The link between elevated concentrations of ambient particulate matter (PM) and increased mortality has been investigated in numerous studies. Here we analyzed the role of different particle size fractions with respect to total and cardio-respiratory mortality in Erfurt, Germany, between 1995 and 2001. Number concentrations (NC) of PM were measured using an aerosol spectrometer consisting of a Differential Mobility Particle Sizer and a Laser Aerosol Spectrometer to characterize particles between 0.01 and 0.5 and between 0.1 and 2.5 mm, respectively. We derived daily means of particle NC for ultrafine (0.01-0.1 mm) and for fine particles (0.01-2.5 mm). Assuming spherical particles of a constant density, we estimated the mass concentrations (MC) of particles in these size ranges. Concurrently, data on daily total and cardio-respiratory death counts were obtained from local health authorities. The data were analyzed using Poisson Generalized Additive Models adjusting for trend, seasonality, influenza epidemics, day of the week, and meteorology using smooth functions or indicator variables. We found statistically significant associations between elevated ultrafine particle (UFP; diameter: 0.01-0.1 mm) NC and total as well as cardio-respiratory mortality, each with a 4 days lag. The relative mortality risk (RR) for a 9748 cm À3 increase in UFP NC was RR ¼ 1.029 and its 95% confidence interval (CI) ¼ 1.003-1.055 for total mortality. For cardio-respiratory mortality we found: RR ¼ 1.031, 95% CI: 1.003-1.060. No association between fine particle MC and mortality was found. This study shows that UFP, representing fresh combustion particles, may be an important component of urban air pollution associated with health effects.

Matrix metalloproteinases (MMP) play a key role in the breakdown of extracellular matrix and in inflammatory processes. MMP1 is the most highly expressed interstitial collagenase degrading fibrillar collagens. Overexpression of MMP1 has been shown in tumor tissues and has been suggested to be associated with tumor invasion and metastasis. Nine haplotype tagging and additional two intronic single nucleotide polymorphisms (SNP) of MMP1 were genotyped in a case control sample, consisting of 635 lung cancer cases with onset of disease below 51 years of age and 1,300 age-and sex-matched cancer-free controls. Two regions of linkage disequilibrium (LD) of MMP1 could be observed: a region of low LD comprising the 5 ¶ region including the promoter and a region of high LD starting from exon 1 to the end of the gene and including the 3 ¶ flanking region. Several SNPs were identified to be individually significantly associated with risk of early-onset lung cancer. The most significant effect was seen for rs1938901 (P = 0.0089), rs193008 (P = 0.0108), and rs996999 (P = 0.0459). For rs996999, significance vanished after correction for multiple testing. For each of these SNPs, the major allele was associated with an increase in risk with an odds ratio between 1.2 and 1.3 (95% confidence interval, 1.0-1.5). The haplotype analysis supported these findings, especially for subgroups with high smoking intensity. In summary, we identified MMP1 to be associated with an increased risk for lung cancer, which was modified by smoking. (Cancer Epidemiol Biomarkers Prev 2008;17(5):1127 -35)

Given the hypothesis that air pollution is associated with elevated blood pressure and heart rate, the effect of daily concentrations of air pollution on blood pressure and heart rate was assessed in 131 adults with coronary heart disease in Helsinki, Finland; Erfurt, Germany; and Amsterdam, the Netherlands. Blood pressure was measured by a digital monitor, and heart rate was calculated as beats per minute from an electrocardiogram recording with the patient in supine position. Particle concentrations were measured at central measuring sites. Linear regression was used to model the association between 24-hr mean concentrations of particles and blood pressure and heart rate. Estimates were adjusted for trend, day of week, temperature, barometric pressure, relative humidity, and medication use. Pooled effect estimates showed a small significant decrease in diastolic and systolic blood pressure in association with particulate air pollution; a slight decrease in heart rate was found. Of the three centers, Erfurt revealed the most consistent particle effects. The results do not support findings from previous studies that had shown an increase in blood pressure and heart rate in healthy individuals in association with particles. However, particle effects might differ in cardiac patients because of medication intake and disease status, both affecting the autonomic control of the heart. Key words: autonomic control, blood pressure, cardiovascular disease, fine and ultrafine particles, heart rate. Environmental Medicine Article clinical visits once every 2 weeks and daily recording of symptoms and medication use. Subjects who were included in the study had to be free-dwelling nonsmokers and ≥ 50 years of age with doctor-diagnosed coronary heart disease. Subjects with a recent (< 3 months) cardiac event such as myocardial infarction, stroke, coronary artery bypass graft, or percutaneous transluminal coronary angioplasty (PTCA) were excluded from the panels. Other exclusion criteria were unstable angina pectoris and type 1 diabetes mellitus. Subjects were examined by a physician to exclude persons who were too ill, unable to perform the exercise challenge, or likely to have problems with the study for other reasons. The subjects were characterized by a questionnaire and a recording of a 12-lead standard resting electrocardiogram (ECG).In Amsterdam, panelists were recruited by sending out information letters and screening questionnaires to retirement homes. Because the response was low, a newspaper advertisement was used and letters were distributed in areas mainly inhabited by senior citizens to enroll more subjects. Finally, subjects were recruited via the department of cardiology of the academic medical center. In Erfurt, the study population was recruited through a local cardiologist. In Helsinki, subjects were recruited by an advertisement in the journal of a patient organization of the Finnish Heart Association. Furthermore, information letters were distributed to members of the association with the postal code of the...

The association between particulate air pollution and asthma medication use and symptoms was assessed in a panel study of 53 adult asthmatics in Erfurt, Germany in winter 1996/1997.Number concentrations of ultrafine particles, 0.01-0.1 mm in diameter (NC0.01-0.1), mean 17,300?cm -3 , and mass concentrations of fine particles 0.01-2.5 mm in diameter (MC0.01-2.5), mean 30.3 mg?m -3 , were measured concurrently. They were not highly correlated (r=0.45). The associations between ambient particle concentrations and the prevalence of inhaled b 2 -agonist, corticosteroid use and asthma symptoms, were analysed separately with logistic regression models, adjusting for trend, temperature, weekend, holidays, and first order autocorrelation of the error.Cumulative exposures over 14 days of ultrafine and fine particles were associated with corticosteroid use. b 2 -agonist use was associated with 5-day mean NC0.01-0.1 and MC0.01-2.5. The prevalence of asthma symptoms was associated with ambient particle concentrations. The results suggest that reported asthma medication use and symptoms increase in association with particulate air pollution and gaseous pollutants such as nitrogen dioxide. Eur Respir J 2002; 20: 691-702.

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