Long term exposure to ambient air pollution and incidence of acute coronary events: prospective cohort study and meta-analysis in 11 European cohorts from the ESCAPE Project

Abstract

Objectives To study the effect of long term exposure to airborne pollutants on the incidence of acute coronary events in 11 cohorts participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE).Design Prospective cohort studies and meta-analysis of the results.Setting Cohorts in Finland, Sweden, Denmark, Germany, and Italy.Participants 100 166 people were enrolled from 1997 to 2007 and followed for an average of 11.5 years. Participants were free from previous coronary events at baseline.Main outcome measures Modelled concentrations of particulate matter <2.5 μm (PM2.5), 2.5-10 μm (PMcoarse), and <10 μm (PM10) in aerodynamic diameter, soot (PM2.5 absorbance), nitrogen oxides, and traffic exposure at the home address based on measurements of air pollution conducted in 2008-12. Cohort specific hazard ratios for incidence of acute coronary events (myocardial infarction and unstable angina) per fixed increments of the pollutants with adjustment for sociodemographic and lifestyle risk factors, and pooled random effects meta-analytic hazard ratios.Results 5157 participants experienced incident events. A 5 μg/m3 increase in estimated annual mean PM2.5 was associated with a 13% increased risk of coronary events (hazard ratio 1.13, 95% confidence interval 0.98 to 1.30), and a 10 μg/m3 increase in estimated annual mean PM10 was associated with a 12% increased risk of coronary events (1.12, 1.01 to 1.25) with no evidence of heterogeneity between cohorts. Positive associations were detected below the current annual European limit value of 25 μg/m3 for PM2.5 (1.18, 1.01 to 1.39, for 5 μg/m3 increase in PM2.5) and below 40 μg/m3 for PM10 (1.12, 1.00 to 1.27, for 10 μg/m3 increase in PM10). Positive but non-significant associations were found with other pollutants.Conclusions Long term exposure to particulate matter is associated with incidence of coronary events, and this association persists at levels of exposure below the current European limit values.

MECHANISMS IN ENDOCRINOLOGY: Effect of long-term exposure to air pollution on type 2 diabetes mellitus risk: a systemic review and meta-analysis of cohort studies

“…The adverse effects of air pollution on cardiovascular disease, lung cancer, and natural-cause mortality have been well established in several major epidemiological studies (5,6,7,8,9). The findings from the meta-analysis further add the evidence for the adverse effect of air pollution on risk of type 2 diabetes mellitus.…”

“…Though the increasing incidence of type 2 diabetes may be a result of increasing obesity, other potential risk factors have been proposed, such as air pollution (1,2,4). In recent years, several major epidemiological studies have showed that air pollution is obviously associated with increased risks of cardiovascular disease, lung cancer, and natural-cause mortality (5,6,7,8,9). However, the effect of air pollution on type 2 diabetes risk has not been clearly described.…”

Long-term particulate matter exposure: Attributing health effects to individual PM components

“…Two Canadian papers found the opposite for both cardiovascular and COPD endpoints (Gan et al, 2010;Gan et al, 2013); in their joint models, BC dominated PM 2.5 . Several of the European papers reported significant associations with PM 2.5 , but not with PM abs in single-pollutant models Cesaroni et al, 2014;Fuks et al, 2014;MacIntyre et al, 2014;Pedersen et al, 2013;Raascshou-Nielsen et al, 2013); hence, within Europe the ESCAPE study appears to suggest that PM 2.5 mass is a better indicator of pollution of concern than PM abs . The Canadian studies suggest the opposite.…”

Effects of Air Pollution and Blood Mitochondrial DNA Methylation on Markers of Heart Rate Variability

“…Normal mitochondrial function generates reactive oxygen species, and because of its proximal location, mtDNA is particularly vulnerable to oxidative damage. Effects of air pollution on mtDNA damage, including copy number variation,7 8‐hydroxy‐2′‐deoxyguanosine formation,8 and heteroplasmy,9 have been reported in human and animal studies. Recently, DNA methylation machinery was found in mitochondria,10 and mtDNA methylation levels have been shown to be associated with mitochondrial gene expression,11 which suggests possible roles for mtDNA methylation in controlling mitochondrial functions and biogenesis.…”