LONG-TERM EXPOSURE TO AIR POLLUTION WITHIN EUROPEAN CITIES AND CARDIOVASCULAR DISEASE: THE ESCAPE STUDY

Abstract

Background and Aims. Work package 5 of the European multicenter ESCAPE project aims to delineate the role of long-term exposures to ambient particles in cardiovascular disease development and coronary artery and cerebrovascular disease incidence. Specifically the impact of ambient air pollution on markers of inflammation, and gene-environment interactions (aim1), on blood pressure and prevalence of hypertension (aim2), on the risk for build-up of preclinical atherosclerosis measured by intima-media thickness (IMT) of the carotid artery (aim3), and on incident coronary events (aim4) will be evaluated. Methods. The 14 contributing adult cohort studies originate from Austria, Denmark, Finland, Germany, Italy, Norway, Spain, Sweden, and Switzerland and cover different geographical regions within Europe. All participating cohorts assessed the spatial variability of PM10, PM2.5 and NOx within their communities based on the ESCAPE exposure protocol. City-specific analyses with subsequent pooling of the regression coefficients applying methods for meta-analyses are underway and first results will be shown. Endpoint-specific confounders and effect-modifiers are considered and include e.g. gender, age, BMI, smoking, alcohol intake, social class indicators, dietary variables, and noise. Results. A different set of cohorts will participate in each specific aim. There are 8 cohorts contributing to aim1 with 32,000 participants, 14 cohorts to aim2 with 228,800 participants, and 4 cohorts to aim3 with 9,500 participants. 9 cohorts participate to aim4 with a study population of 120,000. The follow-up time varied between studies ranging from 15 months to 15 years. Conclusions. The project will provide important information for the assessments of the role of ambient air pollution on the development of cardiovascular disease integrating effects of pollution on systemic inflammation, hypertension, atherosclerosis, and incident events. Thereby, ESCAPE will provide important information for estimating the overall public health impact of air pollution and for developing prevention strategies for at risk populations based on air quality measures.