1. Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events: Results from 11 European Cohorts within the ESCAPE Project.
- Author
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Stafoggia, Massimo, Cesaroni, Giulia, Peters, Annette, Andersen, Zorana J., Badaloni, Chiara, Beelen, Rob, Caracciolo, Barbara, Cyrys, Josef, de Faire, Ulf, de Hoogh, Kees, Eriksen, Kirsten T., Fratiglioni, Laura, Galassi, Claudia, Gigante, Bruna, Havulinna, Aki S., Hennig, Frauke, Hilding, Agneta, Hoek, Gerard, Hoffmann, Barbara, and Houthuijs, Danny
- Subjects
STROKE risk factors ,AIR pollution ,CHI-squared test ,CONFIDENCE intervals ,LONGITUDINAL method ,META-analysis ,REGRESSION analysis ,RESEARCH funding ,ENVIRONMENTAL exposure ,PARTICULATE matter ,PROPORTIONAL hazards models ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
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: PM
2.5 [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). [ABSTRACT FROM AUTHOR]- Published
- 2014
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