Air Pollution and Atherosclerosis: A Cross-Sectional Analysis of FourEuropean Cohort Studies in the ESCAPE Study

Abstract

Background:In four European cohorts, we investigated the cross-sectional association between long-term exposure to air pollution and intima-media thickness of the common carotid artery (CIMT), a preclinical marker of atherosclerosis.Methods:Individually assigned levels of nitrogen dioxide, nitrogen oxides, particulate matter ≤ 2.5 μm (PM2.5), absorbance of PM2.5 (PM2.5abs), PM10, PMcoarse, and two indicators of residential proximity to highly trafficked roads were obtained under a standard exposure protocol (European Study of Cohorts for Air Pollution Effects—ESCAPE study) in the Stockholm area (Sweden), the Ausburg and Ruhr area (Germany), and the Girona area (Spain). We used linear regression and meta-analyses to examine the association between long-term exposure to air pollution and CIMT.Results:The meta-analysis with 9,183 individuals resulted in an estimated increase in CIMT (geometric mean) of 0.72% (95% CI: –0.65%, 2.10%) per 5-μg/m3 increase in PM2.5 and 0.42% (95% CI: –0.46%, 1.30%) per 10–5/m increase in PM2.5abs. Living in proximity to high traffic was also positively but not significantly associated with CIMT. Meta-analytic estimates for other pollutants were inconsistent. Results were similar across different adjustment sets and sensitivity analyses. In an extended meta-analysis for PM2.5 with three other previously published studies, a 0.78% (95% CI: –0.18%, 1.75%) increase in CIMT was estimated for a 5-μg/m3 contrast in PM2.5.Conclusions:Using a standardized exposure and analytical protocol in four European cohorts, we found that cross-sectional associations between CIMT and the eight ESCAPE markers of long-term residential air pollution exposure did not reach statistical significance. The additional meta-analysis of CIMT and PM2.5 across all published studies also was positive but not significant.Citation:Perez L, Wolf K, Hennig F, Penell J, Basagaña X, Foraster M, Aguilera I, Agis D, Beelen R, Brunekreef B, Cyrys J, Fuks KB, Adam M, Baldassarre D, Cirach M, Elosua R, Dratva J, Hampel R, Koenig W, Marrugat J, de Faire U, Pershagen G, Probst-Hensch NM, de Nazelle A, Nieuwenhuijsen MJ, Rathmann W, Rivera M, Seissler J, Schindler C, Thiery J, Hoffmann B, Peters A, Künzli N. 2015. Air pollution and atherosclerosis: a cross-sectional analysis of four European cohort studies in the ESCAPE Study. Environ Health Perspect 123:597–605; http://dx.doi.org/10.1289/ehp.1307711

Associations of night-time road traffic noise with carotid intima-media thickness and blood pressure: The Whitehall II and SABRE study cohorts

“…However, in these studies traffic noise was not measured or included as a separate exposure variable. Although positive associations between particulate air pollution and cIMT have been reported (Tonne et al 2012;Wilker et al 2013), inverse non-significant associations were observed with NO2 or NOx in a study with four European cohorts (Perez et al 2015), which agrees with our findings.…”

“…These changes, when severe, increase the risk of occlusion that may result in acute atherothrombotic events such as myocardial infarction and stroke (Eikendal et al 2015;O'Leary et al 1999). Although associations between air pollution and cIMT have been investigated (Perez et al 2015;Tonne et al 2012;Wilker et al 2013), we are not aware of studies examining associations between exposure to road traffic noise and cIMT. This association could be on the stress-related pathway between traffic noise exposure and cardiovascular events (Basner et al 2014;Munzel et al 2014) as systolic blood pressure stress reactions, for example, have been linked to progression of cIMT (Jennings et al 2004).…”

Comparison of Land-Use Regression Modeling with Dispersion and Chemistry Transport Modeling to Assign Air Pollution Concentrations within the Ruhr Area

“…Although all exposure metrics are equally used as a surrogate of personal exposure in epidemiological studies, exposure modeling is strongly influenced by the spatial and temporal variation of exposure and exposure sources [5]. Furthermore, aims, application, input data but also the complexity of models might differ, yielding not only different exposure estimates but consequently different health effect estimates in terms of magnitude and/or statistical significance [5,13].…”

Tráfego veicular e a espessura da camada íntima média das carótidas no Estudo Longitudinal da Saúde do Adulto-ELSA Brasil

“…Outra meta-análise realizada por Liu et al, (2015) Cinco outros estudos desta revisão sistemática Lenters et al, 2010;Gan et al, 2014;Perez et al, 2015) referiram-se à relação entre EIMC e proximidade ao tráfego. Devido à expressão de dados diferentes resultados de metodologias distintas, não foi possível realizar meta-análise.…”

“…Perez et al (2015) concluíram, também, em seu estudo, que morar na proximidade de vias de alto tráfego pode ser positivamente associado às medidas da EIMC. Vários outros estudos recentes observando as associações de EIMC com exposição ao combustível de biomassa descrito por Painschab et al (2013) e a poluição do ar relacionada com o tráfego (Rivera et al, 2013) mostraram resultados estatisticamente significativos.…”