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Personal measurements of radiofrequency electromagnetic fields (RF-EMF) have been used in several studies to characterise personal exposure in daily life, but such data are limitedly available for adolescents, and not yet for the United Kingdom (UK). In this study, we aimed to characterise personal exposure to RF-EMF in adolescents and to study the association between exposure and rules applied at school and at home to restrict wireless communication use, likely implemented to reduce other effects of mobile technology (e.g. distraction). We measured exposure to RF-EMF for 16 common frequency bands (87.5 MHz–3.5 GHz), using portable measurement devices (ExpoM-RF), in a subsample of adolescents participating in the cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP) from Greater London (UK) (n = 188). School and home rules were assessed by questionnaire and concerned the school's availability of WiFi and mobile phone policy, and parental restrictions on permitted mobile phone use. Adolescents recorded their activities in real time using a diary app on a study smartphone, while characterizing their personal RF-EMF exposure in daily life, during different activities and times of the day. Data analysis was done for 148 adolescents from 29 schools who recorded RF-EMF data for a median duration of 47 h. The majority (74%) of adolescents spent part of their time at school during the measurement period. Median total RF-EMF exposure was 40 μW/m2 at home, 94 μW/m2 at school, and 100 μW/m2 overall. In general, restrictions at school or at home made little difference for adolescents’ measured exposure to RF-EMF, except for uplink exposure from mobile phones while at school, which was found to be significantly lower for adolescents attending schools not permitting phone use at all, compared to adolescents attending schools allowing mobile phone use during breaks. This difference was not statistically significant for total personal exposure. Total exposure to RF-EMF in adolescents living in Greater London tended to be higher compared to exposure levels reported in other European countries. This study suggests that school policies and parental restrictions are not associated with a lower RF-EMF exposure in adolescents.

Background: While airborne pollen is widely recognized as a seasonal cause of sneezing and itchy eyes, its effects on pulmonary function, cardiovascular health, sleep quality, and cognitive performance are less well-established. It is likely that the public health impact of pollen may increase in the future due to a higher population prevalence of pollen sensitization as well as earlier, longer, and more intense pollen seasons, trends attributed to climate change. The effects of pollen on health outcomes have previously been studied through cross-sectional design or at two time points, namely preceding and within the period of pollen exposure. We are not aware of any observational study in adults that has analyzed the dose-response relationship between daily ambient pollen concentration and cardiovascular, pulmonary, cognitive, sleep, or quality of life outcomes. Many studies have relied on self-reported pollen allergy status rather than objectively confirming pollen sensitization. In addition, many studies lacked statistical power due to small sample sizes or were highly restrictive with their inclusion criteria, making the findings less transferable to the “real world.” Methods: The EPOCHAL study is an observational panel study which aims to relate ambient pollen concentration to six specific health domains: (1) pulmonary function and inflammation; (2) cardiovascular outcomes (blood pressure and heart rate variability); (3) cognitive performance; (4) sleep; (5) health-related quality of life (HRQoL); and (6) allergic rhinitis symptom severity. Our goal is to enroll 400 individuals with diverse allergen sensitization profiles. The six health domains will be assessed while ambient exposure to pollen of different plants naturally varies. Health data will be collected through six home nurse visits (at approximately weekly intervals) as well as 10 days of independent tracking of blood pressure, sleep, cognitive performance, HRQoL, and symptom severity by participants. Through repeated health assessments, we aim to uncover and characterize dose-response relationships between exposure to different species of pollen and numerous acute health effects, considering (non-)linearity, thresholds, plateaus and slopes. Conclusion: A gain of knowledge in pollen-health outcome relationships is critical to inform future public health policies and will ultimately lead toward better symptom forecasts and improved personalized prevention and treatment.

Objective Children and adolescents living in agricultural areas are likely to be exposed to mixtures of pesticides during their daily activities, which may impair their neurodevelopment. We investigated various such activities in relation to headache severity and neurodevelopment of school-children living in rural agricultural areas in the Western Cape of South Africa. Method We used baseline date from 1001 school-children of the Child Health Agricultural Pesticide Cohort Study in South Africa (CapSA) aged 9–16 from seven schools and three agriculture areas in the Western Cape. Questionnaires were administrated to assess activities related to pesticide exposure and health symptoms addressing four types of activities: 1) child farm activities related to pesticide handling, 2) eating crops directly from the field, 3) contact with surface water around the field, and 4) seen and smelt pesticide spraying activities. Neurocognitive performance across three domains of attention, memory and processing speed were assessed by means of an iPad-based cognitive assessment tool, Cambridge Automated NeuroPsychological Battery (CANTAB). Headache severity was enquired using a standard Headache Impact Test (HIT-6) tool. Cross-sectional regression analysis was performed. Results About 50% of the cohort report to have ever been engaged in activities related to pesticide exposure including farm activities, eating crops directly from the field and leisure activities. Headache severity score was consistently increased in relation to pesticide-related farm activities (score increase of 1.99; 95% CI: 0.86, 3.12), eating crops (1.52; 0.41, 2.67) and leisure activities of playing, swimming or bathing in nearby water (1.25; 0.18, 2.33). For neurocognitive outcomes, an overall negative trend with pesticide exposure-related activities was observed. Among others, involvement in pesticide-related farm activities was associated with a lower multi-tasking accuracy score (−2.74; −5.19, −0.29), while lower strategy in spatial working memory (−0.29; −0.56; −0.03) and lower paired associated learning (−0.88; −1.60, −0.17) was observed for those who pick crops off the field compared to those who do not pick crops off the field. Eating fruits directly from the vineyard or orchard was associated with a lower motor screening speed (−0.06; −0.11, −0.01) and lower rapid visual processing accuracy score (−0.02; −0.03, 0.00). Conclusions Children who indicate activities related to pesticide exposure may be at higher risk for developing headaches and lower cognitive performance in the domains of attention, memory and processing speed. However, self-reported data and cross-sectional design are a limitation. Future research in CapSA will consider pesticide exposure estimations via urinary biomarkers and longitudinal assessment of cognitive functions.

Longitudinal shifts in pollen onset, duration, and intensity are public health concerns for the growing number of individuals with pollen sensitization. National analyses of long-term pollen changes are influenced by how a plant's main pollen season (MPS) is defined. Prior Swiss studies have inconsistently applied MPS definitions, leading to heterogeneous conclusions regarding the magnitude, directionality, and significance of multi-decade pollen trends. We examined national pollen data in Switzerland between 1990 and 2020, applying six MPS definitions (2 percentage-based and 4 threshold-based) to twelve relevant allergenic plants. We analyzed changes in pollen season using both linear regression and locally estimated scatterplot smoothing (LOESS). For 4 of the 12 plant species, there is unanimity between definitions regarding earlier onset of pollen season (p < 0.05), with magnitude of 31-year change dependent on specific MPS definition (hazel: 9–18 days; oak: 5–13 days; grasses: 8–25 days; and nettle/hemp: 6–25 days). There is also consensus (p < 0.05) for modified MPS duration among hazel (21–104% longer), nettle/hemp (8–52% longer), and ash (18–38% shorter). Between-definition agreement is highest for MPS intensity analysis, with consensus for significant increases in seasonal pollen quantity (p < 0.05) among hazel, birch, oak, beech, and nettle/hemp. The largest relative intensification is noted for hazel (110–146%) and beech (162–237%). LOESS analysis indicates that these multi-decade pollen changes are typically nonlinear. The robustness of MPS definitions is highly dependent on annual pollen accumulation, with definition choice particularly influential for long-term analysis of low-pollen plants such as ragweed. We identify systematic differences between MPS definitions and suggest future aerobiologic studies apply multiple definitions to minimize bias. In summary, national pollen onset, duration, and intensity have shifted for some plants in Switzerland, with MPS definition choice affecting magnitude and significance of these variations. Future public health research can determine whether these temporal and quantitative pollen changes correlate with longitudinal differences in population pollen sensitization., Graphical abstract Unlabelled Image, Highlights • We analyzed 3 decades of Swiss data for 12 plants using 6 pollen season definitions. • Over 1990–2020, pollen seasons began earlier for hazel, oak, grasses and nettle/hemp. • Pollen accumulation intensified for hazel, birch, oak, beech and nettle/hemp. • Pollen season definition impacts magnitude, direction, and significance of trends. • Climate change is impacting public health through changes in pollen release.

Mobile phone use, predominantly smartphones, is almost ubiquitous amongst both adults and children. However adults and children have different usage patterns. A major challenge with research on mobile phone use is the reliability of self-reported phone activity for accurate exposure assessment. We investigated the agreement between self-reported mobile phone use data and objective mobile operator traffic data in a subset of adolescents aged 11–12 years participating in the Study of Cognition, Adolescents and Mobile Phones (SCAMP) cohort. We examined self-reported mobile phone use, including call frequency, cumulative call time duration and text messages sent among adolescents from SCAMP and matched these data with records provided by mobile network operators (n = 350). The extent of agreement between self-reported mobile phone use and mobile operator traffic data use was evaluated using Cohen's weighted Kappa (ĸ) statistics. Sensitivity and specificity of self-reported low (< 1 call/day, ≤ 5 min of call/day or ≤ 5 text messages sent/day) and high (≥ 11 calls/day, > 30 min of call/day or ≥ 11 text messages sent /day) use were estimated. Agreement between self-reported mobile phone use and mobile operator traffic data was highest for the duration spent talking on mobile phones per day on weekdays (38.9%) and weekends (29.4%) compared to frequency of calls and number of text messages sent. Adolescents overestimated their mobile phone use during weekends compared to weekdays. Analysis of agreement showed little difference overall between the sexes and socio-economic groups. Weighted kappa between self-reported and mobile operator traffic data for call frequency during weekdays was κ = 0.12, 95% CI 0.06–0.18. Of the three modes of mobile phone use measured in the questionnaire, call frequency was the most sensitive for low mobile phone users on weekdays and weekends (77.1, 95% CI: 69.3—83.7 and 72.0, 95% CI: 65.0–78.4, respectively). Specificity was moderate to high for high users with the highest for call frequency during weekdays (98.4, 95% CI: 96.4–99.5). Despite differential agreement between adolescents’ self-reported mobile phone use and mobile operator traffic data, our findings demonstrate that self-reported usage adequately distinguishes between high and low use. The greater use of mobile smartphones over Wi-Fi networks by adolescents, as opposed to mobile phone networks, means operator data are not the gold standard for exposure assessment in this age group. This has important implications for epidemiologic research on the health effects of mobile phone use in adolescents., Highlights • We assessed the validity of adolescents’ self-reported mobile phone use. • The study accounted for weekday and weekend use of mobile phones separately. • Findings show that self-reported usage distinguishes between high and low use. • We recommend a combination of self-reported use over Wi-Fi & operator traffic data. • Combined data will improve accurate exposure estimation in epidemiological studies.

Communication technologies are rapidly changing and this may affect public exposure to radiofrequency electromagnetic fields (RF-EMF). This systematic review of literature aims to update a previous review on public everyday RF-EMF exposure in Europe, which covered publications until 2015. From 144 eligible records identified by means of a systematic search in PubMed, Embase and Web of Knowledge databases, published between May 2015 and 1 July 2018, 26 records met the inclusion criteria. We extracted quantitative data on public exposure in different indoors, outdoors and transport environments. The data was descriptively analyzed with respect to the exposure patterns between different types of environments. Mean RF-EMF exposure in homes, schools and offices were between 0.04 and 0.76 V/m. Mean outdoor exposure values ranged from 0.07 to 1.27 V/m with downlink signals from mobile phone base stations being the most relevant contributor. RF-EMF levels tended to increase with increasing urbanity. Levels in public transport (bus, train and tram) and cars were between 0.14 and 0.69 V/m. The highest levels, up to 1.97 V/m, were measured in public transport stations with downlink as the most relevant contributor. In line with previous studies, RF-EMF exposure levels were highest in the transportation systems followed by outdoor and private indoor environments. This review does not indicate a noticeable increase in everyday RF-EMF exposure since 2012 despite increasing use of wireless communication devices.

Background: Exposure to ambient air pollution may be associated with impaired mental health, including depression. However, evidence originates mainly from animal studies and epidemiological studies in specific subgroups. We investigated the association between air pollution and depressed mood in four European general population cohorts.Methods: Data were obtained from LifeLines (the Netherlands), KORA (Germany), HUNT (Norway), and FINRISK (Finland). Residential exposure to particles (PM2.5, PM(2.5)absorbance, PM10) and nitrogen dioxide (NO2) was estimated using land use regression (LUR) models developed for the European Study of Cohorts for Air Pollution Effects (ESCAPE) and using European wide LUR models. Depressed mood was assessed with interviews and questionnaires. Logistic regression analyses were used to investigate the cohort specific associations between air pollution and depressed mood.Results: A total of 70,928 participants were included in our analyses. Depressed mood ranged from 1.6% (KORA) to 11.3% (FINRISK). Cohort specific associations of the air pollutants and depressed mood showed heterogeneous results. For example, positive associations were found for NO2 in LifeLines (odds ratio [OR] = 1.34; 95% CI: 1.17, 1.53 per 10 mu g/m(3) increase in NO2), whereas negative associations were found in HUNT (OR= 0.79; 95% CI: 0.66, 0.94 per 10 mu g/m(3) increase in NO2).Conclusions: Our analyses of four European general population cohorts found no consistent evidence for an association between ambient air pollution and depressed mood. (C) 2015 Elsevier GmbH. All rights reserved.

Background Electronic media use is increasing in low- and middle-income countries, thus we aim to investigate the prevalence of different aspects of e-media use and its association to symptoms and neurocognitive outcomes in rural South Africa. Methods In the cohort study, “Child health Agricultural Pesticide study in South Africa (CapSA)”, of 1001 children and adolescents, aged 9–16 years, we enquired at baseline about the following aspects of e-media use: (1) call duration (2) total screen time (3) night-time awakenings from mobile phone use, and (4) Mobile Phone Problematic Use. Four health outcomes were included: sleep disturbance, health related quality of life (HRQoL), headaches and cognitive performance, assessed through six tests on domains of attention, memory and processing speed, using the iPad-based software, CAmbridge Neuropsychological Test Automated Battery (CANTAB). Linear regression analysis adjusted for relevant confounders was conducted with categorized exposure variables low, medium and high use. Results One third of the cohort (31.8%) are mobile phone users reporting average duration of calls per day up to 75 min (mean = 2.5 mins; SD = 8.9 mins). Amongst 46% of the cohort who report e-media device use, total screen time ranged from 1 min to 441 min (mean = 28.3; SD = 53.0). Findings Amongst those reporting regular night-time awakenings (≥1 times per week) from mobile phones, HRQol declined by 2.9 (95% CI: −6.1, 0.3), the sleep disturbance score increased by 2.0 (1.1, 2.9) units and headache impact score significantly increased by 5.4 (2.6; 8.2) units compared to non-exposed. Cognitive performance scores tended to be slightly improved mostly in moderate e-media users. The reaction response speed was consistently improved amongst all four exposure groups compared to non-users. Conclusion These results are among the first from Africa on benefits and risks associated with e-media use. Our findings imply that with regard to the education of adolescents, a vigilant balance is needed to profit from the beneficial effects of moderate e-media use on cognition, while preventing the negative side effects for HRQoL, sleep disturbance and headache severity.

We aimed to assess the personal radiofrequency electromagnetic field (RF-EMF) exposure levels of children and adults through their activities, with consideration to the body shadowing effect. We recruited 50 child-adult pairs, living in Seoul, Cheonan, and Ulsan, South Korea. RF-EMF measurements were performed between September and December 2016, using a portable exposure meter tailored to capture 14 Korean radiofrequency (RF) bands ranging from 87.5 to 5875MHz. The participants carried the device for 48h and kept a time-activity diary using a smartphone application in flight mode. To enhance accuracy of the exposure assessment, the body shadowing effect was compensated during the statistical analysis with the measured RF-EMF exposure. The compensation was conducted using the hybrid model that represents the decrease of the exposure level due to the body shadowing effect. A generalized linear mixed model was used to compare the RF-EMF exposure levels by subjects and activities. The arithmetic (geometric) means of the total power density were 174.9 (36.6) μW/m2 for all participants, 226.9 (44.6) for fathers, 245.4 (44.8) for mothers, and 116.2 (30.1) for children. By compensating for the body shadowing effect, the total RF-EMF exposure increased marginally, approximately 1.4 times. Each frequency band contribution to total RF-EMF exposure consisted of 76.7%, 2.4%, 9.9%, 5.0%, 3.3%, and 2.6% for downlink, uplink, WiFi, FM Radio, TV, and WiBro bands, respectively. Among the three regions, total RF-EMF exposure was highest in Seoul, and among the activities, it was highest in the metro, followed by foot/bicycle, bus/car, and outside. The contribution of base-station exposure to total RF-EMF exposure was the highest both in parents and children. Total and base-station RF-EMF exposure levels in Korea were higher than those reported in European countries.

A multi-band Body-Worn Distributed exposure Meter (BWDM) calibrated for simultaneous measurement of the incident power density in 11 telecommunication frequency bands, is proposed. The BDWM consists of 22 textile antennas integrated in a garment and is calibrated on six human subjects in an anechoic chamber to assess its measurement uncertainty in terms of 68% confidence interval of the on-body antenna aperture. It is shown that by using multiple antennas in each frequency band, the uncertainty of the BWDM is 22 dB improved with respect to single nodes on the front and back of the torso and variations are decreased to maximum 8.8 dB. Moreover, deploying single antennas for different body morphologies results in a variation up to 9.3 dB, which is reduced to 3.6 dB using multiple antennas for six subjects with various body mass index values. The designed BWDM, has an improved uncertainty of up to 9.6 dB in comparison to commercially available personal exposure meters calibrated on body. As an application, an average incident power density in the range of 26.7-90.8 muW.m - 2 is measured in Ghent, Belgium. The measurements show that commercial personal exposure meters underestimate the actual exposure by a factor of up to 20.6.

Background: The potential impact of microwave radiofrequency electromagnetic fields (RF-EMF) emitted by wireless communication devices on neurocognitive functions of adolescents is controversial. In a previous analysis, we found changes in figural memory scores associated with a higher cumulative RF-EMF brain dose in adolescents. Objective: We aimed to follow-up our previous results using a new study population, dose estimation, and approach to controlling for confounding from media usage itself. Methods: RF-EMF brain dose for each participant was modeled. Multivariable linear regression models were fitted on verbal and figural memory score changes over 1 y and on estimated cumulative brain dose and RF-EMF related and unrelated media usage (n=669–676). Because of the hemispheric lateralization of memory, we conducted a laterality analysis for phone call ear preference. To control for the confounding of media use behaviors, a stratified analysis for different media usage groups was also conducted. Results: We found decreased figural memory scores in association with an interquartile range (IQR) increase in estimated cumulative RF-EMF brain dose scores: −0.22 (95% CI: −0.47, 0.03; IQR: 953 mJ/kg per day) in the whole sample, −0.39 (95% CI: −0.67, −0.10; IQR: 953 mJ/kg per day) in right-side users (n=532), and −0.26 (95% CI: −0.42, −0.10; IQR: 341 mJ/kg per day) when recorded network operator data were used for RF-EMF dose estimation (n=274). Media usage unrelated to RF-EMF did not show significant associations or consistent patterns, with the exception of consistent (nonsignificant) positive associations between data traffic duration and verbal memory. Conclusions: Our findings for a cohort of Swiss adolescents require confirmation in other populations but suggest a potential adverse effect of RF-EMF brain dose on cognitive functions that involve brain regions mostly exposed during mobile phone use. https://doi.org/10.1289/EHP2427

Indoor air quality is a growing concern as we spend the majority of time indoors and as new buildings are increasingly airtight for energy saving purposes. For a better understanding of residential indoor air pollution in Switzerland we conducted repeated 1 2 week long indoor and outdoor measurements of particle number concentrations (PNC) particulate matter (PM) light absorbance of PM2.5 (PMabsorbance) and nitrogen dioxide (NO2). Residents of all homes were enrolled in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). Indoor levels were comparable in urban areas and generally low in rural homes. Average indoor levels were 7800 particles/cm(3) (interquartile range=7200); 8.7?µg/m(3) (6.5) PM2.5 and 10.2?µg/m(3) (11.2) NO2. All pollutants showed large variability of indoor/outdoor ratios between sites. We observed similar diurnal patterns for indoor and outdoor PNC. Nevertheless the correlation of average indoor and outdoor PNC between sites as well as longitudinal indoor/outdoor correlations within sites were low. Our results show that a careful evaluation of home characteristics is needed when estimating indoor exposure to pollutants with outdoor origin.Journal of Exposure Science and Environmental Epidemiology advance online publication 11 February 2015; doi:10.1038/jes.2015.3.

Aims: Elevation of a child's blood pressure may cause possible health risks in later life. There is evidence for adverse effects of exposure to air pollution and noise on blood pressure in adults. Little is known about these associations in children. We investigated the associations of air pollution and noise exposure with blood pressure in 12-year-olds. Methods: Blood pressure was measured at age 12 years in 1432 participants of the PIAMA birth cohort study. Annual average exposure to traffic-related air pollution [NO2, mass concentrations of particulate matter with diameters of less than 2.5 μm (PM2.5) and less than 10 μm (PM10), and PM2.5 absorbance] at the participants' home and school addresses at the time of blood pressure measurements was estimated by land-use regression models. Air pollution exposure on the days preceding blood pressure measurements was estimated from routine air monitoring data. Long-term noise exposure was assessed by linking addresses to modelled equivalent road traffic noise levels. Associations of exposures with blood pressure were analysed by linear regression. Effects are presented for an interquartile range increase in exposure. Results: Long-term exposure to NO2 and PM2.5 absorbance were associated with increased diastolic blood pressure, in children who lived at the same address since birth [adjusted mean difference (95% confidence interval) [mmHg] 0.83 (0.06 to 1.61) and 0.75 (-0.08 to 1.58), respectively], but not with systolic blood pressure. We found no association of blood pressure with short-term air pollution or noise exposure. Conclusions: Long-term exposure to traffic-related air pollution may increase diastolic blood pressure in children.

BACKGROUND: Research examining associations between air pollution exposure and respiratory symptoms in adults has generally been inconclusive. This may be related in part to sample size issues, which also preclude analysis in potentially vulnerable subgroups. OBJECTIVES: We estimated associations between air pollution exposures and the prevalence of wheeze and shortness of breath using harmonized baseline data from two very large European cohorts, Lifelines (2006-2013) and UK Biobank (2006-2010). Our aim was also to determine whether the relationship between air pollution and respiratory symptom prevalence differed between individuals with different characteristics. METHODS: Cross-sectional analyses explored associations between prevalence of self-reported wheeze and shortness of breath and annual mean particulate matter with aerodynamic diameter

Objectives The World Health Organization has developed ambient air quality guidelines at levels considered to be safe or of acceptable risk for human health. These guidelines are meant to support governments in defining national standards. It is unclear how they are followed. Methods We compiled an inventory of ambient air quality standards for 194 countries worldwide for six air pollutants: PM2.5, PM10, ozone, nitrogen dioxide, sulphur dioxide and carbon monoxide. We conducted literature and internet searches and asked country representatives about national ambient air quality standards. Results We found information on 170 countries including 57 countries that did not set any air quality standards. Levels varied greatly by country and by pollutant. Ambient air quality standards for PM2.5, PM10 and SO2 poorly complied with WHO guideline values. The agreement was higher for CO, SO2 (10-min averaging time) and NO2. Conclusions Regulatory differences mirror the differences in air quality and the related burden of disease around the globe. Governments worldwide should adopt science based air quality standards and clean air management plans to continuously improve air quality locally, nationally, and globally. Electronic supplementary material The online version of this article (doi:10.1007/s00038-017-0952-y) contains supplementary material, which is available to authorized users.

BACKGROUND: Few studies on long-term exposure to air pollution and mortality have been reported from Europe. Within the multicentre European Study of Cohorts for Air Pollution Effects (ESCAPE), we aimed to investigate the association between natural-cause mortality and long-term exposure to several air pollutants. METHODS: We used data from 22 European cohort studies, which created a total study population of 367,251 participants. All cohorts were general population samples, although some were restricted to one sex only. With a strictly standardised protocol, we assessed residential exposure to air pollutants as annual average concentrations of particulate matter (PM) with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and between 10 μm and 2.5 μm (PMcoarse), PM2.5 absorbance, and annual average concentrations of nitrogen oxides (NO2 and NOx), with land use regression models. We also investigated two traffic intensity variables-traffic intensity on the nearest road (vehicles per day) and total traffic load on all major roads within a 100 m buffer. We did cohort-specific statistical analyses using confounder models with increasing adjustment for confounder variables, and Cox proportional hazards models with a common protocol. We obtained pooled effect estimates through a random-effects meta-analysis. FINDINGS: The total study population consisted of 367,251 participants who contributed 5,118,039 person-years at risk (average follow-up 13.9 years), of whom 29,076 died from a natural cause during follow-up. A significantly increased hazard ratio (HR) for PM2.5 of 1.07 (95% CI 1.02-1.13) per 5 μg/m(3) was recorded. No heterogeneity was noted between individual cohort effect estimates (I(2) p value=0.95). HRs for PM2.5 remained significantly raised even when we included only participants exposed to pollutant concentrations lower than the European annual mean limit value of 25 μg/m(3) (HR 1.06, 95% CI 1.00-1.12) or below 20 μg/m(3) (1.07, 1.01-1.13). INTERPRETATION: Long-term exposure to fine particulate air pollution was associated with natural-cause mortality, even within concentration ranges well below the present European annual mean limit value. FUNDING: European Community's Seventh Framework Program (FP7/2007-2011).

The impact of the introduction and advancement in communication technology in recent years on exposure level of the population is largely unknown. The main aim of this study is to systematically review literature on the distribution of radiofrequency electromagnetic field (RF-EMF) exposure in the everyday environment in Europe and summarize key characteristics of various types of RF-EMF studies conducted in the European countries. We systematically searched the ISI Web of Science for relevant literature published between 1 January 2000 and 30 April 2015, which assessed RF-EMF exposure levels by any of the methods: spot measurements, personal measurement with trained researchers and personal measurement with volunteers. Twenty-one published studies met our eligibility criteria of which 10 were spot measurements studies, 5 were personal measurement studies with trained researchers (microenvironmental), 5 were personal measurement studies with volunteers and 1 was a mixed methods study combining data collected by volunteers and trained researchers. RF-EMF data included in the studies were collected between 2005 and 2013. The mean total RF-EMF exposure for spot measurements in European "Homes" and "Outdoor" microenvironments was 0.29 and 0.54 V/m, respectively. In the personal measurements studies with trained researchers, the mean total RF-EMF exposure was 0.24 V/m in "Home" and 0.76 V/m in "Outdoor". In the personal measurement studies with volunteers, the population weighted mean total RF-EMF exposure was 0.16 V/m in "Homes" and 0.20 V/m in "Outdoor". Among all European microenvironments in "Transportation", the highest mean total RF-EMF 1.96 V/m was found in trains of Belgium during 2007 where more than 95% of exposure was contributed by uplink. Typical RF-EMF exposure levels are substantially below regulatory limits. We found considerable differences between studies according to the type of measurements procedures, which precludes cross-country comparison or evaluating temporal trends. A comparable RF-EMF monitoring concept is needed to accurately identify typical RF-EMF exposure levels in the everyday environment.

Background: There is evidence for adverse effects of outdoor air pollution on lung function of children. Quantitative summaries of the effects of air pollution on lung function, however, are lacking due to large differences among studies. Objectives: We aimed to study the association between residential exposure to air pollution and lung function in five European birth cohorts with a standardized exposure assessment following a common protocol. Methods: As part of the European Study of Cohorts for Air Pollution Effects (ESCAPE) we analyzed data from birth cohort studies situated in Germany, Sweden, the Netherlands, and the United Kingdom that measured lung function at 6–8 years of age (n = 5,921). Annual average exposure to air pollution [nitrogen oxides (NO2, NOx), mass concentrations of particulate matter with diameters < 2.5, < 10, and 2.5–10 μm (PM2.5, PM10, and PMcoarse), and PM2.5 absorbance] at the birth address and current address was estimated by land-use regression models. Associations of lung function with estimated air pollution levels and traffic indicators were estimated for each cohort using linear regression analysis, and then combined by random effects meta-analysis. Results: Estimated levels of NO2, NOx, PM2.5 absorbance, and PM2.5 at the current address, but not at the birth address, were associated with small decreases in lung function. For example, changes in forced expiratory volume in 1 sec (FEV1) ranged from –0.86% (95% CI: –1.48, –0.24%) for a 20-μg/m3 increase in NOx to –1.77% (95% CI: –3.34, –0.18%) for a 5-μg/m3 increase in PM2.5. Conclusions: Exposure to air pollution may result in reduced lung function in schoolchildren. Citation: Gehring U, Gruzieva O, Agius RM, Beelen R, Custovic A, Cyrys J, Eeftens M, Flexeder C, Fuertes E, Heinrich J, Hoffmann B, de Jongste JC, Kerkhof M, Klümper C, Korek M, Mölter A, Schultz ES, Simpson A, Sugiri D, Svartengren M, von Berg A, Wijga AH, Pershagen G, Brunekreef B. 2013. Air pollution exposure and lung function in children: the ESCAPE project. Environ Health Perspect 121:1357–1364; http://dx.doi.org/10.1289/ehp.1306770

Background Land Use Regression (LUR) is a popular method to explain and predict spatial contrasts in air pollution concentrations, but LUR models for ultrafine particles, such as particle number concentration (PNC) are especially scarce. Moreover, no models have been previously presented for the lung deposited surface area (LDSA) of ultrafine particles. The additional value of ultrafine particle metrics has not been well investigated due to lack of exposure measurements and models. Methods Air pollution measurements were performed in 2011 and 2012 in the eight areas of the Swiss SAPALDIA study at up to 40 sites per area for NO2 and at 20 sites in four areas for markers of particulate air pollution. We developed multi-area LUR models for biannual average concentrations of PM2.5, PM2.5 absorbance, PM10, PMcoarse, PNC and LDSA, as well as alpine, non-alpine and study area specific models for NO2, using predictor variables which were available at a national level. Models were validated using leave-one-out cross-validation, as well as independent external validation with routine monitoring data. Results Model explained variance (R2) was moderate for the various PM mass fractions PM2.5 (0.57), PM10 (0.63) and PMcoarse (0.45), and was high for PM2.5 absorbance (0.81), PNC (0.87) and LDSA (0.91). Study-area specific LUR models for NO2 (R2 range 0.52–0.89) outperformed combined-area alpine (R2 = 0.53) and non-alpine (R2 = 0.65) models in terms of both cross-validation and independent external validation, and were better able to account for between-area variability. Predictor variables related to traffic and national dispersion model estimates were important predictors. Conclusions LUR models for all pollutants captured spatial variability of long-term average concentrations, performed adequately in validation, and could be successfully applied to the SAPALDIA cohort. Dispersion model predictions or area indicators served well to capture the between area variance. For NO2, applying study-area specific models was preferable over applying combined-area alpine/non-alpine models. Correlations between pollutants were higher in the model predictions than in the measurements, so it will remain challenging to disentangle their health effects. Electronic supplementary material The online version of this article (doi:10.1186/s12940-016-0137-9) contains supplementary material, which is available to authorized users.

Background Adolescents belong to the heaviest users of wireless communication devices, but little is known about their personal exposure to radiofrequency electromagnetic fields (RF-EMF). Objectives The aim of this paper is to describe personal RF-EMF exposure of Swiss adolescents and evaluate exposure relevant factors. Furthermore, personal measurements were used to estimate average contributions of various sources to the total absorbed RF-EMF dose of the brain and the whole body. Methods Personal exposure was measured using a portable RF-EMF measurement device (ExpoM-RF) measuring 13 frequency bands ranging from 470 to 3600 MHz. The participants carried the device for three consecutive days and kept a time-activity diary. In total, 90 adolescents aged 13 to 17 years participated in the study conducted between May 2013 and April 2014. In addition, personal measurement values were combined with dose calculations for the use of wireless communication devices to quantify the contribution of various RF-EMF sources to the daily RF-EMF dose of adolescents. Results Main contributors to the total personal RF-EMF measurements of 63.2 μW/m2 (0.15 V/m) were exposures from mobile phones (67.2%) and from mobile phone base stations (19.8%). WLAN at school and at home had little impact on the personal measurements (WLAN accounted for 3.5% of total personal measurements). According to the dose calculations, exposure from environmental sources (broadcast transmitters, mobile phone base stations, cordless phone base stations, WLAN access points, and mobile phones in the surroundings) contributed on average 6.0% to the brain dose and 9.0% to the whole-body dose. Conclusions RF-EMF exposure of adolescents is dominated by their own mobile phone use. Environmental sources such as mobile phone base stations play a minor role.

Background: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population. Objective: To evaluate the association between long-term exposure to ambient air pollution and BC incidence. Design, setting, and participants: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N =303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NO x ), particulate matter (PM) with diameter 10), 2.5), between 2.5 and 10μm (PM2.5-10), PM2.5 absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project. Outcome measurements and statistical analysis: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence. Results and limitations: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m3 increase in NO2 and 5-μg/m3 increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure. Conclusions: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC. Patient summary: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk. We assessed the link between outdoor air pollution at the place of residence and bladder cancer using the largest study population to date, extensive assessment of exposure, and comprehensive data on personal risk factors. Exposure to outdoor air pollution was not associated with bladder cancer incidence.

Background: Childhood blood pressure is an important predictor of hypertension and cardiovascular disease in adulthood. Evidence for an association between ambient particulate matter (PM) exposure and blood pressure is increasing, but little is known about the relevance of different PM constituents. Objectives: We investigated the association between particulate matter composition and blood pressure at age 12 years. Methods: Annual average concentrations of copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc in particles with diameters of less than 2.5 μm (PM2.5) and 10 μm (PM10) were estimated by land-use regression modeling for the home addresses of the participants of the prospective PIAMA birth cohort study. Associations between element concentrations and blood pressure measurements performed at age 12 years were investigated by linear regression with and without adjustment for confounders. Results: After adjustment for potential confounders we found statistically significant positive associations of diastolic blood pressure with iron, silicon, and potassium in PM10 in children who lived at the same address since birth [mean difference (95% confidence interval) 0.67 (0.02;1.31) mm Hg, 0.85 (0.18;1.52) mm Hg, and 0.75 (0.09;1.41) mm Hg, respectively, per interquartile range increase in exposure]. Also, we found marginally significant (p

Although there is evidence that ultrafine particles (UFP) do affect human health there are currently no legal ambient standards. The main reasons are the absence of spatially resolved exposure data to investigate long-term health effects and the challenge of defining representative reference sites for monitoring given the high dependence of UFP on proximity to sources. The objectives of this study were to evaluate the spatial distribution of UFP in four areas of the Swiss Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) and to investigate the representativeness of routine air monitoring stations for residential sites in these areas. Repeated UFP measurements during three seasons have been conducted at a total of 80 residential sites and four area specific reference sites over a median duration of 7 days. Arithmetic mean residential PNC scattered around the median of 10,800 particles/cm(3) (interquartile range [IQR] = 7800 particles/cm(3)). Spatial within area contrasts (90th/10th percentile ratios) were around two; increased contrasts were observed during weekday rush-hours. Temporal UFP patterns were comparable at reference and residential sites in all areas. Our data show that central monitoring sites can represent residential conditions when locations are well chosen with respect to the local sources--namely traffic. For epidemiological research, locally resolved spatial models are needed to estimate individuals' long-term exposures to UFP of outdoor origin at home, during commute and at work.

Background: ambient particulate matter (PM) exposure is associated with children's respiratory health. little is known about the importance of different PM constituents. We investigated the effects of PM constituents on asthma, allergy, and lung function until the age of 11-12 years. Methods: For 3,702 participants of a prospective birth cohort study, questionnaire-reported asthma and hay fever and measurements of allergic sensitization and lung function were linked with annual average concentrations of copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc in particles with diameters of less than 2.5 and 10 μm (PM2.5 and PM10) at birth addresses and current addresses from land-use regression models. exposure-health relations were analyzed by multiple (repeated measures) logistic and linear regressions. Results: asthma incidence and prevalence of asthma symptoms and rhinitis were positively associated with zinc in PM10 at the birth address (odds ratio [95% confidence interval] per interquartile range increase in exposure 1.13 [1.02, 1.25], 1.08 [1.00, 1.17], and 1.16 [1.04, 1.30], respectively). Moreover, asthma symptoms were positively associated with copper in PM10 at the current address (1.06 [1.00, 1.12]). allergic sensitization was positively associated with copper and iron in PM10 at the birth address (relative risk [95% con-fidence interval] 1.07 [1.01, 1.14] and 1.10 [1.03, 1.18]) and current address. Forced expiratory volume in 1 second was negatively associated with copper and iron in PM2.5 (change [95% confidence interval]-2.1% [-1.1,-0.1%] and-1.0% [-2.0,-0.0%]) and FeF75-50 with copper in PM10 at the current address (-2.3% [-4.3,-0.3%]). Conclusion: PM constituents, in particular iron, copper, and zinc, reflecting poorly regulated non-tailpipe road traffic emissions, may increase the risk of asthma and allergy in schoolchildren.

Given the shrinking spatial contrasts in outdoor air pollution in Switzerland and the trends toward tightly insulated buildings, the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) needs to understand to what extent outdoor air pollution remains a determinant for residential indoor exposure. The objectives of this paper are to identify determining factors for indoor air pollution concentrations of particulate matter (PM), ultrafine particles in the size range from 15 to 300 nm, black smoke measured as light absorbance of PM (PMabsorbance) and nitrogen dioxide (NO2) and to develop predictive indoor models for SAPALDIA. Multivariable regression models were developed based on indoor and outdoor measurements among homes of selected SAPALDIA participants in three urban (Basel, Geneva, Lugano) and one rural region (Wald ZH) in Switzerland, various home characteristics and reported indoor sources such as cooking. Outdoor levels of air pollutants were important predictors for indoor air pollutants, except for the coarse particle fraction. The fractions of outdoor concentrations infiltrating indoors were between 30% and 66%, the highest one was observed for PMabsorbance. A modifying effect of open windows was found for NO2 and the ultrafine particle number concentration. Cooking was associated with increased particle and NO2 levels. This study shows that outdoor air pollution remains an important determinant of residential indoor air pollution in Switzerland. Keywords: Indoor air pollution, Multivariable regression models, Particulate matter, Particle number concentration, Ultrafine particles, Nitrogen dioxide, SAPALDIA, Switzerland

The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE).Residential exposure to nitrogen oxides (NO2, NOx) and particulate matter (PM) was modelled and traffic indicators were assessed in a standardised manner. The spirometric parameters forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from 7613 subjects were considered as outcomes. Cohort-specific results were combined using meta-analysis.We did not observe an association of air pollution with longitudinal change in lung function, but we observed that a 10 μg·m−3 increase in NO2 exposure was associated with lower levels of FEV1 (−14.0 mL, 95% CI −25.8 to −2.1) and FVC (−14.9 mL, 95% CI −28.7 to −1.1). An increase of 10 μg·m−3 in PM10, but not other PM metrics (PM2.5, coarse fraction of PM, PM absorbance), was associated with a lower level of FEV1 (−44.6 mL, 95% CI −85.4 to −3.8) and FVC (−59.0 mL, 95% CI −112.3 to −5.6). The associations were particularly strong in obese persons.This study adds to the evidence for an adverse association of ambient air pollution with lung function in adults at very low levels in Europe.

Background Studies have shown associations between mortality and long-term exposure to particulate matter air pollution. Few cohort studies have estimated the effects of the elemental composition of particulate matter on mortality. Objectives Our aim was to study the association between natural-cause mortality and long-term exposure to elemental components of particulate matter. Methods Mortality and confounder data from 19 European cohort studies were used. Residential exposure to eight a priori–selected components of particulate matter (PM) was characterized following a strictly standardized protocol. Annual average concentrations of copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc within PM size fractions ≤ 2.5 μm (PM2.5) and ≤ 10 μm (PM10) were estimated using land-use regression models. Cohort-specific statistical analyses of the associations between mortality and air pollution were conducted using Cox proportional hazards models using a common protocol followed by meta-analysis. Results The total study population consisted of 291,816 participants, of whom 25,466 died from a natural cause during follow-up (average time of follow-up, 14.3 years). Hazard ratios were positive for almost all elements and statistically significant for PM2.5 sulfur (1.14; 95% CI: 1.06, 1.23 per 200 ng/m3). In a two-pollutant model, the association with PM2.5 sulfur was robust to adjustment for PM2.5 mass, whereas the association with PM2.5 mass was reduced. Conclusions Long-term exposure to PM2.5 sulfur was associated with natural-cause mortality. This association was robust to adjustment for other pollutants and PM2.5. Citation Beelen R, Hoek G, Raaschou-Nielsen O, Stafoggia M, Andersen ZJ, Weinmayr G, Hoffmann B, Wolf K, Samoli E, Fischer PH, Nieuwenhuijsen MJ, Xun WW, Katsouyanni K, Dimakopoulou K, Marcon A, Vartiainen E, Lanki T, Yli-Tuomi T, Oftedal B, Schwarze PE, Nafstad P, De Faire U, Pedersen NL, Östenson C-G, Fratiglioni L, Penell J, Korek M, Pershagen G, Eriksen KT, Overvad K, Sørensen M, Eeftens M, Peeters PH, Meliefste K, Wang M, Bueno-de-Mesquita HB, Sugiri D, Krämer U, Heinrich J, de Hoogh K, Key T, Peters A, Hampel R, Concin H, Nagel G, Jaensch A, Ineichen A, Tsai MY, Schaffner E, Probst-Hensch NM, Schindler C, Ragettli MS, Vilier A, Clavel-Chapelon F, Declercq C, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Katsoulis M, Trichopoulou A, Keuken M, Jedynska A, Kooter IM, Kukkonen J, Sokhi RS, Vineis P, Brunekreef B. 2015. Natural-cause mortality and long-term exposure to particle components: an analysis of 19 European cohorts within the Multi-Center ESCAPE Project. Environ Health Perspect 123:525–533; http://dx.doi.org/10.1289/ehp.1408095

Rationale: Prospective cohort studies have shown that chronic exposure to particulate matter and traffic-related air pollution is associated with reduced survival. However, the effects on nonmalignant respiratory mortality are less studied, and the data reported are less consistent. Objectives: We have investigated the relationship of long-term exposure to air pollution and nonmalignant respiratory mortality in 16 cohorts with individual level data within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE). Methods: Data from 16 ongoing cohort studies from Europe were used. The total number of subjects was 307,553. There were 1,559 respiratory deaths during follow-up. Measurements and Main Results: Air pollution exposure was estimated by land use regression models at the baseline residential addresses of study participants and traffic-proximity variables were derived from geographical databases following a standardized procedure within, the ESCAPE study. Cohort-specific hazard ratios obtained by Cox proportional hazard models from standardized individual cohort analyses were combined using metaanalyses. We found no significant associations between air pollution exposure and nonmalignant respiratory mortality. Most hazard ratios were slightly below unity, with the exception of the traffic-proximity indicators. Conclusions: In this study of 16 cohorts, there was no-association between air pollution exposure and nonmalignant respiratory mortality.

Land use regression (LUR) models are often used to predict long-term average concentrations of air pollutants. Little is known how well LUR models predict personal exposure. In this study, the agreement of LUR models with measured personal exposure was assessed. The measured components were particulate matter with a diameter smaller than 2.5 μm (PM2.5), soot (reflectance of PM2.5), nitrogen oxides (NOx), and nitrogen dioxide (NO2). In Helsinki, Utrecht, and Barcelona, 15 volunteers (from semiurban, urban background, and traffic sites) followed prescribed time activity patterns. Per participant, six 96 h outdoor, indoor, and personal measurements spread over three seasons were conducted. Soot LUR models were significantly correlated with measured average outdoor and personal soot concentrations. Soot LUR models explained 39%, 44%, and 20% of personal exposure variability (R(2)) in Helsinki, Utrecht, and Barcelona. NO2 LUR models significantly predicted outdoor concentrations and personal exposure in Utrecht and Helsinki, whereas NOx and PM2.5 LUR models did not predict personal exposure. PM2.5, NO2, and NOx models were correlated with personal soot, the component least affected by indoor sources. LUR modeled and measured outdoor, indoor, and personal concentrations were highly correlated for all pollutants when data from the three cities were combined. This study supports the use of intraurban LUR models for especially soot in air pollution epidemiology.

Objectives Land use regression (LUR) modelling is a popular method to estimate outdoor air pollution concentrations at the home and/or work addresses of individual subjects in epidemiological studies. Typically, such models are constructed using measurements from dedicated monitoring campaigns lasting up to 1 year. It is unknown to what extent such models can adequately predict concentrations in earlier or later time periods. We tested the stability of measured and modelled spatial contrasts in outdoor nitrogen dioxide (NO 2 ) pollution across the Netherlands over 8 years. Methods NO 2 measurements were conducted at 40 locations in the Netherlands in 1999–2000. In 2007, NO 2 was again measured at 144 locations, of which 35 were the same as in 1999–2000. This enabled us to compare measurements as well as model predictions between the two time periods. Results NO 2 measurements conducted in 2007 agreed well with NO 2 measurements taken in 1999–2000 at the same locations (R 2 =0.86). LUR models from 1999–2000 and 2007 explained 85% and 86% of observed spatial variance, respectively. The 2007 LUR model explained 77% of spatial variability in the 1999–2000 measurements and the 1999–2000 model explained 81% of variability in the 2007 measurements. Conclusion We found good agreement between measured spatial contrasts in outdoor NO 2 in 1999–2000 and 2007. LUR models predicted spatial contrast 8 years in the past (2007 model) and 8 years in the future (1999–2000 model) well. This supports the use of LUR models in epidemiological studies with health data available for a later or earlier timepoint.

Background: Subclinical atherosclerosis has been associated with long-term exposure to particulate matter (PM), but the relevance of particle size and sources of exposure remains unclear. Objectives: We investigated the association of long-term exposure to PM10 (≤ 10 μm), PM2.5 (≤ 2.5 μm: total mass, vehicular, and crustal sources), and ultrafine particles [UFP < 0.1 μm: particle number concentration (PNC) and lung-deposited surface area (LDSA)] with carotid intima-media thickness (CIMT). Methods: We used data from 1,503 participants ≥ 50 years old who participated in the third examination of the Swiss SAPALDIA cohort. Exposures were obtained from dispersion models and land-use regression models. Covariate information, including previous cardiovascular risk factors, was obtained from the second and third SAPALDIA examinations. Results: The adjusted percent difference in CIMT associated with an exposure contrast between the 10th and 90th percentile was 1.58% (95% CI: –0.30, 3.47%) for PM10, 2.10% (95% CI: 0.04, 4.16%) for PM2.5, 1.67% (95% CI: –0.13, 3.48%) for the vehicular source of PM2.5, –0.58% (95% CI: –3.95, 2.79%) for the crustal source of PM2.5, 2.06% (95% CI: 0.03, 4.10%) for PNC, and 2.32% (95% CI: 0.23, 4.40%) for LDSA. Stronger associations were observed among diabetics, subjects with low-educational level, and those at higher cardiovascular risk. Conclusions: CIMT was associated with exposure to PM10, PM2.5, and UFP. The PM2.5 source-specific analysis showed a positive association for the vehicular source but not for the crustal source. Although the effects of PNC and LDSA were similar in magnitude, two-pollutant and residual-based models suggested that LDSA may be a better marker for the health relevance of UFP. Citation: Aguilera I, Dratva J, Caviezel S, Burdet L, de Groot E, Ducret-Stich RE, Eeftens M, Keidel D, Meier R, Perez L, Rothe T, Schaffner E, Schmit-Trucksäss A, Tsai MY, Schindler C, Künzli N, Probst-Hensch N. 2016. Particulate matter and subclinical atherosclerosis: associations between different particle sizes and sources with carotid intima-media thickness in the SAPALDIA study. Environ Health Perspect 124:1700–1706; http://dx.doi.org/10.1289/EHP161