM: 101704339

Informations de publication

Date de publication:
09 2021
Historique:
received: 16 07 2020
revised: 23 06 2021
accepted: 02 07 2021
pubmed: 12 9 2021
medline: 26 11 2021
entrez: 11 9 2021
Statut: ppublish

Résumé

Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we investigated the associations of long-term exposures to fine particulate matter (PM We did a pooled analysis of individual data from six population-based cohort studies within ELAPSE, from Sweden, Denmark, the Netherlands, and Germany (recruited 1992-2004), and harmonised individual and area-level variables between cohorts. Participants (all adults) were followed up until migration from the study area, death, or incident stroke or coronary heart disease, or end of follow-up (2011-15). Mean 2010 air pollution concentrations from centrally developed European-wide land use regression models were assigned to participants' baseline residential addresses. We used Cox proportional hazards models with increasing levels of covariate adjustment to investigate the association of air pollution exposure with incidence of stroke and coronary heart disease. We assessed the shape of the concentration-response function and did subset analyses of participants living at pollutant concentrations lower than predefined values. From the pooled ELAPSE cohorts, data on 137 148 participants were analysed in our fully adjusted model. During a median follow-up of 17·2 years (IQR 13·8-19·5), we observed 6950 incident events of stroke and 10 071 incident events of coronary heart disease. Incidence of stroke was associated with PM Long-term air pollution exposure was associated with incidence of stroke and coronary heart disease, even at pollutant concentrations lower than current limit values. Health Effects Institute.

Sections du résumé

BACKGROUND
Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we investigated the associations of long-term exposures to fine particulate matter (PM
METHODS
We did a pooled analysis of individual data from six population-based cohort studies within ELAPSE, from Sweden, Denmark, the Netherlands, and Germany (recruited 1992-2004), and harmonised individual and area-level variables between cohorts. Participants (all adults) were followed up until migration from the study area, death, or incident stroke or coronary heart disease, or end of follow-up (2011-15). Mean 2010 air pollution concentrations from centrally developed European-wide land use regression models were assigned to participants' baseline residential addresses. We used Cox proportional hazards models with increasing levels of covariate adjustment to investigate the association of air pollution exposure with incidence of stroke and coronary heart disease. We assessed the shape of the concentration-response function and did subset analyses of participants living at pollutant concentrations lower than predefined values.
FINDINGS
From the pooled ELAPSE cohorts, data on 137 148 participants were analysed in our fully adjusted model. During a median follow-up of 17·2 years (IQR 13·8-19·5), we observed 6950 incident events of stroke and 10 071 incident events of coronary heart disease. Incidence of stroke was associated with PM
INTERPRETATION
Long-term air pollution exposure was associated with incidence of stroke and coronary heart disease, even at pollutant concentrations lower than current limit values.
FUNDING
Health Effects Institute.

Identifiants

DOI: 10.1016/S2542-5196(21)00195-9 PMID: 34508683
pubmed: 34508683
pii: S2542-5196(21)00195-9
doi: 10.1016/S2542-5196(21)00195-9
pii:
doi:

Types de publication

Journal Article Meta-Analysis Multicenter Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e620-e632

Subventions

Organisme : NIA NIH HHS
ID : R01 AG008724
Pays : United States

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests We declare no competing interests.

Auteurs

Kathrin Wolf (K)

Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany. Electronic address: kathrin.wolf@helmholtz-muenchen.de.

Barbara Hoffmann (B)

Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

Zorana J Andersen (ZJ)

Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Richard W Atkinson (RW)

Population Health Research Institute, St George's, University of London, London, UK.

Mariska Bauwelinck (M)

Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.

Tom Bellander (T)

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.

Jørgen Brandt (J)

Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate, Interdisciplinary Centre for Climate Change, Aarhus University, Denmark.

Bert Brunekreef (B)

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.

Giulia Cesaroni (G)

Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy.

Jie Chen (J)

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.

Ulf de Faire (U)

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Kees de Hoogh (K)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Daniela Fecht (D)

School of Public Health, Faculty of Medicine, Imperial College London, London, UK.

Francesco Forastiere (F)

Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK.

John Gulliver (J)

School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK; School of Geography, Geology and the Environment, University of Leicester, Leicester, UK.

Ole Hertel (O)

Department of Bioscience, Aarhus University, Roskilde, Denmark.

Ulla Arthur Hvidtfeldt (UA)

Danish Cancer Society Research Center, Copenhagen, Denmark.

Nicole A H Janssen (NAH)

National Institute for Public Health and the Environment, Bilthoven, Netherlands.

Jeanette T Jørgensen (JT)

Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Klea Katsouyanni (K)

School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Matthias Ketzel (M)

Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research, University of Surrey, Surrey, UK.

Jochem O Klompmaker (JO)

National Institute for Public Health and the Environment, Bilthoven, Netherlands; Harvard T H Chan School of Public Health, Boston, MA, USA.

Anton Lager (A)

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Shuo Liu (S)

Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Conor J MacDonald (CJ)

INSERM U1018, CESP, Institut Gustave Roussy, Université Paris-Saclay, Université Paris-Sud, Villejuif, France.

Patrik K E Magnusson (PKE)

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Amar J Mehta (AJ)

Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Gabriele Nagel (G)

Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.

Bente Oftedal (B)

Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.

Nancy L Pedersen (NL)

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Göran Pershagen (G)

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.

Ole Raaschou-Nielsen (O)

Department of Environmental Science, Aarhus University, Roskilde, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark.

Matteo Renzi (M)

Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy.

Debora Rizzuto (D)

Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.

Sophia Rodopoulou (S)

Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Evangelia Samoli (E)

Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Yvonne T van der Schouw (YT)

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

Sara Schramm (S)

Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.

Per Schwarze (P)

Global Health Cluster, Norwegian Institute of Public Health, Oslo, Norway.

Torben Sigsgaard (T)

Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.

Mette Sørensen (M)

Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.

Massimo Stafoggia (M)

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy.

Maciek Strak (M)

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands; National Institute for Public Health and the Environment, Bilthoven, Netherlands.

Anne Tjønneland (A)

Danish Cancer Society Research Center, Copenhagen, Denmark.

W M Monique Verschuren (WMM)

National Institute for Public Health and the Environment, Bilthoven, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

Danielle Vienneau (D)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Gudrun Weinmayr (G)

Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.

Gerard Hoek (G)

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands.

Annette Peters (A)

Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Ludwig Maximilians Universität München, Munich, Germany.

Petter L S Ljungman (PLS)

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pollution de l'environnement › Pollution de l'air › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Ischémie myocardique › Maladie coronarienne › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pollution de l'environnement › Exposition environnementale › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études multicentriques comme sujet › Long-term exposure to low-level ambient air...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Long-term exposure to low-level ambient air...