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1. Long-term exposure to air pollution and chronic kidney disease-associated mortality - results from the pooled cohort of the European multicentre ELAPSE-study

Author: IRAS OH Epidemiology Chemical Agents, IRAS – One Health Chemical, Kadelbach, Pauline, Weinmayr, Gudrun, Chen, Jie, Jaensch Dipl-Dok, Andrea, Rodopoulou, Sophia, Strak, Maciej, de Hoogh, Kees, Andersen, Zorana J, Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, Fecht, Daniela, Forastiere, Prof Francesco, Gulliver, Prof John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Katsouyanni, Prof Klea, Ketzel, Matthias, Leander, Karin, Ljungman, Petter, Magnusson, Patrik K E, Pershagen, Göran, Rizzuto, Debora, Samoli, Evangelia, Severi, Gianluca, Stafoggia, Massimo, Tjønneland, Prof Anne, Vermeulen, Roel, Peters, Annette, Wolf, Kathrin, Raaschou-Nielsen, Prof Ole, Brunekreef, Bert, Hoek, Gerard, Zitt, Emanuel, Nage, Prof Gabriele, IRAS OH Epidemiology Chemical Agents, IRAS – One Health Chemical, Kadelbach, Pauline, Weinmayr, Gudrun, Chen, Jie, Jaensch Dipl-Dok, Andrea, Rodopoulou, Sophia, Strak, Maciej, de Hoogh, Kees, Andersen, Zorana J, Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, Fecht, Daniela, Forastiere, Prof Francesco, Gulliver, Prof John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Katsouyanni, Prof Klea, Ketzel, Matthias, Leander, Karin, Ljungman, Petter, Magnusson, Patrik K E, Pershagen, Göran, Rizzuto, Debora, Samoli, Evangelia, Severi, Gianluca, Stafoggia, Massimo, Tjønneland, Prof Anne, Vermeulen, Roel, Peters, Annette, Wolf, Kathrin, Raaschou-Nielsen, Prof Ole, Brunekreef, Bert, Hoek, Gerard, Zitt, Emanuel, and Nage, Prof Gabriele
Published: 2024

2. Long-term exposure to fine particle elemental components and mortality in Europe:Results from six European administrative cohorts within the ELAPSE project

Author: Rodopoulou, Sophia, Stafoggia, Massimo, Chen, Jie, de Hoogh, Kees, Bauwelinck, Mariska, Mehta, Amar J., Klompmaker, Jochem O., Oftedal, Bente, Vienneau, Danielle, Janssen, Nicole A.H., Strak, Maciej, Andersen, Zorana J., Renzi, Matteo, Cesaroni, Giulia, Nordheim, Carl Fredrik, Bekkevold, Terese, Atkinson, Richard, Forastiere, Francesco, Katsouyanni, Klea, Brunekreef, Bert, Samoli, Evangelia, Hoek, Gerard, Rodopoulou, Sophia, Stafoggia, Massimo, Chen, Jie, de Hoogh, Kees, Bauwelinck, Mariska, Mehta, Amar J., Klompmaker, Jochem O., Oftedal, Bente, Vienneau, Danielle, Janssen, Nicole A.H., Strak, Maciej, Andersen, Zorana J., Renzi, Matteo, Cesaroni, Giulia, Nordheim, Carl Fredrik, Bekkevold, Terese, Atkinson, Richard, Forastiere, Francesco, Katsouyanni, Klea, Brunekreef, Bert, Samoli, Evangelia, and Hoek, Gerard
Abstract: Evidence for the association between long-term exposure to ambient particulate matter components and mortality from natural causes is sparse and inconsistent. We evaluated this association in six large administrative cohorts in the framework of the Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) project. We analyzed data from country-wide administrative cohorts in Norway, Denmark, the Netherlands, Belgium, Switzerland and in Rome (Italy). Annual 2010 mean concentrations of copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V) and zinc (Zn) in fine particulate matter (PM2.5) were estimated using 100 × 100 m Europe-wide hybrid land use regression models assigned to the participants' residential addresses. We applied cohort-specific Cox proportional hazard models controlling for area- and individual-level covariates to evaluate associations with natural mortality. Two pollutant models adjusting for PM2.5 total mass or nitrogen dioxide (NO2) were also applied. We pooled cohort-specific estimates using a random effects meta-analysis. We included almost 27 million participants contributing more than 240 million person-years. All components except Zn were significantly associated with natural mortality [pooled Hazard Ratios (HRs) (95% CI): 1.037 (1.014, 1.060) per 5 ng/m3 Cu; 1.069 (1.031, 1.108) per 100 ng/m3 Fe; 1.039 (1.018, 1.062) per 50 ng/m3 K; 1.024 (1.006, 1.043) per 1 ng/m3 Ni; 1.036 (1.016, 1.057) per 200 ng/m3 S; 1.152 (1.048, 1.266) per 100 ng/m3 Si; 1.020 (1.006, 1.034) per 2 ng/m3 V]. Only K and Si were robust to PM2.5 or NO2 adjustment [pooled HRs (95% CI) per 50 ng/m3 in K: 1.025 (1.008, 1.044), 1.020 (0.999, 1.042) and per 100 ng/m3 in Si: 1.121 (1.039, 1.209), 1.068 (1.022, 1.117) adjusted for PM2.5 and NO2 correspondingly]. Our
Published: 2022

3. Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project

Author: Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Public Health Practice, Stafoggia, Massimo, Oftedal, Bente, Chen, Jie, Rodopoulou, Sophia, Renzi, Matteo, Atkinson, Richard W., Bauwelinck, Mariska, Klompmaker, Jochem O., Mehta, Amar, Vienneau, Danielle, Andersen, Zorana J., Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, de Hoogh, Kees, Fecht, Daniela, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla A., Jöckel, Karl Heinz, Jørgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Kristoffersen, Doris Tove, Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Nagel, Gabriele, Pershagen, Göran, Peters, Annette, Raaschou-Nielsen, Ole, Rizzuto, Debora, Schramm, Sara, Schwarze, Per E., Severi, Gianluca, Sigsgaard, Torben, Strak, Maciek, van der Schouw, Yvonne T., Verschuren, Monique, Weinmayr, Gudrun, Wolf, Kathrin, Zitt, Emanuel, Samoli, Evangelia, Forastiere, Francesco, Brunekreef, Bert, Hoek, Gerard, Janssen, Nicole A.H., Cardiovasculaire Epi Team 1, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Public Health Practice, Stafoggia, Massimo, Oftedal, Bente, Chen, Jie, Rodopoulou, Sophia, Renzi, Matteo, Atkinson, Richard W., Bauwelinck, Mariska, Klompmaker, Jochem O., Mehta, Amar, Vienneau, Danielle, Andersen, Zorana J., Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, de Hoogh, Kees, Fecht, Daniela, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla A., Jöckel, Karl Heinz, Jørgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Kristoffersen, Doris Tove, Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Nagel, Gabriele, Pershagen, Göran, Peters, Annette, Raaschou-Nielsen, Ole, Rizzuto, Debora, Schramm, Sara, Schwarze, Per E., Severi, Gianluca, Sigsgaard, Torben, Strak, Maciek, van der Schouw, Yvonne T., Verschuren, Monique, Weinmayr, Gudrun, Wolf, Kathrin, Zitt, Emanuel, Samoli, Evangelia, Forastiere, Francesco, Brunekreef, Bert, Hoek, Gerard, and Janssen, Nicole A.H.
Published: 2022

4. Long-term exposure to air pollution and liver cancer incidence in six European cohorts

Author: So, Rina, Chen, Jie, Mehta, Amar J., Liu, Shuo, Strak, Maciej, Wolf, Kathrin, Hvidtfeldt, Ulla A., Rodopoulou, Sophia, Stafoggia, Massimo, Klompmaker, Jochem O., Samoli, Evangelia, Raaschou-Nielsen, Ole, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Lim, Youn-Hee, Westendorp, Rudi, Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Lager, Anton, Lang, Alois, Ljungman, Petter L., Magnusson, Patrik K. E., Nagel, Gabriele, Simonsen, Mette K., Pershagen, Goran, Peter, Raphael S., Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Sigsgaard, Torben, Vienneau, Danielle, Weinmayr, Gudrun, Severi, Gianluca, Fecht, Daniela, Tjonneland, Anne, Leander, Karin, Hoek, Gerard, Andersen, Zorana J., So, Rina, Chen, Jie, Mehta, Amar J., Liu, Shuo, Strak, Maciej, Wolf, Kathrin, Hvidtfeldt, Ulla A., Rodopoulou, Sophia, Stafoggia, Massimo, Klompmaker, Jochem O., Samoli, Evangelia, Raaschou-Nielsen, Ole, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Lim, Youn-Hee, Westendorp, Rudi, Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Lager, Anton, Lang, Alois, Ljungman, Petter L., Magnusson, Patrik K. E., Nagel, Gabriele, Simonsen, Mette K., Pershagen, Goran, Peter, Raphael S., Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Sigsgaard, Torben, Vienneau, Danielle, Weinmayr, Gudrun, Severi, Gianluca, Fecht, Daniela, Tjonneland, Anne, Leander, Karin, Hoek, Gerard, and Andersen, Zorana J.
Abstract: Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the Effects of low-level air pollution: A study in Europe (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015. The annual average exposure to nitrogen dioxide (NO2), particulate matter with diameter <2.5 mu m (PM2.5), black carbon (BC), warm-season ozone (O-3), and eight elemental components of PM2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, and potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330 064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO2 (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 mu g/m(3)), PM2.5 (1.12, 0.92-1.36 per 5 mu g/m(3)), and BC (1.15, 1.00-1.33 per 0.5 10(-5)/m) and liver cancer incidence. Associations with NO2 and BC persisted in two-pollutant models with PM2.5. Most components of PM2.5 were associated with the risk of liver cancer, with the strongest associations for sulfur and vanadium, which were robust to adjustment for PM2.5 or NO2. Our study suggests that ambient air pollution may increase the risk of liver cancer, even at concentrations below current EU standards.
Published: 2021
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5. Long-term exposure to low-level air pollution and incidence of asthma : the ELAPSE project

Author: Liu, Shuo, Therming Jorgensen, Jeanette, Ljungman, Petter, Pershagen, Goran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K. E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Nielsen, Ole Raaschou, Wolf, Kathrin, Hoffmann, Barbara, Brnekree, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelrick, Mariska, Varraso, Raphaelle, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A. H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjonneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Kristoffersen, Doris Tove, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Jovanovic Andersen, Zorana, Liu, Shuo, Therming Jorgensen, Jeanette, Ljungman, Petter, Pershagen, Goran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K. E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Nielsen, Ole Raaschou, Wolf, Kathrin, Hoffmann, Barbara, Brnekree, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelrick, Mariska, Varraso, Raphaelle, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A. H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjonneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Kristoffersen, Doris Tove, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Jovanovic Andersen, Zorana
Abstract: Background: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 mu m (PM2.5), nitrogen dioxide (NO2) and black carbon (BC) with asthma incidence in adults. Methods: We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land-use regression models at participants' baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders. Results: Of 98326 participants, 1965 developed asthma during a mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 mu g.m(-3) for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 mu g.m(-3) for NO2 and 1.15 (95% CI 1.08-1.23) per 0.5 x 10(-5) m(-1) for BC. Hazard ratios were larger in cohort subsets with exposure levels below the European Union and US limit values and possibly World Health Organization guidelines for PM2.5 and NO2. NO 2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration-response curves showed no evidence of a threshold. Conclusions: Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.
Published: 2021
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6. Long-term exposure to fine particle elemental components and lung cancer incidence in the ELAPSE pooled cohort

Author: Arthur Hvidtfeldt, Ulla, Chen, Jie, Jovanovic Andersen, Zorana, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Therming Jørgensen, Jeanette, Katsouyanni, Klea, Jöckel, Karl-Heinz, Ketzel, Matthias, Klompmaker, Jochem O., Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L. S., Magnusson, Patrik K. E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Severi, Gianluca, Sigsgaard, Torben, Stafoggia, Massimo, Strak, Maciej, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Arthur Hvidtfeldt, Ulla, Chen, Jie, Jovanovic Andersen, Zorana, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Therming Jørgensen, Jeanette, Katsouyanni, Klea, Jöckel, Karl-Heinz, Ketzel, Matthias, Klompmaker, Jochem O., Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L. S., Magnusson, Patrik K. E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Severi, Gianluca, Sigsgaard, Torben, Stafoggia, Massimo, Strak, Maciej, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, and Raaschou-Nielsen, Ole
Abstract: Background: An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study builds on recent findings from the Effects of Low-level Air Pollution: A Study in Europe (ELAPSE) collaboration and addresses the potential association between specific elemental components of PM2.5 and lung cancer incidence. Methods: We pooled seven cohorts from across Europe and assigned exposure estimates for eight components of PM2.5 representing non-tail pipe emissions (copper (Cu), iron (Fe), and zinc (Zn)), long-range transport (sulfur (S)), oil burning/industry emissions (nickel (Ni), vanadium (V)), crustal material (silicon (Si)), and biomass burning (potassium (K)) to cohort participants' baseline residential address based on 100 m by 100 m grids from newly developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). Results: The pooled study population comprised 306,550 individuals with 3916 incident lung cancer events during 5,541,672 person-years of follow-up. We observed a positive association between exposure to all eight components and lung cancer incidence, with adjusted HRs of 1.10 (95% CI 1.05, 1.16) per 50 ng/m(3) PM2.5 K, 1.09 (95% CI 1.02, 1.15) per 1 ng/m3 PM2.5 Ni, 1.22 (95% CI 1.11, 1.35) per 200 ng/m(3) PM2.5 S, and 1.07 (95% CI 1.02, 1.12) per 200 ng/m(3) PM2.5 V. Effect estimates were largely unaffected by adjustment for nitrogen dioxide (NO2). After adjustment for PM2.5 mass, effect estimates of K, Ni, S
Published: 2021
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7. Long-term low-level ambient air pollution exposure and risk of lung cancer - A pooled analysis of 7 European cohorts

Author: Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Jovanovic Andersen, Zorana, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl-Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L. S., Magnusson, Patrik K. E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Fecht, Daniela, Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Jovanovic Andersen, Zorana, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl-Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L. S., Magnusson, Patrik K. E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, and Fecht, Daniela
Abstract: Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods: The Effects of Low-level Air Pollution: a Study in Europe (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O-3) to assign exposure to cohort participants' residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socioeconomic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O-3 (warm season) were 24.2 mu g/m(3) (19.5, 29.7), 15.4 mu g/m(3) (12.8, 17.3), 1.6 10(-5)m(-1) (1.3, 1.8), and 86.6 mu g/m(3) (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 mu g/m(3)). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supra-linear association with no evidence of a threshold. In subset analyses, risk estimates were clearly elevated for the subset o
Published: 2021
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8. Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease : The ELAPSE project

Author: Liu, Shuo, Jørgensen, Jeanette T., Ljungman, Petter, Pershagen, Göran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K. E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Raaschou-Nielsen, Ole, Wolf, Kathrin, Hoffmann, Barbara, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelinck, Mariska, Varraso, Raphaëlle, Boutron-Ruault, Marie-Christine, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A. H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjønneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Bekkevold, Terese, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Andersen, Zorana J., Liu, Shuo, Jørgensen, Jeanette T., Ljungman, Petter, Pershagen, Göran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K. E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Raaschou-Nielsen, Ole, Wolf, Kathrin, Hoffmann, Barbara, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelinck, Mariska, Varraso, Raphaëlle, Boutron-Ruault, Marie-Christine, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A. H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjønneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Bekkevold, Terese, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Andersen, Zorana J.
Abstract: Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods: Within the 'Effects of Low-Level Air Pollution: A Study in Europe' (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 mu m (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants' baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models. Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 mu g/m(3) for PM2.5, 1.11 (1.06, 1.16) per 10 mu g/m(3) for NO2, and 1.11 (1.06, 1.15) per 0.5 10(-5) m(-1) for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC. Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant.
Published: 2021
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9. Delirium in Patients with SARS‐CoV‐2 Infection: A Multicenter Study

Author: Rebora, P, Rozzini, R, Angelo, B, Blangiardo, P, Marchegiani, A, Piazzoli, A, Mazzeo, F, Cesaroni, G, Chizzoli, A, Guerini, F, Bonfanti, P, Morandi, A, Faraci, B, Gentile, S, Bna, C, Savelli, G, Citerio, G, Valsecchi, M, Mazzola, P, Bellelli, G, Celora, G, Deiana, V, Ghezzi, N, Miksza, J, Rebora, Paola, Rozzini, Renzo, Angelo, Bianchetti, Blangiardo, Paolo, Marchegiani, Alice, Piazzoli, Andrea, Mazzeo, Francesca, Cesaroni, Giulia, Chizzoli, Anita, Guerini, Fabio, Bonfanti, Paolo, Morandi, Alessandro, Faraci, Bianca, Gentile, Simona, Bna, Claudio, Savelli, Giordano, Citerio, Giuseppe, Valsecchi, Maria Grazia, Mazzola, Paolo, Bellelli, Giuseppe, Celora, Gabriella Maria, Deiana, Valentina, Ghezzi, Nives, Miksza, Julia, Rebora, P, Rozzini, R, Angelo, B, Blangiardo, P, Marchegiani, A, Piazzoli, A, Mazzeo, F, Cesaroni, G, Chizzoli, A, Guerini, F, Bonfanti, P, Morandi, A, Faraci, B, Gentile, S, Bna, C, Savelli, G, Citerio, G, Valsecchi, M, Mazzola, P, Bellelli, G, Celora, G, Deiana, V, Ghezzi, N, Miksza, J, Rebora, Paola, Rozzini, Renzo, Angelo, Bianchetti, Blangiardo, Paolo, Marchegiani, Alice, Piazzoli, Andrea, Mazzeo, Francesca, Cesaroni, Giulia, Chizzoli, Anita, Guerini, Fabio, Bonfanti, Paolo, Morandi, Alessandro, Faraci, Bianca, Gentile, Simona, Bna, Claudio, Savelli, Giordano, Citerio, Giuseppe, Valsecchi, Maria Grazia, Mazzola, Paolo, Bellelli, Giuseppe, Celora, Gabriella Maria, Deiana, Valentina, Ghezzi, Nives, and Miksza, Julia
Abstract: Objectives: The aims of this study are to report the prevalence of delirium on admission to the unit in patients hospitalized with SARS-CoV-2 infection, to identify the factors associated with delirium, and to evaluate the association between delirium and in-hospital mortality. Design: Multicenter observational cohort study. Settings: Acute medical units in four Italian hospitals. Participants: A total of 516 patients (median age 78 years) admitted to the participating centers with SARS-CoV-2 infection from February 22 to May 17, 2020. Measurements: Comprehensive medical assessment with detailed history, physical examinations, functional status, laboratory and imaging procedures. On admission, delirium was determined by the Diagnostic and Statistical Manual of Mental Disorders (5th edition) criteria, 4AT, m-Richmond Agitation Sedation Scale, or clinical impression depending on the site. The primary outcomes were delirium rates and in-hospital mortality. Results: Overall, 73 (14.1%, 95% confidence interval (CI) = 11.0–17.3%) patients presented delirium on admission. Factors significantly associated with delirium were dementia (odds ratio, OR = 4.66, 95% CI = 2.03–10.69), the number of chronic diseases (OR = 1.20, 95% CI = 1.03; 1.40), and chest X-ray or CT opacity (OR = 3.29, 95% CI = 1.12–9.64 and 3.35, 95% CI = 1.07–10.47, for multiple or bilateral opacities and single opacity vs no opacity, respectively). There were 148 (33.4%) in-hospital deaths in the no-delirium group and 43 (58.9%) in the delirium group (P-value assessed using the Gray test <.001). As assessed by a multivariable Cox model, patients with delirium on admission showed an almost twofold increased hazard ratio for in-hospital mortality with respect to patients without delirium (hazard ratio = 1.88, 95% CI = 1.25–2.83). Conclusion: Delirium is prevalent and associated with in-hospital mortality among older patients hospitalized with SARS-CoV-2 infection.
Published: 2021

10. Long-term exposure to fine particle elemental components and lung cancer incidence in the ELAPSE pooled cohort

Author: Hvidtfeldt, Ulla Arthur, Chen, Jie, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Jöckel, Karl Heinz, Ketzel, Matthias, Klompmaker, Jochem O., Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Severi, Gianluca, Sigsgaard, Torben, Stafoggia, Massimo, Strak, Maciej, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Hvidtfeldt, Ulla Arthur, Chen, Jie, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Jöckel, Karl Heinz, Ketzel, Matthias, Klompmaker, Jochem O., Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Severi, Gianluca, Sigsgaard, Torben, Stafoggia, Massimo, Strak, Maciej, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, and Raaschou-Nielsen, Ole
Abstract: Background: An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study builds on recent findings from the “Effects of Low-level Air Pollution: A Study in Europe” (ELAPSE) collaboration and addresses the potential association between specific elemental components of PM2.5 and lung cancer incidence. Methods: We pooled seven cohorts from across Europe and assigned exposure estimates for eight components of PM2.5 representing non-tail pipe emissions (copper (Cu), iron (Fe), and zinc (Zn)), long-range transport (sulfur (S)), oil burning/industry emissions (nickel (Ni), vanadium (V)), crustal material (silicon (Si)), and biomass burning (potassium (K)) to cohort participants’ baseline residential address based on 100 m by 100 m grids from newly developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). Results: The pooled study population comprised 306,550 individuals with 3916 incident lung cancer events during 5,541,672 person-years of follow-up. We observed a positive association between exposure to all eight components and lung cancer incidence, with adjusted HRs of 1.10 (95% CI 1.05, 1.16) per 50 ng/m3 PM2.5 K, 1.09 (95% CI 1.02, 1.15) per 1 ng/m3 PM2.5 Ni, 1.22 (95% CI 1.11, 1.35) per 200 ng/m3 PM2.5 S, and 1.07 (95% CI 1.02, 1.12) per 200 ng/m3 PM2.5 V. Effect estimate
Published: 2021

11. Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease:a pooled analysis of six European cohorts within the ELAPSE project

Author: Wolf, Kathrin, Hoffmann, Barbara, Andersen, Zorana J., Atkinson, Richard W., Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, de Faire, Ulf, de Hoogh, Kees, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Liu, Shuo, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pedersen, Nancy L., Pershagen, Goran, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Strak, Maciek, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Peters, Annette, Ljungman, Petter L. S., Wolf, Kathrin, Hoffmann, Barbara, Andersen, Zorana J., Atkinson, Richard W., Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, de Faire, Ulf, de Hoogh, Kees, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Liu, Shuo, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pedersen, Nancy L., Pershagen, Goran, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Strak, Maciek, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Peters, Annette, and Ljungman, Petter L. S.
Abstract: Background Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we investigated the associations of long-term exposures to fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon, and warm-season ozone (O-3) with the incidence of stroke and acute coronary heart disease.Methods We did a pooled analysis of individual data from six population-based cohort studies within ELAPSE, from Sweden, Denmark, the Netherlands, and Germany (recruited 1992-2004), and harmonised individual and area-level variables between cohorts. Participants (all adults) were followed up until migration from the study area, death, or incident stroke or coronary heart disease, or end of follow-up (2011-15). Mean 2010 air pollution concentrations from centrally developed European-wide land use regression models were assigned to participants' baseline residential addresses. We used Cox proportional hazards models with increasing levels of covariate adjustment to investigate the association of air pollution exposure with incidence of stroke and coronary heart disease. We assessed the shape of the concentration-response function and did subset analyses of participants living at pollutant concentrations lower than predefined values.Findings From the pooled ELAPSE cohorts, data on 137 148 participants were analysed in our fully adjusted model. During a median follow-up of 17.2 years (IQR 13.8-19.5), we observed 6950 incident events of stroke and 10 071 incident events of coronary heart disease. Incidence of stroke was associated with PM2.5 (hazard ratio 1.10 [95% CI 1.01-1.21] per 5 mu g/m(3) increase), NO2 (1.08 [1.04-1.12] per 10 mu g/m(3) increase), and black carbon (1.06 [1.02-1.10] per 0.5 10(
Published: 2021

12. Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project:pooled analysis

Author: Strak, Maciej, Weinmayr, Gudrun, Rodopoulou, Sophia, Chen, Jie, de Hoogh, Kees, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bekkevold, Terese, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jockel, Karl-Heinz, Jorgensen, Jeanette, Ketzel, Matthias, Klompmaker, Jochem, Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Schouw, Yvonne T. van der, Schramm, Sara, Severi, Gianluca, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Wolf, Kathrin, Katsouyanni, Klea, Brunekreef, Bert, Hoek, Gerard, Samoli, Evangelia, Strak, Maciej, Weinmayr, Gudrun, Rodopoulou, Sophia, Chen, Jie, de Hoogh, Kees, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bekkevold, Terese, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jockel, Karl-Heinz, Jorgensen, Jeanette, Ketzel, Matthias, Klompmaker, Jochem, Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Schouw, Yvonne T. van der, Schramm, Sara, Severi, Gianluca, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Wolf, Kathrin, Katsouyanni, Klea, Brunekreef, Bert, Hoek, Gerard, and Samoli, Evangelia
Abstract: OBJECTIVETo investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines.DESIGNPooled analysis of eight cohorts.SETTINGMulticentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries.PARTICIPANTS325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM2.5), nitrogen dioxide, ozone, and black carbon.MAIN OUTCOME MEASURESDeaths due to natural causes and cause specific mortality.RESULTSOf 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 mu g/m(3) in PM2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 mu g/m(3) increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 mu g/m(3) an increase of 5 mu g/m(3) in PM2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths.CONCLUSIONSOur study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about rev
Published: 2021

13. Long-Term Exposure to Fine Particle Elemental Components and Natural and Cause-Specific Mortality-a Pooled Analysis of Eight European Cohorts within the ELAPSE Project

Author: Chen, Jie, Rodopoulou, Sophia, de Hoogh, Kees, Strak, Maciej, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Joeckel, Karl-Heinz, Jorgensen, Jeanette, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar, Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Brunekreef, Bert, Hoek, Gerard, Chen, Jie, Rodopoulou, Sophia, de Hoogh, Kees, Strak, Maciej, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Joeckel, Karl-Heinz, Jorgensen, Jeanette, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar, Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Brunekreef, Bert, and Hoek, Gerard
Abstract: BACKGROUND: Inconsistent associations between long-term exposure to particles with an aerodynamic diameterOBJECTIVES: We investigated the associations between long-term exposure to PM2.5 elemental components and mortality in a large pooled European cohort; to compare health effects of PM2.5 components estimated with two exposure modeling approaches, namely, supervised linear regression (SLR) and random forest (RF) algorithms.METHODS: We pooled data from eight European cohorts with 323,782 participants, average age 49 y at baseline (1985-2005). Residential exposure to 2010 annual average concentration of eight PM2.5 components [copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V), and zinc (Zn)] was estimated with Europe-wide SLR and RF models at a 100 X 100 m scale. We applied Cox proportional hazards models to investigate the associations between components and natural and cause-specific mortality. In addition, two-pollutant analyses were conducted by adjusting each component for PM2.5 mass and nitrogen dioxide (NO2) separately.RESULTS: We observed 46,640 natural-cause deaths with 6,317,235 person-years and an average follow-up of 19.5 y. All SLR-modeled components were statistically significantly associated with natural-cause mortality in single-pollutant models with hazard ratios (HRs) from 1.05 to 1.27. Similar HRs were observed for RE-modeled Cu, Fe, K, S, V, and Zn with wider confidence intervals (CIs). HRs for SLR-modeled Ni, S, Si, V, and Zn remained above unity and (almost) significant after adjustment for both PM2.5 and NO2. HRs only remained (almost) significant for RE-modeled K and V in two-pollutant models. The HRs for V were 1.03 (95% CI: 1.02, 1.05) and 1.06 (95% CI: 1.02, 1.10) for SLR- and RF-modeled exposures, respectively, per 2 ng/m(3), adjusting for PM2.5 mass. Associations with cause-specific mortality were less consistent in two-pollutant models.CONCLUSION: Long-term exposure
Published: 2021

14. Long-term exposure to low-level air pollution and incidence of asthma:the ELAPSE project

Author: Liu, Shuo, Jorgensen, Jeanette Therming, Ljungman, Petter, Pershagen, Goran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K. E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Nielsen, Ole Raaschou, Wolf, Kathrin, Hoffmann, Barbara, Brnekree, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelrick, Mariska, Varraso, Raphaelle, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Herte, Ole, de Hoogh, Kees, Janssen, Nicole A. H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjonneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Kristoffersen, Doris Tove, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Andersen, Zorana Jovanovic, Liu, Shuo, Jorgensen, Jeanette Therming, Ljungman, Petter, Pershagen, Goran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K. E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Nielsen, Ole Raaschou, Wolf, Kathrin, Hoffmann, Barbara, Brnekree, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelrick, Mariska, Varraso, Raphaelle, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Herte, Ole, de Hoogh, Kees, Janssen, Nicole A. H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjonneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Kristoffersen, Doris Tove, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Andersen, Zorana Jovanovic
Abstract: Background: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameterMethods: We pooled data from three cohorts in Denmark and Sweden with information on asthma hospital diagnoses. The average concentrations of air pollutants in 2010 were modelled by hybrid land-use regression models at participants' baseline residential addresses. Associations of air pollution exposures with asthma incidence were explored with Cox proportional hazard models, adjusting for potential confounders.Results: Of 98326 participants, 1965 developed asthma during a mean follow-up of 16.6 years. We observed associations in fully adjusted models with hazard ratios of 1.22 (95% CI 1.04-1.43) per 5 mu g.m(-3) for PM2.5, 1.17 (95% CI 1.10-1.25) per 10 mu g.m(-3) for NO2 and 1.15 (95% CI 1.08-1.23) per 0.5 x 10(-5) m(-1) for BC. Hazard ratios were larger in cohort subsets with exposure levels below the European Union and US limit values and possibly World Health Organization guidelines for PM2.5 and NO2. NO 2 and BC estimates remained unchanged in two-pollutant models with PM2.5, whereas PM2.5 estimates were attenuated to unity. The concentration-response curves showed no evidence of a threshold.Conclusions: Long-term exposure to air pollution, especially from fossil fuel combustion sources such as motorised traffic, was associated with adult-onset asthma, even at levels below the current limit values.
Published: 2021

15. Long-term exposure to fine particle elemental components and lung cancer incidence in the ELAPSE pooled cohort

Author: Hvidtfeldt, Ulla Arthur, Chen, Jie, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Jöckel, Karl Heinz, Ketzel, Matthias, Klompmaker, Jochem O., Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Severi, Gianluca, Sigsgaard, Torben, Stafoggia, Massimo, Strak, Maciej, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Hvidtfeldt, Ulla Arthur, Chen, Jie, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Jöckel, Karl Heinz, Ketzel, Matthias, Klompmaker, Jochem O., Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Severi, Gianluca, Sigsgaard, Torben, Stafoggia, Massimo, Strak, Maciej, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, and Raaschou-Nielsen, Ole
Abstract: Background: An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study builds on recent findings from the “Effects of Low-level Air Pollution: A Study in Europe” (ELAPSE) collaboration and addresses the potential association between specific elemental components of PM2.5 and lung cancer incidence. Methods: We pooled seven cohorts from across Europe and assigned exposure estimates for eight components of PM2.5 representing non-tail pipe emissions (copper (Cu), iron (Fe), and zinc (Zn)), long-range transport (sulfur (S)), oil burning/industry emissions (nickel (Ni), vanadium (V)), crustal material (silicon (Si)), and biomass burning (potassium (K)) to cohort participants’ baseline residential address based on 100 m by 100 m grids from newly developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). Results: The pooled study population comprised 306,550 individuals with 3916 incident lung cancer events during 5,541,672 person-years of follow-up. We observed a positive association between exposure to all eight components and lung cancer incidence, with adjusted HRs of 1.10 (95% CI 1.05, 1.16) per 50 ng/m3 PM2.5 K, 1.09 (95% CI 1.02, 1.15) per 1 ng/m3 PM2.5 Ni, 1.22 (95% CI 1.11, 1.35) per 200 ng/m3 PM2.5 S, and 1.07 (95% CI 1.02, 1.12) per 200 ng/m3 PM2.5 V. Effect estimate
Published: 2021

16. Modeling multi-level survival data in multi-center epidemiological cohort studies:Applications from the ELAPSE project

Author: Samoli, Evangelia, Rodopoulou, Sophia, Hvidtfeldt, Ulla A., Wolf, Kathrin, Stafoggia, Massimo, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole A.H., Ketzel, Matthias, Klompmaker, Jochem O., Liu, Shuo, Ljungman, Petter, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Kristoffersen, Doris T., Severi, Gianluca, Sigsgaard, Torben, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Katsouyanni, Klea, Samoli, Evangelia, Rodopoulou, Sophia, Hvidtfeldt, Ulla A., Wolf, Kathrin, Stafoggia, Massimo, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole A.H., Ketzel, Matthias, Klompmaker, Jochem O., Liu, Shuo, Ljungman, Petter, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Kristoffersen, Doris T., Severi, Gianluca, Sigsgaard, Torben, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Katsouyanni, Klea
Abstract: Background: We evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). Methods: We applied five approaches in a multivariable Cox model to account for the first level of clustering corresponding to cohort specification: (1) not accounting for the cohort or using (2) indicator variables, (3) strata, (4) a frailty term in frailty Cox models, (5) a random intercept under a mixed Cox, for cohort identification. We accounted for the second level of clustering due to common characteristics in the residential area by (1) a random intercept per small area or (2) applying variance correction. We assessed the stratified, frailty and mixed Cox approach through simulations under different scenarios for heterogeneity in the underlying hazards and the air pollution effects. Results: Effect estimates were stable under approaches used to adjust for cohort but substantially differed when no adjustment was applied. Further adjustment for the small area grouping increased the effect estimates’ standard errors. Simulations confirmed identical results between the stratified and frailty models. In ELAPSE we selected a stratified multivariable Cox model to account for between-cohort heterogeneity without adjustment for small area level, due to the small number of subjects and events in the latter. Conclusions: Our study supports the need to account for between-cohort heterogeneity in multi-center collaborations using pooled individual level data.
Published: 2021

17. Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease:The ELAPSE project

Author: Liu, Shuo, Jørgensen, Jeanette T., Ljungman, Petter, Pershagen, Göran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K.E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Raaschou-Nielsen, Ole, Wolf, Kathrin, Hoffmann, Barbara, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelinck, Mariska, Varraso, Raphaëlle, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A.H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjønneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Bekkevold, Terese, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Andersen, Zorana J., Liu, Shuo, Jørgensen, Jeanette T., Ljungman, Petter, Pershagen, Göran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K.E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Raaschou-Nielsen, Ole, Wolf, Kathrin, Hoffmann, Barbara, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelinck, Mariska, Varraso, Raphaëlle, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A.H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjønneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Bekkevold, Terese, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Andersen, Zorana J.
Abstract: Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods: Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants’ baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models. Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 µg/m3 for PM2.5, 1.11 (1.06, 1.16) per 10 µg/m3 for NO2, and 1.11 (1.06, 1.15) per 0.5 10−5m−1 for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC. Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant.
Published: 2021

18. Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Author: Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Fecht, Daniela, Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, and Fecht, Daniela
Abstract: Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods: The “Effects of Low-level Air Pollution: a Study in Europe” (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O3) to assign exposure to cohort participants’ residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O3 (warm season) were 24.2 µg/m3 (19.5, 29.7), 15.4 µg/m3 (12.8, 17.3), 1.6 10−5m−1 (1.3, 1.8), and 86.6 µg/m3 (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 µg/m3). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supr
Published: 2021

19. Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease:a pooled analysis of six European cohorts within the ELAPSE project

Author: Wolf, Kathrin, Hoffmann, Barbara, Andersen, Zorana J., Atkinson, Richard W., Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, de Faire, Ulf, de Hoogh, Kees, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Liu, Shuo, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pedersen, Nancy L., Pershagen, Goran, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Strak, Maciek, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Peters, Annette, Ljungman, Petter L. S., Wolf, Kathrin, Hoffmann, Barbara, Andersen, Zorana J., Atkinson, Richard W., Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, de Faire, Ulf, de Hoogh, Kees, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jorgensen, Jeanette T., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Liu, Shuo, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pedersen, Nancy L., Pershagen, Goran, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Strak, Maciek, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Peters, Annette, and Ljungman, Petter L. S.
Abstract: Background Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we investigated the associations of long-term exposures to fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon, and warm-season ozone (O-3) with the incidence of stroke and acute coronary heart disease.Methods We did a pooled analysis of individual data from six population-based cohort studies within ELAPSE, from Sweden, Denmark, the Netherlands, and Germany (recruited 1992-2004), and harmonised individual and area-level variables between cohorts. Participants (all adults) were followed up until migration from the study area, death, or incident stroke or coronary heart disease, or end of follow-up (2011-15). Mean 2010 air pollution concentrations from centrally developed European-wide land use regression models were assigned to participants' baseline residential addresses. We used Cox proportional hazards models with increasing levels of covariate adjustment to investigate the association of air pollution exposure with incidence of stroke and coronary heart disease. We assessed the shape of the concentration-response function and did subset analyses of participants living at pollutant concentrations lower than predefined values.Findings From the pooled ELAPSE cohorts, data on 137 148 participants were analysed in our fully adjusted model. During a median follow-up of 17.2 years (IQR 13.8-19.5), we observed 6950 incident events of stroke and 10 071 incident events of coronary heart disease. Incidence of stroke was associated with PM2.5 (hazard ratio 1.10 [95% CI 1.01-1.21] per 5 mu g/m(3) increase), NO2 (1.08 [1.04-1.12] per 10 mu g/m(3) increase), and black carbon (1.06 [1.02-1.10] per 0.5 10(
Published: 2021

20. Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project:pooled analysis

Author: Strak, Maciej, Weinmayr, Gudrun, Rodopoulou, Sophia, Chen, Jie, de Hoogh, Kees, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bekkevold, Terese, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jockel, Karl-Heinz, Jorgensen, Jeanette, Ketzel, Matthias, Klompmaker, Jochem, Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Schouw, Yvonne T. van der, Schramm, Sara, Severi, Gianluca, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Wolf, Kathrin, Katsouyanni, Klea, Brunekreef, Bert, Hoek, Gerard, Samoli, Evangelia, Strak, Maciej, Weinmayr, Gudrun, Rodopoulou, Sophia, Chen, Jie, de Hoogh, Kees, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bekkevold, Terese, Bellander, Tom, Boutron-Ruault, Marie-Christine, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Jockel, Karl-Heinz, Jorgensen, Jeanette, Ketzel, Matthias, Klompmaker, Jochem, Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, Magnusson, Patrik K. E., Mehta, Amar J., Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Schouw, Yvonne T. van der, Schramm, Sara, Severi, Gianluca, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Verschuren, W. M. Monique, Vienneau, Danielle, Wolf, Kathrin, Katsouyanni, Klea, Brunekreef, Bert, Hoek, Gerard, and Samoli, Evangelia
Abstract: OBJECTIVETo investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines.DESIGNPooled analysis of eight cohorts.SETTINGMulticentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six European countries.PARTICIPANTS325 367 adults from the general population recruited mostly in the 1990s or 2000s with detailed lifestyle data. Stratified Cox proportional hazard models were used to analyse the associations between air pollution and mortality. Western Europe-wide land use regression models were used to characterise residential air pollution concentrations of ambient fine particulate matter (PM2.5), nitrogen dioxide, ozone, and black carbon.MAIN OUTCOME MEASURESDeaths due to natural causes and cause specific mortality.RESULTSOf 325 367 adults followed-up for an average of 19.5 years, 47 131 deaths were observed. Higher exposure to PM2.5, nitrogen dioxide, and black carbon was associated with significantly increased risk of almost all outcomes. An increase of 5 mu g/m(3) in PM2.5 was associated with 13% (95% confidence interval 10.6% to 15.5%) increase in natural deaths; the corresponding figure for a 10 mu g/m(3) increase in nitrogen dioxide was 8.6% (7% to 10.2%). Associations with PM2.5, nitrogen dioxide, and black carbon remained significant at low concentrations. For participants with exposures below the US standard of 12 mu g/m(3) an increase of 5 mu g/m(3) in PM2.5 was associated with 29.6% (14% to 47.4%) increase in natural deaths.CONCLUSIONSOur study contributes to the evidence that outdoor air pollution is associated with mortality even at low pollution levels below the current European and North American standards and WHO guideline values. These findings are therefore an important contribution to the debate about rev
Published: 2021

21. Modeling multi-level survival data in multi-center epidemiological cohort studies:Applications from the ELAPSE project

Author: Samoli, Evangelia, Rodopoulou, Sophia, Hvidtfeldt, Ulla A., Wolf, Kathrin, Stafoggia, Massimo, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole A.H., Ketzel, Matthias, Klompmaker, Jochem O., Liu, Shuo, Ljungman, Petter, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Kristoffersen, Doris T., Severi, Gianluca, Sigsgaard, Torben, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Katsouyanni, Klea, Samoli, Evangelia, Rodopoulou, Sophia, Hvidtfeldt, Ulla A., Wolf, Kathrin, Stafoggia, Massimo, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole A.H., Ketzel, Matthias, Klompmaker, Jochem O., Liu, Shuo, Ljungman, Petter, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Kristoffersen, Doris T., Severi, Gianluca, Sigsgaard, Torben, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Katsouyanni, Klea
Abstract: Background: We evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). Methods: We applied five approaches in a multivariable Cox model to account for the first level of clustering corresponding to cohort specification: (1) not accounting for the cohort or using (2) indicator variables, (3) strata, (4) a frailty term in frailty Cox models, (5) a random intercept under a mixed Cox, for cohort identification. We accounted for the second level of clustering due to common characteristics in the residential area by (1) a random intercept per small area or (2) applying variance correction. We assessed the stratified, frailty and mixed Cox approach through simulations under different scenarios for heterogeneity in the underlying hazards and the air pollution effects. Results: Effect estimates were stable under approaches used to adjust for cohort but substantially differed when no adjustment was applied. Further adjustment for the small area grouping increased the effect estimates’ standard errors. Simulations confirmed identical results between the stratified and frailty models. In ELAPSE we selected a stratified multivariable Cox model to account for between-cohort heterogeneity without adjustment for small area level, due to the small number of subjects and events in the latter. Conclusions: Our study supports the need to account for between-cohort heterogeneity in multi-center collaborations using pooled individual level data.
Published: 2021

22. Long-term exposure to low-level air pollution and incidence of chronic obstructive pulmonary disease:The ELAPSE project

Author: Liu, Shuo, Jørgensen, Jeanette T., Ljungman, Petter, Pershagen, Göran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K.E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Raaschou-Nielsen, Ole, Wolf, Kathrin, Hoffmann, Barbara, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelinck, Mariska, Varraso, Raphaëlle, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A.H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjønneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Bekkevold, Terese, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, Andersen, Zorana J., Liu, Shuo, Jørgensen, Jeanette T., Ljungman, Petter, Pershagen, Göran, Bellander, Tom, Leander, Karin, Magnusson, Patrik K.E., Rizzuto, Debora, Hvidtfeldt, Ulla A., Raaschou-Nielsen, Ole, Wolf, Kathrin, Hoffmann, Barbara, Brunekreef, Bert, Strak, Maciej, Chen, Jie, Mehta, Amar, Atkinson, Richard W., Bauwelinck, Mariska, Varraso, Raphaëlle, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Cesaroni, Giulia, Forastiere, Francesco, Fecht, Daniela, Gulliver, John, Hertel, Ole, de Hoogh, Kees, Janssen, Nicole A.H., Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Nagel, Gabriele, Oftedal, Bente, Peters, Annette, Tjønneland, Anne, Rodopoulou, Sophia P., Samoli, Evangelia, Bekkevold, Terese, Sigsgaard, Torben, Stafoggia, Massimo, Vienneau, Danielle, Weinmayr, Gudrun, Hoek, Gerard, and Andersen, Zorana J.
Abstract: Background: Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives: We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods: Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE) study, we pooled data from three cohorts, from Denmark and Sweden, with information on COPD hospital discharge diagnoses. Hybrid land use regression models were used to estimate annual mean concentrations of particulate matter with a diameter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) in 2010 at participants’ baseline residential addresses, which were analysed in relation to COPD incidence using Cox proportional hazards models. Results: Of 98,058 participants, 4,928 developed COPD during 16.6 years mean follow-up. The adjusted hazard ratios (HRs) and 95% confidence intervals for associations with COPD incidence were 1.17 (1.06, 1.29) per 5 µg/m3 for PM2.5, 1.11 (1.06, 1.16) per 10 µg/m3 for NO2, and 1.11 (1.06, 1.15) per 0.5 10−5m−1 for BC. Associations persisted in subset participants with PM2.5 or NO2 levels below current EU and US limit values and WHO guidelines, with no evidence for a threshold. HRs for NO2 and BC remained unchanged in two-pollutant models with PM2.5, whereas the HR for PM2.5 was attenuated to unity with NO2 or BC. Conclusions: Long-term exposure to low-level air pollution is associated with the development of COPD, even below current EU and US limit values and possibly WHO guidelines. Traffic-related pollutants NO2 and BC may be the most relevant.
Published: 2021

23. Long-term low-level ambient air pollution exposure and risk of lung cancer – A pooled analysis of 7 European cohorts

Author: Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, Fecht, Daniela, Hvidtfeldt, Ulla Arthur, Severi, Gianluca, Andersen, Zorana Jovanovic, Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Boutron-Ruault, Marie Christine, Brandt, Jørgen, Brunekreef, Bert, Cesaroni, Giulia, Chen, Jie, Concin, Hans, Forastiere, Francesco, van Gils, Carla H., Gulliver, John, Hertel, Ole, Hoek, Gerard, Hoffmann, Barbara, de Hoogh, Kees, Janssen, Nicole, Jöckel, Karl Heinz, Jørgensen, Jeanette Therming, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Krog, Norun Hjertager, Lang, Alois, Leander, Karin, Liu, Shuo, Ljungman, Petter L.S., Magnusson, Patrik K.E., Mehta, Amar Jayant, Nagel, Gabriele, Oftedal, Bente, Pershagen, Göran, Peter, Raphael Simon, Peters, Annette, Renzi, Matteo, Rizzuto, Debora, Rodopoulou, Sophia, Samoli, Evangelia, Schwarze, Per Everhard, Sigsgaard, Torben, Simonsen, Mette Kildevæld, Stafoggia, Massimo, Strak, Maciek, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Raaschou-Nielsen, Ole, and Fecht, Daniela
Abstract: Background/aim: Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods: The “Effects of Low-level Air Pollution: a Study in Europe” (ELAPSE) collaboration pools seven cohorts from across Europe. We developed hybrid models combining air pollution monitoring, land use data, satellite observations, and dispersion model estimates for nitrogen dioxide (NO2), fine particulate matter (PM2.5), black carbon (BC), and ozone (O3) to assign exposure to cohort participants’ residential addresses in 100 m by 100 m grids. We applied stratified Cox proportional hazards models, adjusting for potential confounders (age, sex, calendar year, marital status, smoking, body mass index, employment status, and neighborhood-level socio-economic status). We fitted linear models, linear models in subsets, Shape-Constrained Health Impact Functions (SCHIF), and natural cubic spline models to assess the shape of the association between air pollution and lung cancer at concentrations below existing standards and guidelines. Results: The analyses included 307,550 cohort participants. During a mean follow-up of 18.1 years, 3956 incident lung cancer cases occurred. Median (Q1, Q3) annual (2010) exposure levels of NO2, PM2.5, BC and O3 (warm season) were 24.2 µg/m3 (19.5, 29.7), 15.4 µg/m3 (12.8, 17.3), 1.6 10−5m−1 (1.3, 1.8), and 86.6 µg/m3 (78.5, 92.9), respectively. We observed a higher risk for lung cancer with higher exposure to PM2.5 (HR: 1.13, 95% CI: 1.05, 1.23 per 5 µg/m3). This association was robust to adjustment for other pollutants. The SCHIF, spline and subset analyses suggested a linear or supr
Published: 2021

24. Long-Term Exposure to Fine Particle Elemental Components and Natural and Cause-Specific Mortality-a Pooled Analysis of Eight European Cohorts within the ELAPSE Project

Author: Chen, Jie, Rodopoulou, Sophia, de Hoogh, Kees, Strak, Maciej, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Joeckel, Karl-Heinz, Jorgensen, Jeanette, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar, Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Brunekreef, Bert, Hoek, Gerard, Chen, Jie, Rodopoulou, Sophia, de Hoogh, Kees, Strak, Maciej, Andersen, Zorana J., Atkinson, Richard, Bauwelinck, Mariska, Bellander, Tom, Brandt, Jorgen, Cesaroni, Giulia, Concin, Hans, Fecht, Daniela, Forastiere, Francesco, Gulliver, John, Hertel, Ole, Hoffmann, Barbara, Hvidtfeldt, Ulla Arthur, Janssen, Nicole A. H., Joeckel, Karl-Heinz, Jorgensen, Jeanette, Katsouyanni, Klea, Ketzel, Matthias, Klompmaker, Jochem O., Lager, Anton, Leander, Karin, Liu, Shuo, Ljungman, Petter, MacDonald, Conor J., Magnusson, Patrik K. E., Mehta, Amar, Nagel, Gabriele, Oftedal, Bente, Pershagen, Goran, Peters, Annette, Raaschou-Nielsen, Ole, Renzi, Matteo, Rizzuto, Debora, Samoli, Evangelia, van der Schouw, Yvonne T., Schramm, Sara, Schwarze, Per, Sigsgaard, Torben, Sørensen, Mette, Stafoggia, Massimo, Tjonneland, Anne, Vienneau, Danielle, Weinmayr, Gudrun, Wolf, Kathrin, Brunekreef, Bert, and Hoek, Gerard
Abstract: BACKGROUND: Inconsistent associations between long-term exposure to particles with an aerodynamic diameterOBJECTIVES: We investigated the associations between long-term exposure to PM2.5 elemental components and mortality in a large pooled European cohort; to compare health effects of PM2.5 components estimated with two exposure modeling approaches, namely, supervised linear regression (SLR) and random forest (RF) algorithms.METHODS: We pooled data from eight European cohorts with 323,782 participants, average age 49 y at baseline (1985-2005). Residential exposure to 2010 annual average concentration of eight PM2.5 components [copper (Cu), iron (Fe), potassium (K), nickel (Ni), sulfur (S), silicon (Si), vanadium (V), and zinc (Zn)] was estimated with Europe-wide SLR and RF models at a 100 X 100 m scale. We applied Cox proportional hazards models to investigate the associations between components and natural and cause-specific mortality. In addition, two-pollutant analyses were conducted by adjusting each component for PM2.5 mass and nitrogen dioxide (NO2) separately.RESULTS: We observed 46,640 natural-cause deaths with 6,317,235 person-years and an average follow-up of 19.5 y. All SLR-modeled components were statistically significantly associated with natural-cause mortality in single-pollutant models with hazard ratios (HRs) from 1.05 to 1.27. Similar HRs were observed for RE-modeled Cu, Fe, K, S, V, and Zn with wider confidence intervals (CIs). HRs for SLR-modeled Ni, S, Si, V, and Zn remained above unity and (almost) significant after adjustment for both PM2.5 and NO2. HRs only remained (almost) significant for RE-modeled K and V in two-pollutant models. The HRs for V were 1.03 (95% CI: 1.02, 1.05) and 1.06 (95% CI: 1.02, 1.10) for SLR- and RF-modeled exposures, respectively, per 2 ng/m(3), adjusting for PM2.5 mass. Associations with cause-specific mortality were less consistent in two-pollutant models.CONCLUSION: Long-term exposure
Published: 2021

25. Associations between air pollution and pediatric eczema, rhinoconjunctivitis and asthma: A meta-analysis of European birth cohorts

Author: IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Fuertes, Elaine, Sunyer, Jordi, Gehring, Ulrike, Porta, Daniela, Forastiere, Francesco, Cesaroni, Giulia, Vrijheid, Martine, Guxens, Mònica, Annesi-Maesano, Isabella, Slama, Rémy, Maier, Dieter, Kogevinas, Manolis, Bousquet, Jean, Chatzi, Leda, Lertxundi, Aitana, Basterrechea, Mikel, Esplugues, Ana, Ferrero, Amparo, Wright, John, Mason, Dan, McEachan, Rosie, Garcia-Aymerich, Judith, Jacquemin, Bénédicte, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Fuertes, Elaine, Sunyer, Jordi, Gehring, Ulrike, Porta, Daniela, Forastiere, Francesco, Cesaroni, Giulia, Vrijheid, Martine, Guxens, Mònica, Annesi-Maesano, Isabella, Slama, Rémy, Maier, Dieter, Kogevinas, Manolis, Bousquet, Jean, Chatzi, Leda, Lertxundi, Aitana, Basterrechea, Mikel, Esplugues, Ana, Ferrero, Amparo, Wright, John, Mason, Dan, McEachan, Rosie, Garcia-Aymerich, Judith, and Jacquemin, Bénédicte
Published: 2020

26. Associations between air pollution and pediatric eczema, rhinoconjunctivitis and asthma: A meta-analysis of European birth cohorts

Author: IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Fuertes, Elaine, Sunyer, Jordi, Gehring, Ulrike, Porta, Daniela, Forastiere, Francesco, Cesaroni, Giulia, Vrijheid, Martine, Guxens, Mònica, Annesi-Maesano, Isabella, Slama, Rémy, Maier, Dieter, Kogevinas, Manolis, Bousquet, Jean, Chatzi, Leda, Lertxundi, Aitana, Basterrechea, Mikel, Esplugues, Ana, Ferrero, Amparo, Wright, John, Mason, Dan, McEachan, Rosie, Garcia-Aymerich, Judith, Jacquemin, Bénédicte, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Fuertes, Elaine, Sunyer, Jordi, Gehring, Ulrike, Porta, Daniela, Forastiere, Francesco, Cesaroni, Giulia, Vrijheid, Martine, Guxens, Mònica, Annesi-Maesano, Isabella, Slama, Rémy, Maier, Dieter, Kogevinas, Manolis, Bousquet, Jean, Chatzi, Leda, Lertxundi, Aitana, Basterrechea, Mikel, Esplugues, Ana, Ferrero, Amparo, Wright, John, Mason, Dan, McEachan, Rosie, Garcia-Aymerich, Judith, and Jacquemin, Bénédicte
Published: 2020

27. Associations between air pollution and pediatric eczema, rhinoconjunctivitis and asthma: A meta-analysis of European birth cohorts

Author: IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Fuertes, Elaine, Sunyer, Jordi, Gehring, Ulrike, Porta, Daniela, Forastiere, Francesco, Cesaroni, Giulia, Vrijheid, Martine, Guxens, Mònica, Annesi-Maesano, Isabella, Slama, Rémy, Maier, Dieter, Kogevinas, Manolis, Bousquet, Jean, Chatzi, Leda, Lertxundi, Aitana, Basterrechea, Mikel, Esplugues, Ana, Ferrero, Amparo, Wright, John, Mason, Dan, McEachan, Rosie, Garcia-Aymerich, Judith, Jacquemin, Bénédicte, IRAS OH Epidemiology Chemical Agents, dIRAS RA-2, Fuertes, Elaine, Sunyer, Jordi, Gehring, Ulrike, Porta, Daniela, Forastiere, Francesco, Cesaroni, Giulia, Vrijheid, Martine, Guxens, Mònica, Annesi-Maesano, Isabella, Slama, Rémy, Maier, Dieter, Kogevinas, Manolis, Bousquet, Jean, Chatzi, Leda, Lertxundi, Aitana, Basterrechea, Mikel, Esplugues, Ana, Ferrero, Amparo, Wright, John, Mason, Dan, McEachan, Rosie, Garcia-Aymerich, Judith, and Jacquemin, Bénédicte
Published: 2020

28. Prenatal and postnatal exposure to air pollution and emotional and aggressive symptoms in children from 8 European birth cohorts

Author: Procesos psicológicos básicos y su desarrollo, Oinarrizko psikologia prozesuak eta haien garapena, Jorcano, Ainhoa, Lubczynska, Malgorzata J., Pierotti, Livia, Altug, Hicran, Ballester, Ferrán, Cesaroni, Giulia, El Marroun, Hanan, Fernandez Somoano, Ana, Freire, Carmen, Hanke, Wojciech, Hoek, Gerard, Ibarluzea Maurolagoitia, Jesús María, Iniguez, Carmen, Jansen, Pauline W., Lepeule, Johanna, Markevych, Iana, Polanska, Kinga, Porta, Daniela, Schikowski, Tamara, Slama, Remy, Standl, Marie, Tardón, Adonina, Vrijkotte, Tanja G. M., Von Berg, Andrea, Tiemeier, Henning, Sunyer, Jordi, Guxens, Mónica, Procesos psicológicos básicos y su desarrollo, Oinarrizko psikologia prozesuak eta haien garapena, Jorcano, Ainhoa, Lubczynska, Malgorzata J., Pierotti, Livia, Altug, Hicran, Ballester, Ferrán, Cesaroni, Giulia, El Marroun, Hanan, Fernandez Somoano, Ana, Freire, Carmen, Hanke, Wojciech, Hoek, Gerard, Ibarluzea Maurolagoitia, Jesús María, Iniguez, Carmen, Jansen, Pauline W., Lepeule, Johanna, Markevych, Iana, Polanska, Kinga, Porta, Daniela, Schikowski, Tamara, Slama, Remy, Standl, Marie, Tardón, Adonina, Vrijkotte, Tanja G. M., Von Berg, Andrea, Tiemeier, Henning, Sunyer, Jordi, and Guxens, Mónica
Abstract: Background: The association between air pollution exposure and emotional and behavioural problems in children is unclear. We aimed to assess prenatal and postnatal exposure to several air pollutants and child's depressive and anxiety symptoms, and aggressive symptoms in children of 7-11 years. Methods: We analysed data of 13182 children from 8 European population-based birth cohorts. Concentrations of nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter (PM) with diameters of <= 10 mu m (PM10), <= 2.5 mu m (PM2.5), and between 10 and 2.5 mu m (PMcoarse), the absorbance of PM2.5 filters (PM(2.5)abs), and polycyclic aromatic hydrocarbons (PAHs) were estimated at residential addresses of each participant. Depressive and anxiety symptoms and aggressive symptoms were assessed at 7-11 years of age using parent reported tests. Children were classified in borderline/clinical range or clinical range using validated cut offs. Region specific models were adjusted for various socio-economic and lifestyle characteristics and then combined using random effect meta-analysis. Multiple imputation and inverse probability weighting methods were applied to correct for potential attrition bias. Results: A total of 1896 (14.4%) children were classified as having depressive and anxiety symptoms in the borderline/clinical range, and 1778 (13.4%) as having aggressive symptoms in the borderline/clinical range. Overall, 1108 (8.4%) and 870 (6.6%) children were classified as having depressive and anxiety symptoms, and aggressive symptoms in the clinical range, respectively. Prenatal exposure to air pollution was not associated with depressive and anxiety symptoms in the borderline/clinical range (e.g. OR 1.02 [95%CI 0.95 to 1.10] per 10 mu g/m(3) higher NO2) nor with aggressive symptoms in the borderline/clinical range (e.g. OR 1.04 [95%CI 0.96 to 1.12] per 10 mu g/m(3) higher NO2). Similar results were observed for the symptoms in the clinical range, and for postnatal exposures t
Published: 2019

29. Prenatal and postnatal exposure to air pollution and emotional and aggressive symptoms in children from 8 European birth cohorts

Author: Procesos psicológicos básicos y su desarrollo, Oinarrizko psikologia prozesuak eta haien garapena, Jorcano, Ainhoa, Lubczynska, Malgorzata J., Pierotti, Livia, Altug, Hicran, Ballester, Ferrán, Cesaroni, Giulia, El Marroun, Hanan, Fernandez Somoano, Ana, Freire, Carmen, Hanke, Wojciech, Hoek, Gerard, Ibarluzea Maurolagoitia, Jesús María, Iniguez, Carmen, Jansen, Pauline W., Lepeule, Johanna, Markevych, Iana, Polanska, Kinga, Porta, Daniela, Schikowski, Tamara, Slama, Remy, Standl, Marie, Tardón, Adonina, Vrijkotte, Tanja G. M., Von Berg, Andrea, Tiemeier, Henning, Sunyer, Jordi, Guxens, Mónica, Procesos psicológicos básicos y su desarrollo, Oinarrizko psikologia prozesuak eta haien garapena, Jorcano, Ainhoa, Lubczynska, Malgorzata J., Pierotti, Livia, Altug, Hicran, Ballester, Ferrán, Cesaroni, Giulia, El Marroun, Hanan, Fernandez Somoano, Ana, Freire, Carmen, Hanke, Wojciech, Hoek, Gerard, Ibarluzea Maurolagoitia, Jesús María, Iniguez, Carmen, Jansen, Pauline W., Lepeule, Johanna, Markevych, Iana, Polanska, Kinga, Porta, Daniela, Schikowski, Tamara, Slama, Remy, Standl, Marie, Tardón, Adonina, Vrijkotte, Tanja G. M., Von Berg, Andrea, Tiemeier, Henning, Sunyer, Jordi, and Guxens, Mónica
Abstract: Background: The association between air pollution exposure and emotional and behavioural problems in children is unclear. We aimed to assess prenatal and postnatal exposure to several air pollutants and child's depressive and anxiety symptoms, and aggressive symptoms in children of 7-11 years. Methods: We analysed data of 13182 children from 8 European population-based birth cohorts. Concentrations of nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter (PM) with diameters of <= 10 mu m (PM10), <= 2.5 mu m (PM2.5), and between 10 and 2.5 mu m (PMcoarse), the absorbance of PM2.5 filters (PM(2.5)abs), and polycyclic aromatic hydrocarbons (PAHs) were estimated at residential addresses of each participant. Depressive and anxiety symptoms and aggressive symptoms were assessed at 7-11 years of age using parent reported tests. Children were classified in borderline/clinical range or clinical range using validated cut offs. Region specific models were adjusted for various socio-economic and lifestyle characteristics and then combined using random effect meta-analysis. Multiple imputation and inverse probability weighting methods were applied to correct for potential attrition bias. Results: A total of 1896 (14.4%) children were classified as having depressive and anxiety symptoms in the borderline/clinical range, and 1778 (13.4%) as having aggressive symptoms in the borderline/clinical range. Overall, 1108 (8.4%) and 870 (6.6%) children were classified as having depressive and anxiety symptoms, and aggressive symptoms in the clinical range, respectively. Prenatal exposure to air pollution was not associated with depressive and anxiety symptoms in the borderline/clinical range (e.g. OR 1.02 [95%CI 0.95 to 1.10] per 10 mu g/m(3) higher NO2) nor with aggressive symptoms in the borderline/clinical range (e.g. OR 1.04 [95%CI 0.96 to 1.12] per 10 mu g/m(3) higher NO2). Similar results were observed for the symptoms in the clinical range, and for postnatal exposures t
Published: 2019

30. Prenatal and postnatal exposure to air pollution and emotional and aggressive symptoms in children from 8 European birth cohorts

Author: Procesos psicológicos básicos y su desarrollo, Oinarrizko psikologia prozesuak eta haien garapena, Jorcano, Ainhoa, Lubczynska, Malgorzata J., Pierotti, Livia, Altug, Hicran, Ballester, Ferrán, Cesaroni, Giulia, El Marroun, Hanan, Fernández Somoano, Ana, Freire, Carmen, Hanke, Wojciech, Hoek, Gerard, Ibarluzea Maurolagoitia, Jesús María, Iñiguez, Carmen, Jansen, Pauline W., Lepeule, Johanna, Markevych, Iana, Polanska, Kinga, Porta, Daniela, Schikowski, Tamara, Slama, Remy, Standl, Marie, Tardón, Adonina, Vrijkotte, Tanja G. M., Von Berg, Andrea, Tiemeier, Henning, Sunyer, Jordi, Guxens, Mónica, Procesos psicológicos básicos y su desarrollo, Oinarrizko psikologia prozesuak eta haien garapena, Jorcano, Ainhoa, Lubczynska, Malgorzata J., Pierotti, Livia, Altug, Hicran, Ballester, Ferrán, Cesaroni, Giulia, El Marroun, Hanan, Fernández Somoano, Ana, Freire, Carmen, Hanke, Wojciech, Hoek, Gerard, Ibarluzea Maurolagoitia, Jesús María, Iñiguez, Carmen, Jansen, Pauline W., Lepeule, Johanna, Markevych, Iana, Polanska, Kinga, Porta, Daniela, Schikowski, Tamara, Slama, Remy, Standl, Marie, Tardón, Adonina, Vrijkotte, Tanja G. M., Von Berg, Andrea, Tiemeier, Henning, Sunyer, Jordi, and Guxens, Mónica
Abstract: Background: The association between air pollution exposure and emotional and behavioural problems in children is unclear. We aimed to assess prenatal and postnatal exposure to several air pollutants and child's depressive and anxiety symptoms, and aggressive symptoms in children of 7-11 years. Methods: We analysed data of 13182 children from 8 European population-based birth cohorts. Concentrations of nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter (PM) with diameters of <= 10 mu m (PM10), <= 2.5 mu m (PM2.5), and between 10 and 2.5 mu m (PMcoarse), the absorbance of PM2.5 filters (PM(2.5)abs), and polycyclic aromatic hydrocarbons (PAHs) were estimated at residential addresses of each participant. Depressive and anxiety symptoms and aggressive symptoms were assessed at 7-11 years of age using parent reported tests. Children were classified in borderline/clinical range or clinical range using validated cut offs. Region specific models were adjusted for various socio-economic and lifestyle characteristics and then combined using random effect meta-analysis. Multiple imputation and inverse probability weighting methods were applied to correct for potential attrition bias. Results: A total of 1896 (14.4%) children were classified as having depressive and anxiety symptoms in the borderline/clinical range, and 1778 (13.4%) as having aggressive symptoms in the borderline/clinical range. Overall, 1108 (8.4%) and 870 (6.6%) children were classified as having depressive and anxiety symptoms, and aggressive symptoms in the clinical range, respectively. Prenatal exposure to air pollution was not associated with depressive and anxiety symptoms in the borderline/clinical range (e.g. OR 1.02 [95%CI 0.95 to 1.10] per 10 mu g/m(3) higher NO2) nor with aggressive symptoms in the borderline/clinical range (e.g. OR 1.04 [95%CI 0.96 to 1.12] per 10 mu g/m(3) higher NO2). Similar results were observed for the symptoms in the clinical range, and for postnatal exposures t
Published: 2019

31. Air Pollution Exposure During Pregnancy and Symptoms of Attention Deficit and Hyperactivity Disorder in Children in Europe

Author: Forns, Joan, Sunyer, Jordi, Garcia-Esteban, Raquel, Porta, Daniela, Ghassabian, Akhgar, Giorgis-Allemand, Lise, Gong, Tong, Gehring, Ulrike, Sørensen, Mette, Standl, Marie, Sugiri, Dorothee, Almqvist, Catarina, Andiarena, Ainara, Badaloní, Chiara, Beelen, Rob, Berdel, Dietrich, Cesaroni, Giulia, Charles, Marie-Aline, Eriksen, Kirsten Thorup, Estarlich, Marisa, Fernandez, Mariana F, Forhan, Anne, Jaddoe, Vincent W V, Korek, Michal, Lichtenstein, Paul, Lertxundi, Aitana, Lopez-Espinosa, Maria-Jose, Markevych, Iana, de Nazelle, Audrey, Raaschou-Nielsen, Ole, Nieuwenhuijsen, Mark, Pérez-Lobato, Rocío, Philippat, Claire, Slama, Rémy, Tiesler, Carla M T, Verhulst, Frank C, von Berg, Andrea, Vrijkotte, Tanja, Nybo Andersen, Anne-Marie, Heude, Barbara, Krämer, Ursula, Heinrich, Joachim, Tiemeier, Henning, Forastiere, Francesco, Pershagen, Göran, Brunekreef, Bert, Guxens, Mònica, Forns, Joan, Sunyer, Jordi, Garcia-Esteban, Raquel, Porta, Daniela, Ghassabian, Akhgar, Giorgis-Allemand, Lise, Gong, Tong, Gehring, Ulrike, Sørensen, Mette, Standl, Marie, Sugiri, Dorothee, Almqvist, Catarina, Andiarena, Ainara, Badaloní, Chiara, Beelen, Rob, Berdel, Dietrich, Cesaroni, Giulia, Charles, Marie-Aline, Eriksen, Kirsten Thorup, Estarlich, Marisa, Fernandez, Mariana F, Forhan, Anne, Jaddoe, Vincent W V, Korek, Michal, Lichtenstein, Paul, Lertxundi, Aitana, Lopez-Espinosa, Maria-Jose, Markevych, Iana, de Nazelle, Audrey, Raaschou-Nielsen, Ole, Nieuwenhuijsen, Mark, Pérez-Lobato, Rocío, Philippat, Claire, Slama, Rémy, Tiesler, Carla M T, Verhulst, Frank C, von Berg, Andrea, Vrijkotte, Tanja, Nybo Andersen, Anne-Marie, Heude, Barbara, Krämer, Ursula, Heinrich, Joachim, Tiemeier, Henning, Forastiere, Francesco, Pershagen, Göran, Brunekreef, Bert, and Guxens, Mònica
Abstract: BACKGROUND: Exposure to air pollution during pregnancy may increase attention-deficit/hyperactivity disorder (ADHD) symptoms in children, but findings have been inconsistent. We aimed to study this association in a collaborative study of eight European population-based birth/child cohorts, including 29,127 mother-child pairs.METHODS: Air pollution concentrations (nitrogen dioxide [NO2] and particulate matter [PM]) were estimated at the birth address by land-use regression models based on monitoring campaigns performed between 2008 and 2011. We extrapolated concentrations back in time to exact pregnancy periods. Teachers or parents assessed ADHD symptoms at 3-10 years of age. We classified children as having ADHD symptoms within the borderline/clinical range and within the clinical range using validated cutoffs. We combined all adjusted area-specific effect estimates using random-effects meta-analysis and multiple imputations and applied inverse probability-weighting methods to correct for loss to follow-up.RESULTS: We classified a total of 2,801 children as having ADHD symptoms within the borderline/clinical range, and 1,590 within the clinical range. Exposure to air pollution during pregnancy was not associated with a higher odds of ADHD symptoms within the borderline/clinical range (e.g., adjusted odds ratio [OR] for ADHD symptoms of 0.95, 95% confidence interval [CI] = 0.89, 1.01 per 10 µg/m increase in NO2 and 0.98, 95% CI = 0.80, 1.19 per 5 µg/m increase in PM2.5). We observed similar associations for ADHD within the clinical range.CONCLUSIONS: There was no evidence for an increase in risk of ADHD symptoms with increasing prenatal air pollution levels in children aged 3-10 years. See video abstract at, http://links.lww.com/EDE/B379.
Published: 2018

32. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter

Author: Burnett, Richard, Chen, Hong, Szyszkowicz, Mieczysław, Fann, Neal, Hubbell, Bryan, Pope, C Arden, Apte, Joshua S, Brauer, Michael, Cohen, Aaron, Weichenthal, Scott, Coggins, Jay, Di, Qian, Brunekreef, Bert, Frostad, Joseph, Lim, Stephen S, Kan, Haidong, Walker, Katherine D, Thurston, George D, Hayes, Richard B, Lim, Chris C, Turner, Michelle C, Jerrett, Michael, Krewski, Daniel, Gapstur, Susan M, Diver, W Ryan, Ostro, Bart, Goldberg, Debbie, Crouse, Daniel L, Martin, Randall V, Peters, Paul, Pinault, Lauren, Tjepkema, Michael, van Donkelaar, Aaron, Villeneuve, Paul J, Miller, Anthony B, Yin, Peng, Zhou, Maigeng, Wang, Lijun, Marra, Marten, Atkinson, Richard W, Tsang, Hilda, Quoc Thach, Thuan, Cannon, John B, Allen, Ryan T, Hart, Jaime E, Laden, Francine, Cesaroni, Giulia, Forastiere, Francesco, Weinmayr, Gudrun, Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Spadaro, Joseph V, Burnett, Richard, Chen, Hong, Szyszkowicz, Mieczysław, Fann, Neal, Hubbell, Bryan, Pope, C Arden, Apte, Joshua S, Brauer, Michael, Cohen, Aaron, Weichenthal, Scott, Coggins, Jay, Di, Qian, Brunekreef, Bert, Frostad, Joseph, Lim, Stephen S, Kan, Haidong, Walker, Katherine D, Thurston, George D, Hayes, Richard B, Lim, Chris C, Turner, Michelle C, Jerrett, Michael, Krewski, Daniel, Gapstur, Susan M, Diver, W Ryan, Ostro, Bart, Goldberg, Debbie, Crouse, Daniel L, Martin, Randall V, Peters, Paul, Pinault, Lauren, Tjepkema, Michael, van Donkelaar, Aaron, Villeneuve, Paul J, Miller, Anthony B, Yin, Peng, Zhou, Maigeng, Wang, Lijun, Marra, Marten, Atkinson, Richard W, Tsang, Hilda, Quoc Thach, Thuan, Cannon, John B, Allen, Ryan T, Hart, Jaime E, Laden, Francine, Cesaroni, Giulia, Forastiere, Francesco, Weinmayr, Gudrun, Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, and Spadaro, Joseph V
Abstract: Exposure to ambient fine particulate matter (PM2.5) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM2.5 sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM2.5-mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range. We modeled the shape of the association between PM2.5 and nonaccidental mortality using data from 41 cohorts from 16 countries-the Global Exposure Mortality Model (GEMM). We then constructed GEMMs for five specific causes of death examined by the global burden of disease (GBD). The GEMM predicts 8.9 million [95% confidence interval (CI): 7.5-10.3] deaths in 2015, a figure 30% larger than that predicted by the sum of deaths among the five specific causes (6.9; 95% CI: 4.9-8.5) and 120% larger than the risk function used in the GBD (4.0; 95% CI: 3.3-4.8). Differences between the GEMM and GBD risk functions are larger for a 20% reduction in concentrations, with the GEMM predicting 220% higher excess deaths. These results suggest that PM2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.
Published: 2018

33. Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Nagel, Gabriele, Stafoggia, Massimo, Pedersen, Marie, Andersen, Zorana J, Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H, Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L, Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Tjønneland, Anne, Peeters, Petra H, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo-Uria, Ibon, Amiano, Pilar, Dorronsoro, Miren, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Weinmayr, Gudrun, Nagel, Gabriele, Stafoggia, Massimo, Pedersen, Marie, Andersen, Zorana J, Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H, Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L, Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Tjønneland, Anne, Peeters, Petra H, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo-Uria, Ibon, Amiano, Pilar, Dorronsoro, Miren, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, and Weinmayr, Gudrun
Abstract: Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-use regression models for particulate matter (PM) below 10 µm (PM10 ), below 2.5 µm (PM2.5 ), between 2.5 and 10 µm (PMcoarse ), PM2.5 absorbance and nitrogen oxides (NO2 and NOX ) as well as approximated by traffic indicators. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastric cancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5 µg/m3 of PM2.5 was 1.38 (95% CI 0.99; 1.92) for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures considered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influence markedly the effect estimate for PM2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5 was found in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study shows an association between long-term exposure to PM2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk.
Published: 2018

34. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor:the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana J, Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T, Sommar, Johan N, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T, Poulsen, Aslak H, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H, Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana J, Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T, Sommar, Johan N, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T, Poulsen, Aslak H, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H, Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent.Methods: In 12 cohorts from six European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤ 2.5, ≤ 10, and 2.5-10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses.Results: Of 282,194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts had also data on nonmalignant brain tumor, where among 106,786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically non-significant association between malignant brain tumor and PM2.5 absorbance (Hazard Ratio and 95% Confidence Interval: 1.67; 0.89-3.14 per 10 -5/m 3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38-2.71 per 10 -5/m 3) and all other pollutants were lower for nonmalignant than for malignant brain tumors.Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
Published: 2018

35. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor : the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods: In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
Published: 2018
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36. Is there an association between ambient air pollution and bladder cancer incidence? : Analysis of 15 European cohorts

Author: Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Eriksen, Kirsten T., Tjønneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Eriksen, Kirsten T., Tjønneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: BACKGROUND: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population. OBJECTIVE: To evaluate the association between long-term exposure to ambient air pollution and BC incidence. DESIGN, SETTING, AND PARTICIPANTS: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10μm (PM10), <2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10), PM2.5absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence. RESULTS AND LIMITATIONS: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m(3) increase in NO2 and 5-μg/m(3) increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure. CONCLUSIONS: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC. PATIENT SUMMARY: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels
Published: 2018
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37. Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Nagel, Gabriele, Stafoggia, Massimo, Pedersen, Marie, Andersen, Zorana J, Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H, Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L, Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Tjønneland, Anne, Peeters, Petra H, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo-Uria, Ibon, Amiano, Pilar, Dorronsoro, Miren, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Weinmayr, Gudrun, Nagel, Gabriele, Stafoggia, Massimo, Pedersen, Marie, Andersen, Zorana J, Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H, Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L, Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Tjønneland, Anne, Peeters, Petra H, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo-Uria, Ibon, Amiano, Pilar, Dorronsoro, Miren, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, and Weinmayr, Gudrun
Abstract: Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancersof the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient airpollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-useregression models for particulate matter (PM) below 10mm (PM10), below 2.5mm (PM2.5), between 2.5 and 10mm (PMcoarse),PM2.5absorbance and nitrogen oxides (NO2and NOX) as well as approximated by traffic indicators. Cox regression modelswith adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined withrandom effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastriccancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5mg/m3of PM2.5was 1.38 (95% CI 0.99; 1.92)for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures consid-ered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influencemarkedly the effect estimate for PM2.5and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5wasfound in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study showsan association between long-term exposure to PM2.5and gastric cancer, but not UADT cancers, suggesting that air pollutionmay contribute to gastric cancer risk.
Published: 2018
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38. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor : the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods: In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
Published: 2018
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39. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor : the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods: In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
Published: 2018
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40. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor : the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Nilsson Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Östenson, Claes-Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak H., Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet, Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods: In 12 cohorts from 6 European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) ≤2.5, ≤10, and 2.5–10 μm in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant, and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts also had data on nonmalignant brain tumor, where among 106786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically nonsignificant association between malignant brain tumor and PM2.5 absorbance (hazard ratio and 95% CI: 1.67; 0.89–3.14 per 10–5/m3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38–2.71 per 10–5/m3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.
Published: 2018
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41. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter.

Author: Burnett, Richard, Burnett, Richard, Chen, Hong, Szyszkowicz, Mieczysław, Fann, Neal, Hubbell, Bryan, Pope, C Arden, Apte, Joshua S, Brauer, Michael, Cohen, Aaron, Weichenthal, Scott, Coggins, Jay, Di, Qian, Brunekreef, Bert, Frostad, Joseph, Lim, Stephen S, Kan, Haidong, Walker, Katherine D, Thurston, George D, Hayes, Richard B, Lim, Chris C, Turner, Michelle C, Jerrett, Michael, Krewski, Daniel, Gapstur, Susan M, Diver, W Ryan, Ostro, Bart, Goldberg, Debbie, Crouse, Daniel L, Martin, Randall V, Peters, Paul, Pinault, Lauren, Tjepkema, Michael, van Donkelaar, Aaron, Villeneuve, Paul J, Miller, Anthony B, Yin, Peng, Zhou, Maigeng, Wang, Lijun, Janssen, Nicole AH, Marra, Marten, Atkinson, Richard W, Tsang, Hilda, Quoc Thach, Thuan, Cannon, John B, Allen, Ryan T, Hart, Jaime E, Laden, Francine, Cesaroni, Giulia, Forastiere, Francesco, Weinmayr, Gudrun, Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Spadaro, Joseph V, Burnett, Richard, Burnett, Richard, Chen, Hong, Szyszkowicz, Mieczysław, Fann, Neal, Hubbell, Bryan, Pope, C Arden, Apte, Joshua S, Brauer, Michael, Cohen, Aaron, Weichenthal, Scott, Coggins, Jay, Di, Qian, Brunekreef, Bert, Frostad, Joseph, Lim, Stephen S, Kan, Haidong, Walker, Katherine D, Thurston, George D, Hayes, Richard B, Lim, Chris C, Turner, Michelle C, Jerrett, Michael, Krewski, Daniel, Gapstur, Susan M, Diver, W Ryan, Ostro, Bart, Goldberg, Debbie, Crouse, Daniel L, Martin, Randall V, Peters, Paul, Pinault, Lauren, Tjepkema, Michael, van Donkelaar, Aaron, Villeneuve, Paul J, Miller, Anthony B, Yin, Peng, Zhou, Maigeng, Wang, Lijun, Janssen, Nicole AH, Marra, Marten, Atkinson, Richard W, Tsang, Hilda, Quoc Thach, Thuan, Cannon, John B, Allen, Ryan T, Hart, Jaime E, Laden, Francine, Cesaroni, Giulia, Forastiere, Francesco, Weinmayr, Gudrun, Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, and Spadaro, Joseph V
Abstract: Exposure to ambient fine particulate matter (PM2.5) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM2.5 sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM2.5-mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range. We modeled the shape of the association between PM2.5 and nonaccidental mortality using data from 41 cohorts from 16 countries-the Global Exposure Mortality Model (GEMM). We then constructed GEMMs for five specific causes of death examined by the global burden of disease (GBD). The GEMM predicts 8.9 million [95% confidence interval (CI): 7.5-10.3] deaths in 2015, a figure 30% larger than that predicted by the sum of deaths among the five specific causes (6.9; 95% CI: 4.9-8.5) and 120% larger than the risk function used in the GBD (4.0; 95% CI: 3.3-4.8). Differences between the GEMM and GBD risk functions are larger for a 20% reduction in concentrations, with the GEMM predicting 220% higher excess deaths. These results suggest that PM2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.
Published: 2018

42. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor : the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana Jovanovic, Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Sommar, Johan N, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per E., Pyko, Andrei, Pershagen, Göran, Korek, Michal, de Faire, Ulf, Östenson, Claes Göran, Fratiglioni, Laura, Eriksen, Kirsten Thorup, Poulsen, Aslak H, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H, Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet S., Keuken, Menno, De Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana Jovanovic, Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Sommar, Johan N, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per E., Pyko, Andrei, Pershagen, Göran, Korek, Michal, de Faire, Ulf, Östenson, Claes Göran, Fratiglioni, Laura, Eriksen, Kirsten Thorup, Poulsen, Aslak H, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H, Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet S., Keuken, Menno, De Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Published: 2018

43. Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? : Analysis of 15 European Cohorts

Author: Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes Göran, Fratiglioni, Laura, Sørensen, Mette, Eriksen, Kirsten T., Tjønneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes Göran, Fratiglioni, Laura, Sørensen, Mette, Eriksen, Kirsten T., Tjønneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Published: 2018

44. Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts

Author: Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Goran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Odiaeresi, Claes-Goran, Fratiglioni, Laura, Sorensen, Mette, Eriksen, Kirsten T., Tjonneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Goran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Odiaeresi, Claes-Goran, Fratiglioni, Laura, Sorensen, Mette, Eriksen, Kirsten T., Tjonneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Abstract: Background: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population. Objective: To evaluate the association between long-term exposure to ambient air pollution and BC incidence. Design, setting and participants: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N = 303 431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10 mu m (PM10), <2.5 mu m (PM2.5). between 2.5 and 10 mu m (PM2.5-10). PM2.5 absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project. Outcome measurements and statistical analysis: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRS) for BC incidence. Results and limitations: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-mu g/m(3) increase in NO2 and 51-mu g/m(3) increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure. Conclusions: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC. Patient summary: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association be
Published: 2018
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45. Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE)

Author: Weinmayr, Gudrun, Pedersen, Marie, Stafoggia, Massimo, Andersen, Zorana J., Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Goran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes-Göran, Rizzuto, Debora, Sorensen, Mette, Tjønneland, Anne, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Kooter, Ingeborg, Sokhi, Ranjeet, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Nagel, Gabriele, Weinmayr, Gudrun, Pedersen, Marie, Stafoggia, Massimo, Andersen, Zorana J., Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Goran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes-Göran, Rizzuto, Debora, Sorensen, Mette, Tjønneland, Anne, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Kooter, Ingeborg, Sokhi, Ranjeet, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, and Nagel, Gabriele
Abstract: Introduction: Previous analysis from the large European multicentre ESCAPE study showed an association of ambient particulate matter < 2.5 mu m (PM2.5) air pollution exposure at residence with the incidence of gastric cancer. It is unclear which components of PM are most relevant for gastric and also upper aerodigestive tract (UADT) cancer and some of them may not be strongly correlated with PM mass. We evaluated the association between long-term exposure to elemental components of PM2.5 and PM10 and gastric and UADT cancer incidence in European adults. Methods: Baseline addresses of individuals were geocoded and exposure was assessed by land-use regression models for copper (Cu), iron (Fe) and zinc (Zn) representing non-tailpipe traffic emissions; sulphur (S) indicating long-range transport; nickel (Ni) and vanadium (V) for mixed oil-burning and industry; silicon (Si) for crustal material and potassium (K) for biomass burning. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. Results: Ten cohorts in six countries contributed data on 227,044 individuals with an average follow-up of 14.9 years with 633 incident cases of gastric cancer and 763 of UADT cancer. The combined hazard ratio (HR) for an increase of 200 ng/m(3) of PM2.5_S was 1.92 (95%-confidence interval (95%-CI) 1.13; 3.27) for gastric cancer, with no indication of heterogeneity between cohorts (I-2= 0%), and 1.63 (95%-CI 0.88; 3.01) for PM2.5_Zn (I-2= 70%). For the other elements in PM2.5 and all elements in PM10 including PM10_S, non-significant HRs between 0.78 and 1.21 with mostly wide CIs were seen. No association was found between any of the elements and UADT cancer. The HR for PM2.5_S and gastric cancer was robust to adjustment for additional factors, including diet, and restriction to study participants with stable addresses over follow-up resulted in slightly higher effect
Published: 2018
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46. Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? : Analysis of 15 European Cohorts

Author: Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes Göran, Fratiglioni, Laura, Sørensen, Mette, Eriksen, Kirsten T., Tjønneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Pedersen, Marie, Stafoggia, Massimo, Weinmayr, Gudrun, Andersen, Zorana J., Galassi, Claudia, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H., Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L., Östenson, Claes Göran, Fratiglioni, Laura, Sørensen, Mette, Eriksen, Kirsten T., Tjønneland, Anne, Peeters, Petra H., Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J., Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo, Ibon, Amiano, Pilar, Dorronsoro, Miren, Stayner, Leslie T., Kogevinas, Manolis, Nieuwenhuijsen, Mark J., Sokhi, Ranjeet, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Published: 2018

47. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor : the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: Andersen, Zorana Jovanovic, Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Sommar, Johan N, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per E., Pyko, Andrei, Pershagen, Göran, Korek, Michal, de Faire, Ulf, Östenson, Claes Göran, Fratiglioni, Laura, Eriksen, Kirsten Thorup, Poulsen, Aslak H, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H, Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet S., Keuken, Menno, De Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Andersen, Zorana Jovanovic, Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T., Sommar, Johan N, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per E., Pyko, Andrei, Pershagen, Göran, Korek, Michal, de Faire, Ulf, Östenson, Claes Göran, Fratiglioni, Laura, Eriksen, Kirsten Thorup, Poulsen, Aslak H, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H, Bueno-de-Mesquita, Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet S., Keuken, Menno, De Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Published: 2018

48. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter

Author: One Health Chemisch, dIRAS RA-2, Burnett, Richard, Chen, Hong, Szyszkowicz, Mieczysław, Fann, Neal, Hubbell, Bryan, Pope, C Arden, Apte, Joshua S, Brauer, Michael, Cohen, Aaron, Weichenthal, Scott, Coggins, Jay, Di, Qian, Brunekreef, Bert, Frostad, Joseph, Lim, Stephen S, Kan, Haidong, Walker, Katherine D, Thurston, George D, Hayes, Richard B, Lim, Chris C, Turner, Michelle C, Jerrett, Michael, Krewski, Daniel, Gapstur, Susan M, Diver, W Ryan, Ostro, Bart, Goldberg, Debbie, Crouse, Daniel L, Martin, Randall V, Peters, Paul, Pinault, Lauren, Tjepkema, Michael, van Donkelaar, Aaron, Villeneuve, Paul J, Miller, Anthony B, Yin, Peng, Zhou, Maigeng, Wang, Lijun, Marra, Marten, Atkinson, Richard W, Tsang, Hilda, Quoc Thach, Thuan, Cannon, John B, Allen, Ryan T, Hart, Jaime E, Laden, Francine, Cesaroni, Giulia, Forastiere, Francesco, Weinmayr, Gudrun, Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, Spadaro, Joseph V, One Health Chemisch, dIRAS RA-2, Burnett, Richard, Chen, Hong, Szyszkowicz, Mieczysław, Fann, Neal, Hubbell, Bryan, Pope, C Arden, Apte, Joshua S, Brauer, Michael, Cohen, Aaron, Weichenthal, Scott, Coggins, Jay, Di, Qian, Brunekreef, Bert, Frostad, Joseph, Lim, Stephen S, Kan, Haidong, Walker, Katherine D, Thurston, George D, Hayes, Richard B, Lim, Chris C, Turner, Michelle C, Jerrett, Michael, Krewski, Daniel, Gapstur, Susan M, Diver, W Ryan, Ostro, Bart, Goldberg, Debbie, Crouse, Daniel L, Martin, Randall V, Peters, Paul, Pinault, Lauren, Tjepkema, Michael, van Donkelaar, Aaron, Villeneuve, Paul J, Miller, Anthony B, Yin, Peng, Zhou, Maigeng, Wang, Lijun, Marra, Marten, Atkinson, Richard W, Tsang, Hilda, Quoc Thach, Thuan, Cannon, John B, Allen, Ryan T, Hart, Jaime E, Laden, Francine, Cesaroni, Giulia, Forastiere, Francesco, Weinmayr, Gudrun, Jaensch, Andrea, Nagel, Gabriele, Concin, Hans, and Spadaro, Joseph V
Published: 2018

49. Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: One Health Chemisch, dIRAS RA-2, dIRAS RA-I&I RA, LS IRAS EEPI ME (Milieu epidemiologie), Nagel, Gabriele, Stafoggia, Massimo, Pedersen, Marie, Andersen, Zorana J, Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H, Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L, Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Tjønneland, Anne, Peeters, Petra H, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo-Uria, Ibon, Amiano, Pilar, Dorronsoro, Miren, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, Weinmayr, Gudrun, One Health Chemisch, dIRAS RA-2, dIRAS RA-I&I RA, LS IRAS EEPI ME (Milieu epidemiologie), Nagel, Gabriele, Stafoggia, Massimo, Pedersen, Marie, Andersen, Zorana J, Galassi, Claudia, Munkenast, Jule, Jaensch, Andrea, Sommar, Johan, Forsberg, Bertil, Olsson, David, Oftedal, Bente, Krog, Norun H, Aamodt, Geir, Pyko, Andrei, Pershagen, Göran, Korek, Michal, De Faire, Ulf, Pedersen, Nancy L, Östenson, Claes-Göran, Fratiglioni, Laura, Sørensen, Mette, Tjønneland, Anne, Peeters, Petra H, Bueno-de-Mesquita, Bas, Vermeulen, Roel, Eeftens, Marloes, Plusquin, Michelle, Key, Timothy J, Concin, Hans, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Ranzi, Andrea, Cesaroni, Giulia, Forastiere, Francesco, Tamayo-Uria, Ibon, Amiano, Pilar, Dorronsoro, Miren, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, and Weinmayr, Gudrun
Published: 2018

50. Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor: the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Author: dIRAS RA-2, LS IRAS EEPI ME (Milieu epidemiologie), One Health Chemisch, dIRAS RA-I&I RA, Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T, Sommar, Johan N., Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per E., Pyko, Andrei, Pershagen, Göran, Korek, Michal, de Faire, Ulf, Östenson, Claes Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak Harbo, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, H. Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet S., Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, Raaschou-Nielsen, Ole, dIRAS RA-2, LS IRAS EEPI ME (Milieu epidemiologie), One Health Chemisch, dIRAS RA-I&I RA, Andersen, Zorana J., Pedersen, Marie, Weinmayr, Gudrun, Stafoggia, Massimo, Galassi, Claudia, Jørgensen, Jeanette T, Sommar, Johan N., Forsberg, Bertil, Olsson, David, Oftedal, Bente, Aasvang, Gunn Marit, Schwarze, Per E., Pyko, Andrei, Pershagen, Göran, Korek, Michal, de Faire, Ulf, Östenson, Claes Göran, Fratiglioni, Laura, Eriksen, Kirsten T., Poulsen, Aslak Harbo, Tjønneland, Anne, Vaclavik Bräuner, Elvira, Peeters, Petra H., Bueno-de-Mesquita, H. Bas, Jaensch, Andrea, Nagel, Gabriele, Lang, Alois, Wang, Meng, Tsai, Ming-Yi, Grioni, Sara, Marcon, Alessandro, Krogh, Vittorio, Ricceri, Fulvio, Sacerdote, Carlotta, Migliore, Enrica, Vermeulen, Roel, Sokhi, Ranjeet S., Keuken, Menno, de Hoogh, Kees, Beelen, Rob, Vineis, Paolo, Cesaroni, Giulia, Brunekreef, Bert, Hoek, Gerard, and Raaschou-Nielsen, Ole
Published: 2018

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