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The COVID-19 pandemic in Germany in 2020 brought many regulations to impede its transmission such as lockdown. Hence, in this study, we compared the annual air pollutants (CO, NO, NO2, O3, PM10, PM2.5, and BC) in Augsburg in 2020 to the record data in 2010-2019. The annual air pollutants in 2020 were significantly (p, The work is funded by National Natural Science Foundation of China (42101470), Support Project of High-level Teachers in Beijing Municipal Universities in the Period of 13th Five–year Plan (CIT&TCD201904037), the Germany Federal Ministry of Transport and Digital Infrastructure (BMVI) as part of SmartAQnet (19F2003B), the dtec.bw -Digitalization and Technology Research Center of the Bundeswehr (project MORE). We would like to thank to the Administration of Augsburg City for giving access to the traffic data (Tiefbauamt, Markus Furnier).

ZusammenfassungDer zweite Teil des DGP-Positionspapiers zur Gesundheitsgefährdung durch Luftschadstoffe gibt eine Übersicht über die aktuelle Schadstoffbelastung in Deutschland und deren Entwicklung in den letzten 20 Jahren. Zum anderen werden die Effekte auf das kardiovaskuläre System und die zugrundeliegenden biologischen Mechanismen vorgestellt. Luftschadstoffe bilden ein hochkomplexes und dynamisches System aus Tausenden organischen und anorganischen Bestandteilen natürlichen oder anthropogenen Ursprungs. Die Schadstoffe werden lokal produziert oder durch Ferntransport über Hunderte von Kilometern regional eingebracht und dort zusätzlich durch die meteorologischen Verhältnisse modifiziert. Entsprechend den gesetzlichen Vorgaben wird die Qualität der Außenluft nach einheitlichen Vorgaben überwacht, die u. a. die Messung der Immission durch Feinstaub, mit bis zu 2,5 µm (PM2.5) oder bis 10 µm (PM10) aerodynamischem Durchmesser, sowie der Ozon (O3)- und der Stickstoffdioxidbelastung (NO2) vorsieht. Die Luftreinhaltungsmaßnamen haben dazu geführt, dass die Schadstoffbelastung in den vergangenen 20 Jahren in Deutschland deutlich zurückgegangen ist, sodass jetzt v. a. die Gesundheitsgefährdung bei geringer Belastung im Vordergrund steht. Überschreitungen der geltenden europäischen Grenzwerte für Schwefeldioxid, Kohlenmonoxid, Benzol und Blei werden nicht mehr beobachtet. Auch ist die Zahl der Tage mit erhöhten Ozonkonzentrationen zurückgegangen, wenngleich der Jahresmittelwert unverändert geblieben ist. Die Entwicklung von Feinstaub und NO2 ist zwar rückläufig, jedoch werden immer noch die geltenden Grenzwerte für NO2 in den Städten an etwa 40 % der verkehrsnahen Messstationen überschritten. Auch werden die strengeren, gesundheitlich abgeleiteten Richtwerte der WHO für PM2.5, PM10 sowie für NO2 nicht eingehalten, sodass für die deutsche Bevölkerung derzeit kein optimaler Schutz vor einer Gesundheitsgefährdung durch Luftverschmutzung gegeben ist. Die Ergebnisse zahlreicher Quer- und Längsschnittstudien der letzten Jahrzehnte unterstreichen die adversen Effekte der Luftschadstoffe, insbesondere des Feinstaubes, auf das kardiovaskuläre System, wenngleich die Evidenz für die einzelnen Endpunkte noch als unterschiedlich einzustufen ist. Die Studien zeigen auch, dass die kardiovaskulären Auswirkungen von größerer gesundheitlicher Bedeutung für die Bevölkerung sind als die auf den Atemtrakt. Die existierende Evidenz für die kardiovaskuläre Mortalität, Krankenhauseinweisungen, ischämische Herzerkrankungen bzw. Herzinfarkt und Apoplex kann als stark angesehen werden, dagegen ist diese für die Herzinsuffizienz eher moderat. Während die Evidenz für luftschadstoffassoziierte kurzfristige Effekte auf die vegetative Balance des Herzens als ausreichend anzusehen ist, sind langfristige Effekte noch als unklar einzustufen, ebenso wie die heterogenen Studienergebnisse zur luftschadstoffassoziierten Arrhythmogenese, die derzeit eine klare Schlussfolgerung noch nicht zulassen. Ein großer Teil der Studien deutet darauf hin, dass Luftschadstoffe akut und langfristig zum Anstieg des Blutdrucks beitragen können, zu einer gestörten vaskulären Homöostase mit endothelialer Dysfunktion führen sowie die Progression atherosklerotischer Veränderungen fördern können. Diese Effekte stellen biologisch plausible Mechanismen für die mit Luftschadstoffen assoziierten fatalen Ereignisse dar. Kurzzeiteffekte bergen womöglich für gesunde Menschen eher kein Risiko, können aber als plausibler Vorläufer von fatalen Ereignissen bei suszeptiblen Patienten angesehen werden, während repetitive Expositionen bzw. eine hohe Langzeitbelastung zur Entwicklung von kardiovaskulären Erkrankungen auch bei Gesunden beitragen können.

Background: Recent epidemiological studies investigating the modifying effect of air temperature in ozone-mortality associations lack consensus as how to adjust for nonlinear and lagged temperature effect in addition to including an interaction term. Methods: We evaluated the influence of temperature confounding control on temperature-stratified ozone-mortality risks in a time series setting in eight European cities and 86 US cities, respectively. To investigate potential residual confounding, we additionally incorporated next day's ozone in models with differing temperature control. Results: Using only a categorical variable for temperature or only controlling nonlinear effect of low temperatures yielded highly significant ozone effects at high temperatures but also significant residual confounding in both regions. Adjustment for nonlinear effect of temperature, especially high temperatures, substantially reduced ozone effects at high temperatures and residual confounding. Conclusions: Inadequate control for confounding by air temperature leads to residual confounding and an overestimation of the temperature-modifying effect in studies of ozone-related mortality. © 2018 The Authors. Published by Wolters Kluwer Health

According to the World Health Organisation (WHO), environmental air pollution is among the leading risks for noncommunicable diseases worldwide in terms of the global disease burden and the leading environmental cause of disease and death particularly in low- and middle-income countries. Air pollution is a highly complex mixture of various organic and inorganic components from natural and anthropogenic sources, occurring locally or being introduced by longrange transport of pollutants. Moreover, air pollution is modified by regional meteorological conditions. Accordingly, levels and composition of air pollution can vary substantially at a site, nevertheless typically showing a diurnal, weekly and annual cycle. Regulatory limits, as defined by the Air Quality Guidelines of the European Union, are enforced to minimize air pollution associated health hazards for the population. However, legal limits of the European Union clearly exceed the guideline values of the WHO, especially with regard to particulate matter. The burden of ambient air pollution is monitored by means of different indicator pollutants, especially particulate matter up to 2.5m (PM2.5) or 10m (PM10) in aerodynamic diameter, and gases such as nitrogen dioxide (NO2) or ozone (O3). In recent decades, in the western world, decreasing levels of air pollution have been achieved so that the main focus is nowadays on health hazards caused by low concentrations of pollutants. However, in Germany, especially urban areas are still suffering under higher levels of air pollution. In recent decades, a large number of studies have highlighted the harmful effects of air pollution on public health. Primarily, the respiratory and the cardiovascular system are targeted with exposure to higher levels of air pollution being associated with reduced lung function, unspecific respiratory symptoms, increased use of medication and acute exacerbations of lung diseases, myocardial infarction, stroke and even death. Further negative health outcomes such as atherosclerosis, reduced fetal growth, diabetes and limitations of cognitive function and neuronal development are supported by recent studies. Moreover, these studies have substantially improved our understanding of the underlying pathophysiological mechanisms. The 2015 Global Burden of Disease Study underlined the significance of air pollution for public health, particularly in relation to increased morbidity and mortality resulting from chronic diseases. As causal factor for premature death, particularly cardiovascular death, ambient PM2.5 is the number 5 risk factor, well behind the commonly known risk factors elevated blood pressure, smoking, and increased blood levels of glucose and cholesterol. Ambient air pollution is the number 10 risk factor for the disease burden and also the leading environmental risk factor in Germany. Different studies have estimated that ambient air pollution increases mortality and may decrease life expectancy on average by about one year in the European Union. State of the art knowledge on the negative health effects of ambient air pollution and recommendations for environmental safety and health are introduced by this statement of the German Respiratory Society (Deutsche Gesellschaft fur Pneumologie und Beatmungsmedizin). General concepts and health effects concerning the respiratory system are described in the first part of this statement.

Umweltzonen (UWZ) wurden als Maßnahme zur Verbesserung der Luftqualität eingeführt. In Deutschland sind derzeit 58Umweltzonen eingerichtet (Stand Februar 2018), die sich aber speziell in ihrer Größe deutlich unterscheiden. Die Wirksamkeit von Umweltzonen wurde sowohl in zahlreichen Modellrechnungen als auch anhand von PM10-Feinstaub (PM10: Partikel, die einen definierten größenselektierenden Lufteinlass passieren, der für einen aerodynamischen Durchmesser von 10 μm eine Abscheidewirksamkeit von 50 % aufweist) und Stickstoffdioxid (NO2)-Immissionsdaten untersucht. Die Analysen zeigen einen klaren Trend. So ist bei ausreichender Größe der Umweltzone und Gültigkeit der strengsten Schadstoffgruppe ein Rückgang der PM10-Konzentrationen um 5–10 % nachweisbar, an verkehrsbelasteten Messstationen teilweise auch um über 10 %. Der maßgebliche Grund für die Einführung der ab 2005 geltenden PM10-Grenzwerte war die gesundheitsschädigende Wirkung von Feinstaub auf die respiratorische und kardiovaskuläre Morbidität und Mortalität. Als Hauptverursacher hierfür ist der Kraftfahrzeug(Kfz)-Verkehr und insbesondere der emittierte Dieselruß anzusehen. Deshalb spielt für die Festlegung der Schadstoffklassen der Umweltzonen das Vorhandensein von Rußfiltern bei Dieselfahrzeugen eine wichtige Rolle. Leider stützt sich aber die „Erfolgskontrolle“ auf PM10-Feinstaub, dessen Gesamtfraktion lediglich einen relativ kleinen Anteil hochtoxischer Partikel aus Verbrennungsmotoren enthält. Zielführender wäre die Analyse der Luftschadstoffe, die spezifischer für den Kfz-Verkehr sind (zum Beispiel elementarer Kohlenstoff, ultrafeine Partikel, PM2.5-Feinstaub (PM2,5: Partikel, die einen definierten größenselektierenden Lufteinlass passieren, der für einen aerodynamischen Durchmesser von 2,5 μm eine Abscheidewirksamkeit von 50 % aufweist) Feinstaub). Bei „leistungsfähigen“ Umweltzonen wurde für diese Schadstoffe eine deutlich stärkere Reduzierung gezeigt. Das bedeutet gleichzeitig, dass der Vorteil der Umweltzonen für die Gesundheit erheblich größer ist, als sich dies an der Reduktion von PM10-Feinstaub ablesen lässt. Da es sich bei den Plaketten für Umweltzonen faktisch um Feinstaubplaketten handelt, ist es nicht überraschend, dass die Einführung von Umweltzonen zu keiner nachweisbaren Verringerung der NO2-Immission geführt hat.

Background: Although epidemiological studies have reported associations between mortality and both ambient air pollution and air temperature, it remains uncertain whether the mortality effects of air pollution are modified by temperature and vice versa. Moreover, little is known on the interactions between ultrafine particles (diameter ≤ 100 nm, UFP) and temperature. Objective: We investigated whether the short-term associations of particle number concentration (PNC in the ultrafine range (≤100 nm) or total PNC ≤ 3000 nm, as a proxy for UFP), particulate matter ≤ 2.5 μm (PM2.5) and ≤ 10 μm (PM10), and ozone with daily total natural and cardiovascular mortality were modified by air temperature and whether air pollution levels affected the temperature-mortality associations in eight European urban areas during 1999–2013. Methods: We first analyzed air temperature-stratified associations between air pollution and total natural (nonaccidental) and cardiovascular mortality as well as air pollution-stratified temperature-mortality associations using city-specific over-dispersed Poisson additive models with a distributed lag nonlinear temperature term in each city. All models were adjusted for long-term and seasonal trend, day of the week, influenza epidemics, and population dynamics due to summer vacation and holidays. City-specific effect estimates were then pooled using random-effects meta-analysis. Results: Pooled associations between air pollutants and total and cardiovascular mortality were overall positive and generally stronger at high relatively compared to low air temperatures. For example, on days with high air temperatures (>75th percentile), an increase of 10,000 particles/cm3 in PNC corresponded to a 2.51% (95% CI: 0.39%, 4.67%) increase in cardiovascular mortality, which was significantly higher than that on days with low air temperatures (50th percentile), both heat- and cold-related mortality risks increased. Conclusion: Our findings showed that high temperature could modify the effects of air pollution on daily mortality and high air pollution might enhance the air temperature effects. © 2018 Elsevier Ltd

Oxidative potential (OP) has been suggested as a health-relevant measure of air pollution. Little information is available about OP spatial variation and the possibility to model its spatial variability. Our aim was to measure the spatial variation of OP within and between 10 European study areas. The second aim was to develop land use regression (LUR) models to explain the measured spatial variation. OP was determined with the dithiothreitol (DTT) assay in ten European study areas. DTT of PM2.5 was measured at 16–40 sites per study area, divided over street, urban and regional background sites. Three two-week samples were taken per site in a one-year period in three different seasons. We developed study-area specific LUR models and a LUR model for all study areas combined to explain the spatial variation of OP. Significant contrasts between study areas in OP were found. OP DTT levels were highest in southern Europe. DTT levels at street sites were on average 1.10 times higher than at urban background locations. In 5 of the 10 study areas LUR models could be developed with a median R2 of 33%. A combined study area model explained 30% of the measured spatial variability. Overall, LUR models did not explain spatial variation well, possibly due to low levels of OP DTT and a lack of specific predictor variables. © 2016 Elsevier Ltd

Background: Epidemiologic evidence on the association between short-term exposure to ultrafine particles and mortality is weak, due to the lack of routine measurements of these particles and standardized multicenter studies. We investigated the relationship between ultrafine particles and particulate matter (PM) and daily mortality in eight European urban areas. Methods: We collected daily data on nonaccidental and cardiorespiratory mortality, particle number concentrations (as proxy for ultrafine particle number concentration), fine and coarse PM, gases and meteorologic parameters in eight urban areas of Finland, Sweden, Denmark, Germany, Italy, Spain, and Greece, between 1999 and 2013. We applied city-specific time-series Poisson regression models and pooled them with random-effects meta-analysis. Results: We estimated a weak, delayed association between particle number concentration and nonaccidental mortality, with mortality increasing by approximately 0.35% per 10,000 particles/cm 3 increases in particle number concentration occurring 5 to 7 days before death. A similar pattern was found for cause-specific mortality. Estimates decreased after adjustment for fine particles (PM 2.5) or nitrogen dioxide (NO 2). The stronger association found between particle number concentration and mortality in the warmer season (1.14% increase) became null after adjustment for other pollutants. Conclusions: We found weak evidence of an association between daily ultrafine particles and mortality. Further studies are required with standardized protocols for ultrafine particle data collection in multiple European cities over extended study periods. © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Hintergrund: Erhöhte Werte von Luftschadstoffen in der Umgebung sind mit einem erhöhten Risiko für respiratorische Mortalität assoziiert. Bei Langzeit-Exposition gegenüber Feinstaub wurde zudem eine Reduktion spirometrischer Messgrößen beschrieben. Mögliche Auswirkungen[zum vollständigen Text gelangen Sie über die oben angegebene URL], HEC 2016: Health – Exploring Complexity; Joint Conference of GMDS, DGEpi, IEA-EEF, EFMI

An increasing number of epidemiological studies suggest that adverse health effects of air pollution may be related to particulate matter (PM) composition, particularly trace metals. However, we lack comprehensive data on the spatial distribution of these elements.We measured PM2.5 and PM10 in twenty study areas across Europe in three seasonal two-week periods over a year using Harvard impactors and standardized protocols. In each area, we selected street (ST), urban (UB) and regional background (RB) sites (totaling 20) to characterize local spatial variability. Elemental composition was determined by energy-dispersive X-ray fluorescence analysis of all PM2.5 and PM10 filters. We selected a priori eight (Cu, Fe, K, Ni, S, Si, V, Zn) well-detected elements of health interest, which also roughly represented different sources including traffic, industry, ports, and wood burning.PM elemental composition varied greatly across Europe, indicating different regional influences. Average street to urban background ratios ranged from 0.90 (V) to 1.60 (Cu) for PM2.5 and from 0.93 (V) to 2.28 (Cu) for PM10.Our selected PM elements were variably correlated with the main pollutants (PM2.5, PM10, PM2.5 absorbance, NO2 and NOx) across Europe: in general, Cu and Fe in all size fractions were highly correlated (Pearson correlations above 0.75); Si and Zn in the coarse fractions were modestly correlated (between 0.5 and 0.75); and the remaining elements in the various size fractions had lower correlations (around 0.5 or below). This variability in correlation demonstrated the distinctly different spatial distributions of most of the elements. Variability of PM10_Cu and Fe was mostly due to within-study area differences (67% and 64% of overall variance, respectively) versus between-study area and exceeded that of most other traffic-related pollutants, including NO2 and soot, signaling the importance of non-tailpipe (e.g., brake wear) emissions in PM. © 2015 Elsevier Ltd.

Background: Land use regression (LUR) models have been developed mostly to explain intraurban variations in air pollution based on often small local monitoring campaigns. Transferability of LUR models from city to city has been investigated, but little is known about the performance of models based on large numbers of monitoring sites covering a large area. Objectives: We aimed to develop European and regional LUR models and to examine their transferability to areas not used for model development. Methods: We evaluated LUR models for nitrogen dioxide (NO2) and particulate matter (PM; PM2.5, PM2.5 absorbance) by combining standardized measurement data from 17 (PM) and 23 (NO2) ESCAPE (European Study of Cohorts for Air Pollution Effects) study areas across 14 European countries for PM and NO2. Models were evaluated with cross-validation (CV) and hold-out validation (HV). We investigated the transferability of the models by successively excluding each study area from model building. Results: The European model explained 56% of the concentration variability across all sites for NO2, 86% for PM2.5, and 70% for PM2.5 absorbance. The HV R2s were only slightly lower than the model R2 (NO2, 54%; PM2.5, 80%; PM2.5 absorbance, 70%). The European NO2, PM2.5, and PM2.5 absorbance models explained a median of 59%, 48%, and 70% of within-area variability in individual areas. The transferred models predicted a modest-to-large fraction of variability in areas that were excluded from model building (median R2: NO2, 59%; PM2.5, 42%; PM2.5 absorbance, 67%). Conclusions: Using a large data set from 23 European study areas, we were able to develop LUR models for NO2 and PM metrics that predicted measurements made at independent sites and areas reasonably well. This finding is useful for assessing exposure in health studies conducted in areas where no measurements were conducted.

Land use regression (LUR) models have been used to model concentrations of mainly traffic-related air pollutants (nitrogen oxides (NOx), particulate matter (PM) mass or absorbance). Few LUR models are published of PM composition, whereas the interest in health effects related to particle composition is increasing. The aim of our study was to evaluate LUR models of polycyclic aromatic hydrocarbons (PAH), hopanes/steranes, and elemental and organic carbon (EC/OC) content of PM2.5. In 10 European study areas, PAH, hopanes/steranes, and EC/OC concentrations were measured at 16-40 sites per study area. LUR models for each study area were developed on the basis of annual average concentrations and predictor variables including traffic, population, industry, natural land obtained from geographic information systems. The highest median model explained variance (R2) was found for EC - 84%. The median R2 was 51% for OC, 67% for benzo[a]pyrene, and 38% for sum of hopanes/steranes, with large variability between study areas. Traffic predictors were included in most models. Population and natural land were included frequently as additional predictors. The moderate to high explained variance of LUR models and the overall moderate correlation with PM2.5 model predictions support the application of especially the OC and PAH models in epidemiological studies. © 2014 American Chemical Society.

As particulate matter (PM) impacts human health, knowledge about its composition, exposure and source apportionment is required. A study of the urban atmosphere in the case of Augsburg, Germany, during winter (31 January–12 March 2010) is thus presented here. Investigations were performed on the basis of aerosol mass spectrometry and further air pollutants and meteorological measurements, including mixing layer height. Organic matter was separated by source apportionment of PM1 with positive matrix factorization (PMF) in three factors: OOA – oxygenated organic aerosol (secondary organic factor), HOA – hydrocarbon-like organic aerosol (traffic factor or primary organic factor) and WCOA – wood combustion organic aerosol (wood combustion factor), which extend the information from black carbon (BC) measurements. PMF was also applied to the particle size distribution (PSD) data of PM2.5 to determine different source profiles and we assigned them to the particle sources: nucleation aerosol, fresh traffic aerosol, aged traffic aerosol, stationary combustion aerosol and secondary aerosol. Ten different temporal phases were identified on the basis of weather characteristics and aerosol composition and used for correlations of all air pollutants and meteorological parameters. While source apportionment from both organic PM composition and PSD agree and show that the main emission sources of PM exposure are road traffic as well as stationary and wood combustion, secondary aerosol factor concentrations are very often the highest ones. The hierarchical clustering analysis with the Ward method of cross-correlations of each air pollutant and PM component and of the correlations of each pollutant with all meteorological parameters provided two clusters: "secondary pollutants of PM1 and fine particles" and "primary pollutants (including CO and benzene) and accumulation mode particles". The dominant meteorological influences on pollutant concentrations are wind speed and mixing layer height which are coupled with a certain wind direction. The compounds of the cluster "secondary pollutants and fine particles" show a negative correlation with absolute humidity, i.e., low concentrations during high absolute humidity and vice versa. The PM10 limit value exceedances originated not only from the emissions but also in combination with specific meteorological conditions. NC3-10 (number concentration of nucleation mode particles) and NC10-30 (Aitken mode particles), i.e., ultrafine particles and the fresh traffic aerosol, are only weakly dependent on meteorological parameters and thus are driven by emissions. The results of this case study provide information about chemical composition and causes of PM exposure during winter time in urban air pollution.

Limited information is available on the contribution of organic components in particulate matter to health effects related to fine particles. Spatial variability of specific fine particle organic components has not been assessed with consistent methods. The aim of this paper is to assess spatial variation of organic components of fine particles within and between European study areas. Highly standardized measurements of polycyclic aromatic hydrocarbons (PAH), hopanes/steranes, elemental/organic carbon (EC/OC) and levoglucosan were performed measured in ten study areas across Europe. In each study area, measurements were conducted at street, urban and regional background sites. Three two-week samples were taken per site and the annual average levels of pollutants were calculated using continuous measurements at one background site as a reference.Substantial variations within and between the study areas were found. EC/OC and hopanes/steranes concentrations were highest in southern European study areas and lowest in northern locations. PAH concentrations were lowest in London/Oxford and highest in Copenhagen, Rome and Athens. Concentrations at street locations were higher than at background locations in all study areas and for all components. However, these differences varied considerably between study areas and components. EC had the highest median street to urban background ratio (1.62), OC the lowest (1.32). EC was highly correlated with NOx and PM2.5 absorbance in all areas, with median r=0.85 and r=0.89, respectively. The correlation between OC and other components was variable, with a median correlation of 0.65 with PM2.5 mass and a weak (0.18) correlation with σhopanes/steranes. σPAH correlated moderately with EC (r=0.59) and weakly with ∑hopanes/steranes (r=0.36).In conclusion, substantial variability was found in spatial patterns of atmospheric EC, OC, PAH and hopanes/steranes both within and between European study areas. The application of this highly standardized measurement approach across different locations will contribute to a consistent assessment of air pollutant levels and potentially contribute to understanding health effects associated with them. © 2014 Elsevier Ltd.

Background: Associations between long-term exposure to ambient particulate matter (PM) and cardiovascular (CVD) mortality have been widely recognized. However, health effects of long-term exposure to constituents of PM on total CVD mortality have been explored in a single study only. Aims: The aim of this study was to examine the association of PM composition with cardiovascular mortality. Methods: We used data from 19 European ongoing cohorts within the framework of the ESCAPE (European Study of Cohorts for Air Pollution Effects) and TRANSPHORM (Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter) projects. Residential annual average exposure to elemental constituents within particle matter smaller than 2.5 and 10μm (PM2.5 and PM10) was estimated using Land Use Regression models. Eight elements representing major sources were selected a priori (copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc). Cohort-specific analyses were conducted using Cox proportional hazards models with a standardized protocol. Random-effects meta-analysis was used to calculate combined effect estimates. Results: The total population consisted of 322,291 participants, with 9545 CVD deaths. We found no statistically significant associations between any of the elemental constituents in PM2.5 or PM10 and CVD mortality in the pooled analysis. Most of the hazard ratios (HRs) were close to unity, e.g. for PM10 Fe the combined HR was 0.96 (0.84-1.09). Elevated combined HRs were found for PM2.5 Si (1.17, 95% CI: 0.93-1.47), and S in PM2.5 (1.08, 95% CI: 0.95-1.22) and PM10 (1.09, 95% CI: 0.90-1.32). Conclusion: In a joint analysis of 19 European cohorts, we found no statistically significant association between long-term exposure to 8 elemental constituents of particles and total cardiovascular mortality. •Few studies explored long term effects of particle composition exposure to cardiovascular mortality.•We included a large population of 322,291 subjects from 19 cohorts in 12 countries of Europe.•Standardized cohort specific analyses were conducted individually and the results were pooled in meta-analysis.•We found no significant association between elemental constituents representing major sources and cardiovascular mortality.•Positive though non-significant associations were found for S and Si. © 2014 Elsevier Ltd.

Background: Land-use regression (LUR) and dispersion models (DM) are commonly used for estimating individual air pollution exposure in population studies. Few comparisons have however been made of the performance of these methods. Objectives: Within the European Study of Cohorts for Air Pollution Effects (ESCAPE) we explored the differences between LUR and DM estimates for NO2, PM10 and PM2.5. Methods: The ESCAPE study developed LUR models for outdoor air pollution levels based on a harmonised monitoring campaign. In thirteen ESCAPE study areas we further applied dispersion models. We compared LUR and DM estimates at the residential addresses of participants in 13 cohorts for NO2; 7 for PM10 and 4 for PM2.5. Additionally, we compared the DM estimates with measured concentrations at the 20-40 ESCAPE monitoring sites in each area. Results: The median Pearson R (range) correlation coefficients between LUR and DM estimates for the annual average concentrations of NO2, PM10 and PM2.5 were 0.75 (0.19-0.89), 0.39 (0.23-0.66) and 0.29 (0.22-0.81) for 112,971 (13 study areas), 69,591 (7) and 28,519 (4) addresses respectively. The median Pearson R correlation coefficients (range) between DM estimates and ESCAPE measurements were of 0.74 (0.09-0.86) for NO2; 0.58 (0.36-0.88) for PM10 and 0.58 (0.39-0.66) for PM2.5. Conclusions: LUR and dispersion model estimates correlated on average well for NO2 but only moderately for PM10 and PM2.5, with large variability across areas. DM predicted a moderate to large proportion of the measured variation for NO2 but less for PM10 and PM2.5. © 2014 Elsevier Ltd.

Background: Air pollution has been associated with cardiovascular mortality, but it remains unclear as to whether specific pollutants are related to specific cardiovascular causes of death. Within the multicenter European Study of Cohorts for Air Pollution Effects (ESCAPE), we investigated the associations of long-term exposure to several air pollutants with all cardiovascular disease (CVD) mortality, as well as with specific cardiovascular causes of death. Methods: Data from 22 European cohort studies were used. Using a standardized protocol, study area-specific air pollution exposure at the residential address was characterized as annual average concentrations of the following: nitrogen oxides (NO2and NOx); particles with diameters of less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 10 μm to 2.5 μm (PMcoarse); PM2.5absorbance estimated by land-use regression models; and traffic indicators. We applied cohort-specific Cox proportional hazards models using a standardized protocol. Random-effects meta-analysis was used to obtain pooled effect estimates. Results: The total study population consisted of 367,383 participants, with 9994 deaths from CVD (including 4,992 from ischemic heart disease, 2264 from myocardial infarction, and 2484 from cerebrovascular disease). All hazard ratios were approximately 1.0, except for particle mass and cerebrovascular disease mortality; for PM2.5, the hazard ratio was 1.21 (95% confidence interval = 0.87-1.69) per 5 μg/m and for PM10, 1.22 (0.91-1.63) per 10 μg/m. Conclusion: In a joint analysis of data from 22 European cohorts, most hazard ratios for the association of air pollutants with mortality from overall CVD and with specific CVDs were approximately 1.0, with the exception of particulate mass and cerebrovascular disease mortality for which there was suggestive evidence for an association. Copyright © 2014 by Lippincott Williams & Wilkins.

Estimating within-city variability in air pollution concentrations is important. Land use regression (LUR) models are able to explain such small-scale within-city variations. Transparency in LUR model development methods is important to facilitate comparison of methods between different studies. We therefore developed LUR models in a standardized way in 36 study areas in Europe for the ESCAPE (European Study of Cohorts for Air Pollution Effects) project.Nitrogen dioxide (NO2) and nitrogen oxides (NOx) were measured with Ogawa passive samplers at 40 or 80 sites in each of the 36 study areas. The spatial variation in each area was explained by LUR modelling. Centrally and locally available Geographic Information System (GIS) variables were used as potential predictors. A leave-one out cross-validation procedure was used to evaluate the model performance.There was substantial contrast in annual average NO2 and NOx concentrations within the study areas. The model explained variances (R2) of the LUR models ranged from 55% to 92% (median 82%) for NO2 and from 49% to 91% (median 78%) for NOx. For most areas the cross-validation R2 was less than 10% lower than the model R2. Small-scale traffic and population/household density were the most common predictors. The magnitude of the explained variance depended on the contrast in measured concentrations as well as availability of GIS predictors, especially traffic intensity data were important. In an additional evaluation, models in which local traffic intensity was not offered had 10% lower R2 compared to models in the same areas in which these variables were offered.Within the ESCAPE project it was possible to develop LUR models that explained a large fraction of the spatial variance in measured annual average NO2 and NOx concentrations. These LUR models are being used to estimate outdoor concentrations at the home addresses of participants in over 30 cohort studies. © 2013 Elsevier Ltd.

The ESCAPE study (European Study of Cohorts for Air Pollution Effects) investigates relationships between long-term exposure to outdoor air pollution and health using cohort studies across Europe. This paper analyses the spatial variation of PM2.5, PM2.5 absorbance, PM10 and PMcoarse concentrations between and within 20 study areas across Europe.We measured NO2, NOx, PM2.5, PM2.5 absorbance and PM10 between October 2008 and April 2011 using standardized methods. PMcoarse was determined as the difference between PM10 and PM2.5. In each of the twenty study areas, we selected twenty PM monitoring sites to represent the variability in important air quality predictors, including population density, traffic intensity and altitude. Each site was monitored over three 14-day periods spread over a year, using Harvard impactors. Results for each site were averaged after correcting for temporal variation using data obtained from a reference site, which was operated year-round.Substantial concentration differences were observed between and within study areas. Concentrations for all components were higher in Southern Europe than in Western and Northern Europe, but the pattern differed per component with the highest average PM2.5 concentrations found in Turin and the highest PMcoarse in Heraklion. Street/urban background concentration ratios for PMcoarse (mean ratio 1.42) were as large as for PM2.5 absorbance (mean ratio 1.38) and higher than those for PM2.5 (1.14) and PM10 (1.23), documenting the importance of non-tailpipe emissions. Correlations between components varied between areas, but were generally high between NO2 and PM2.5 absorbance (average R2 = 0.80). Correlations between PM2.5 and PMcoarse were lower (average R2 = 0.39). Despite high correlations, concentration ratios between components varied, e.g. the NO2/PM2.5 ratio varied between 0.67 and 3.06.In conclusion, substantial variability was found in spatial patterns of PM2.5, PM2.5 absorbance, PM10 and PMcoarse. The highly standardized measurement of particle concentrations across Europe will contribute to a consistent assessment of health effects across Europe. © 2012 Elsevier Ltd.

The ESCAPE study (European Study of Cohorts for Air Pollution Effects) investigates long-term effects of exposure to air pollution on human health in Europe. This paper documents the spatial variation of measured NO2 and NOx concentrations between and within 36 ESCAPE study areas across Europe.In all study areas NO2 and NOx were measured using standardized methods between October 2008 and April 2011. On average, 41 sites were selected per study area, including regional and urban background as well as street sites. The measurements were conducted in three different seasons, using Ogawa badges. Average concentrations for each site were calculated after adjustment for temporal variation using data obtained from a routine monitor background site.Substantial spatial variability was found in NO2 and NOx concentrations between and within study areas; 40% of the overall NO2 variance was attributable to the variability between study areas and 60% to variability within study areas. The corresponding values for NOx were 30% and 70%. The within-area spatial variability was mostly determined by differences between street and urban background concentrations. The street/urban background concentration ratio for NO2 varied between 1.09 and 3.16 across areas. The highest median concentrations were observed in Southern Europe, the lowest in Northern Europe.In conclusion, we found significant contrasts in annual average NO2 and NOx concentrations between and especially within 36 study areas across Europe. Epidemiological long-term studies should therefore consider different approaches for better characterization of the intra-urban contrasts, either by increasing of the number of monitors or by modelling. © 2012 Elsevier Ltd.

Some studies have suggested that particulate matter (PM) levels during pregnancy may be associated with birth weight. Road traffic is a major source of fine PM (PM with aerodynamic diameter < 2.5 µm ; PM2.5) . We determined to characterize the influence of maternal exposure to atmospheric pollutants due to road traffic and urban activities on offspring term birth weight. Women from a birth cohort [the LISA (Influences of Lifestyle Related Factors on the Human Immune System and Development of Allergies in Children) cohort] who delivered a non-premature baby with a birth weight > 2,500 g in Munich metropolitan area were included. We assessed PM2.5, PM2.5 absorbance (which depends on the blackness of PM2.5, a marker of traffic-related air pollution) , and nitrogen dioxide levels using a land-use regression model, taking into account the type and length of roads, population density, land coverage around the home address, and temporal variations in pollution during pregnancy. Using Poisson regression, we estimated prevalence ratios (PR) of birth weight < 3,000 g, adjusted for gestational duration, sex, maternal smoking, height, weight, and education. Exposure was defined for 1,016 births. Taking the lowest quartile of exposure during pregnancy as a reference, the PR of birth weight < 3,000 g associated with the highest quartile was 1.7 for PM2.5 [95% confidence interval (CI) , 1.2–2.7], 1.8 for PM2.5 absorbance (95% CI, 1.1–2.7) , and 1.2 for NO2 (95% CI, 0.7–1.7) . The PR associated with an increase of 1 µg/m3 in PM2.5 levels was 1.13 (95% CI, 1.00–1.29) . Increases in PM2.5 levels and PM2.5 absorbance were associated with decreases in term birth weight. Traffic-related air pollutants may have adverse effects on birth weight.