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

被引：429

作者：

Cesaroni, Giulia ^{[1
]}

Forastiere, Francesco ^{[1
]}

Stafoggia, Massimo ^{[1
]}

Andersen, Zorana J. ^{[2
,3
]}

Badaloni, Chiara ^{[1
]}

Beelen, Rob ^{[4
]}

Caracciolo, Barbara ^{[5
,6
]}

de Faire, Ulf ^{[7
]}

Erbel, Raimund ^{[8
]}

Eriksen, Kirsten T. ^{[2
]}

Fratiglioni, Laura ^{[5
,9
,10
]}

Galassi, Claudia ^{[11
,12
]}

Hampel, Regina ^{[13
]}

Heier, Margit ^{[13
,14
]}

Hennig, Frauke ^{[15
]}

Hilding, Agneta ^{[16
]}

Hoffmann, Barbara ^{[15
,17
]}

Houthuijs, Danny ^{[18
]}

Joeckel, Karl-Heinz ^{[19
]}

Korek, Michal ^{[7
]}

Lanki, Timo ^{[20
]}

Leander, Karin ^{[7
]}

Magnusson, Patrik K. E. ^{[21
]}

Migliore, Enrica ^{[11
,12
]}

Ostenson, Caes-Goeran ^{[16
]}

Overvad, Kim ^{[22
,23
]}

Pedersen, Nancy L. ^{[21
]}

Pekkanen, Juha J. ^{[20
]}

Penell, Johanna ^{[7
]}

Pershagen, Goeran ^{[7
]}

Pyko, Andrei ^{[7
]}

Raaschou-Nielsen, Ole ^{[2
]}

Ranzi, Andrea ^{[24
]}

Ricceri, Fulvio ^{[25
,27
]}

Sacerdote, Carlotta ^{[11
,12
]}

Salomaa, Veikko ^{[26
]}

Swart, Wim ^{[18
]}

Turunen, Anu W. ^{[20
]}

Vineis, Paolo ^{[25
]}

Weinmayr, Gudrun ^{[15
,28
]}

Wolf, Kathrin ^{[13
]}

de Hoogh, Kees ^{[27
]}

Hoek, Gerard ^{[4
]}

Brunekreef, Bert ^{[4
,29
]}

Peters, Annette ^{[13
]}

机构：

[1] Lazio Reg Hlth Serv, Dept Epidemiol, I-00198 Rome, Italy

[2] Danish Canc Soc Res Ctr, DK-2100 Copenhagen, Denmark

[3] Univ Copenhagen, Dept Publ Hlth, Ctr Epidemiol & Screening, DK-1014 Copenhagen, Denmark

[4] Univ Utrecht, Inst Risk Assessment Sci, NL-3508 TD Utrecht, Netherlands

[5] Karolinska Inst, Aging Res Ctr, Dept Neurobiol, Care Sci & Soc, S-11330 Stockholm, Sweden

[6] Stockholm Univ, Stress Res Inst, SE-10691 Stockholm, Sweden

[7] Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden

[8] Univ Hosp Essen, West German Heart Ctr, D-45122 Essen, Germany

[9] Stockholm Gerontol Res Ctr, S-11330 Stockholm, Sweden

[10] Karolinska Univ Hosp, Div Clin Geriatr, SE-14186 Stockholm, Sweden

[11] Univ Turin, Canc Epidemiol Unit, Citta Salute Sci Hosp, I-10126 Turin, Italy

[12] Ctr Canc Prevent Piemonte, I-10126 Turin, Italy

[13] German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 2, D-85764 Neuherberg, Germany

[14] Cent Hosp Augsburg, MONICA KORA Myocardial Infarct Registry, D-86156 Augsburg, Germany

[15] IUF Leibniz Res Inst Environm Med, D-40225 Dusseldorf, Germany

[16] Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, SE-17177 Stockholm, Sweden

[17] Univ Dusseldorf, Fac Med, D-40225 Dusseldorf, Germany

[18] Natl Inst Publ Hlth & Environm, NL-3720 BA Bilthoven, Netherlands

[19] Univ Hosp Essen, Inst Med Informat Biometry & Epidemiol, D-45122 Essen, Germany

[20] Natl Inst Hlth & Welf THL, Dept Environm Hlth, FI-70701 Kuopio, Finland

[21] Karolinska Inst, Dept Med Epidemiol & Biostatist, SE-17177 Stockholm, Sweden

[22] Aarhus Univ, Epidemiol Sect, Dept Publ Hlth, DK-8000 Aarhus, Denmark

[23] Aalborg Hosp, Dept Cardiol, Cardiovasc Res Ctr, DK-9000 Aalborg, Denmark

[24] Reg Agcy Environm Prevent Emilia Romagna, Environm Hlth Reference Centre, I-41121 Modena, Italy

[25] HuGeF, Mol & Genet Epidemiol Unit, I-10126 Turin, Italy

[26] THL Natl Inst Hlth & Welfare, Dept Chron Dis Prevent, FI-00271 Helsinki, Finland

[27] MRC HPA Ctr Environm & Hlth, Dept Epidemiol & Biostatist, Imperial Coll London, London W2 1PG, England

[28] Univ Ulm, Inst Epidemiol & Med Biometry, D-89069 Ulm, Germany

[29] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, NL-3508 GA Utrecht, Netherlands

来源：

BMJ-BRITISH MEDICAL JOURNAL | 2014年 / 348卷

关键词：

USE REGRESSION-MODELS; CARDIOVASCULAR-DISEASE; PARTICULATE MATTER; HEART-DISEASE; PM2.5; ABSORBENCY; RISK-FACTORS; MORTALITY; HEALTH; AREAS; MEN;

D O I：

10.1136/bmj.f7412

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 mu m (PM2.5), 2.5-10 mu m (PMcoarse), and <10 mu m (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 mu g/m(3) 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 mu g/m(3) 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 mu g/m(3) for PM2.5 (1.18, 1.01 to 1.39, for 5 mu g/m(3) increase in PM2.5) and below 40 mu g/m(3) for PM10 (1.12, 1.00 to 1.27, for 10 mu g/m(3) 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.

引用

页数：16

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