European Community's Seventh Framework Programme.

No abstract

Land Use Regression (LUR) models have been used increasingly for modeling small-scale spatial variation in air pollution concentrations and estimating individual exposure for participants of cohort studies. Within the ESCAPE project, concentrations of PM(2.5), PM(2.5) absorbance, PM(10), and PM(coarse) were measured in 20 European study areas at 20 sites per area. GIS-derived predictor variables (e.g., traffic intensity, population, and land-use) were evaluated to model spatial variation of annual average concentrations for each study area. The median model explained variance (R(2)) was 71% for PM(2.5) (range across study areas 35-94%). Model R(2) was higher for PM(2.5) absorbance (median 89%, range 56-97%) and lower for PM(coarse) (median 68%, range 32- 81%). Models included between two and five predictor variables, with various traffic indicators as the most common predictors. Lower R(2) was related to small concentration variability or limited availability of predictor variables, especially traffic intensity. Cross validation R(2) results were on average 8-11% lower than model R(2). Careful selection of monitoring sites, examination of influential observations and skewed variable distributions were essential for developing stable LUR models. The final LUR models are used to estimate air pollution concentrations at the home addresses of participants in the health studies involved in ESCAPE.

Objectives To study the effect of long term exposure to airborne pollutants on the incidence of acute coronary events in 11 cohorts participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE).Design Prospective cohort studies and meta-analysis of the results.Setting Cohorts in Finland, Sweden, Denmark, Germany, and Italy.Participants 100 166 people were enrolled from 1997 to 2007 and followed for an average of 11.5 years. Participants were free from previous coronary events at baseline.Main outcome measures Modelled concentrations of particulate matter <2.5 μm (PM2.5), 2.5-10 μm (PMcoarse), and <10 μm (PM10) in aerodynamic diameter, soot (PM2.5 absorbance), nitrogen oxides, and traffic exposure at the home address based on measurements of air pollution conducted in 2008-12. Cohort specific hazard ratios for incidence of acute coronary events (myocardial infarction and unstable angina) per fixed increments of the pollutants with adjustment for sociodemographic and lifestyle risk factors, and pooled random effects meta-analytic hazard ratios.Results 5157 participants experienced incident events. A 5 μg/m3 increase in estimated annual mean PM2.5 was associated with a 13% increased risk of coronary events (hazard ratio 1.13, 95% confidence interval 0.98 to 1.30), and a 10 μg/m3 increase in estimated annual mean PM10 was associated with a 12% increased risk of coronary events (1.12, 1.01 to 1.25) with no evidence of heterogeneity between cohorts. Positive associations were detected below the current annual European limit value of 25 μg/m3 for PM2.5 (1.18, 1.01 to 1.39, for 5 μg/m3 increase in PM2.5) and below 40 μg/m3 for PM10 (1.12, 1.00 to 1.27, for 10 μg/m3 increase in PM10). Positive but non-significant associations were found with other pollutants.Conclusions Long term exposure to particulate matter is associated with incidence of coronary events, and this association persists at levels of exposure below the current European limit values.

PM 2.5 , mass concentration of particles less than 2.5 mm in size; PM 2.5 absorbance, measurement of the blackness of PM 2.5 filters, this is a proxy for elemental carbon, which is the dominant light absorbing substance; PM 10 , mass concentration of particles less than 10 mm in size; PM coarse , mass concentration of the coarse fraction of particles between 2.5 mm and 10 mm in size; RB, regional background; RH, relative humidity; ST, Street; TRAPCA, Traffic-Related Air Pollution and Childhood Asthma; UB, urban background; US EPA, United States Environmental Protection Agency.

PM 2.5 : mass concentration of particles less than 2.5 µm in size PM 10 : mass concentration of particles less than 10 µm in size RB: Regional Background site SOP: Standard Operating Procedure ST: Street site TRAPCA: Traffic-Related Air Pollution and Childhood Asthma UB: Urban Background site ABSTRACT The ESCAPE study (European Study of Cohorts for Air Pollution Effects) investigates long-term effects on human health of exposure to air pollution in Europe. Various health endpoints are analysed by using prospective cohort studies in the study areas. This paper documents the spatial variation of measured NO 2 and NO x concentrations between and within 36 study areas across Europe. In 36 study areas NO 2 and NO x were measured using standardized methods between October 2008 and April 2011. In each study area 14 to 80 sites were selected, which represented a wide range of regional, urban and nearby traffic related pollution contrast. The measurements were conducted for two weeks per site in three different seasons, using Ogawa badges. Results for each site were adjusted for temporal variation using data obtained from a routine monitor background site, which operated continuously, and averaged. Substantial spatial variability was found in NO 2 and NO x concentrations between and within study areas. Analysis of variance showed that 40% of the overall NO 2 variance is attributable to the variability between the study areas and 60% is caused by the variability within the study areas. The corresponding values for NO x are 30% (between the study areas) and 70% (within the study areas). The within-area spatial variability was mostly determined by the differences between traffic and urban background concentrations. The traffic/urban background concentration ratio varied between 1.09 and 3.16 across Europe. The NO 2 / NO x ratio varied between 0.47 (Verona) and 0.72 (Heraklion) across study areas. In study areas in southern Europe the highest median concentrations were observed (Barcelona: NO 2 55 µg/m³), followed by densely populated areas in Western Europe (Ruhr area, The Netherlands). The lowest concentrations were observed in all areas in Northern Europe (e.g. Umeå: NO 2 7 µg/m³). In conclusion, we found significant contrast in annual average NO 2 and NO x concentration between and especially within 36 study areas across Europe. Epidemiological studies should therefore characterize intra-urban contrasts. The use of traffic indicators such as "living close to major road" as an exposure variable in epidemiological studies results in different actual NO 2 contrasts. We would like to thank Kees Meliefste, Geert de Vrieze, Marjan Tewis (IRAS, Utrecht University, The Netherlands) for the sampler preparation, analysis and data management. Furthermore, we thank all those who were responsible for air pollution measurements, data management and project supervision in all study areas and especially:

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 μm in diameter], coarse PM (PM between 2.5 and 10 μm), PM10 (PM ≤ 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: A total of 99,446 study participants were included, 3,086 of whom developed stroke. A 5-μg/m3 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 never-smokers (HR = 1.74, 95% CI: 1.06, 2.88), and among participants with PM2.5 exposure < 25 μg/m3 (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.Citation: 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, Östenson CG, Pedersen NL, Pekkanen J, Penell J, Pershagen G, Pundt N, Pyko A, Raaschou-Nielsen O, Ranzi A, Ricceri F, Sacerdote C, Swart WJ, 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. Environ Health Perspect 122:919–925; http://dx.doi.org/10.1289/ehp.1307301

Objectives-To investigate the relation between traYc indicators in the area of residence and the occurrence of chronic respiratory disorders in children. Methods-A population based survey was conducted in 10 areas of northern and central Italy (autumn 1994 to winter 1995) in two age groups (6-7 and 13-14 years). Information on several respiratory disorders and on traYc near residences was collected with a questionnaire given to children and to their parents. The sample analysed included 39 275 subjects (response rate 94.4%). Outcomes were: (a) early (first 2 years of life) respiratory diseases, and (b) current respiratory disorders (asthma, wheeze, cough, or phlegm in the past year). Odds ratios (ORs) and 95% confidence intervals (95% CIs), adjusted for several potential confounders, were estimated from logistic regression models. Main results were stratified by level of urbanisation (metropolitan areas, other centres). Results-In the metropolitan areas, high frequency of lorry traYc in the street of residence was associated with significantly increased risks for many adverse respiratory outcomes. Among early respiratory diseases, the strongest associations were found for recurrent bronchitis (OR 1.69, 95% CI 1.24 to 2.30), bronchiolitis (1.74, 1.09 to 2.77) and pneumonia (1.84, 1.27 to 2.65), although no association was detected for episodes of wheezing bronchitis. All the current respiratory disorders were positively and consistently associated with frequency of lorry traYc, particularly the most severe bronchitic and wheezing symptoms: persistent phlegm for >2 months (1.68; 1.14 to 2.48), and severe wheeze limiting speech (1.86; 1.26 to 2.73). No or weaker associations with heavy vehicular traYc were detected in urban and rural areas and no increased risks were found in the whole sample with the reported traYc density in the zone of residence. After extensive evaluations, the potential of reporting bias seems unlikely. Conclusion-Exposure to exhausts from heavy vehicular traYc may have several adverse eVects on respiratory health of children living in metropolitan areas, increasing the occurrence of lower respiratory tract infections early in life and of wheezing and bronchitic symptoms at school age. (Occup Environ Med 1998;55:771-778)