Mixtures of long-term exposure to ambient air pollution, built environment and temperature and stroke incidence across Europe

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Mixtures of long-term exposure to ambient air pollution, built environment and temperature and stroke incidence across Europe

de Bont, Jeroen (författare): Karolinska Institutet

Pickford, Regina (författare): Institute of Epidemiology (EPI), Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt GmbH, Neuherberg, Germany

Åström, Christofer, 1983- (författare): Umeå universitet,Institutionen för folkhälsa och klinisk medicin

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Colomar, Fabian (författare): ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

Dimakopoulou, Konstantina (författare): Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

de Hoogh, Kees (författare): Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland

Ibi, Dorina (författare): Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands

Katsouyanni, Klea (författare): Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, Environmental Research Group, Imperial College London, United Kingdom; NIHR HPRU in Environmental Exposures and Health, Imperial College London, London, United Kingdom

Melén, Erik (författare): Karolinska Institutet

Nobile, Federica (författare): Department of Epidemiology, Lazio Region Health Service /ASL Roma 1, Rome, Italy

Pershagen, Göran (författare): Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Persson, Åsa (författare): Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Samoli, Evangelia (författare): Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Stafoggia, Massimo (författare): Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service /ASL Roma 1, Rome, Italy

Tonne, Cathryn (författare): ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

Vlaanderen, Jelle (författare): Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands

Wolf, Kathrin (författare): Institute of Epidemiology (EPI), Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt GmbH, Neuherberg, Germany

Vermeulen, Roel (författare): Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands

Peters, Annette (författare): Institute of Epidemiology (EPI), Helmholtz Zentrum München – Deutsches Forschungszentrum für Gesundheit und Umwelt GmbH, Neuherberg, Germany; Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany; Munich Heart Alliance, German Center for Cardiovascular Health (DZHK e.V., partner-site Munich), Munich, Germany

Ljungman, Petter (författare): Karolinska Institutet

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Elsevier, 2023
2023
Engelska.
Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 179

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://umu.diva-por... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; visa färre...

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Introduction: The complex interplay of multiple environmental factors and cardiovascular has scarcely been studied. Within the EXPANSE project, we evaluated the association between long-term exposure to multiple environmental indices and stroke incidence across Europe.Methods: Participants from three traditional adult cohorts (Germany, Netherlands and Sweden) and four administrative cohorts (Catalonia [region Spain], Rome [city-wide], Greece and Sweden [nationwide]) were followed until incident stroke, death, migration, loss of follow-up or study end. We estimated exposures at residential addresses from different exposure domains: air pollution (nitrogen dioxide (NO2), particulate matter < 2.5 μm (PM2.5), black carbon (BC), ozone), built environment (green/blue spaces, impervious surfaces) and meteorology (seasonal mean and standard deviation of temperatures). Associations between environmental exposures and stroke were estimated in single and multiple-exposure Cox proportional hazard models, and Principal Component (PC) Analyses derived prototypes for specific exposures domains. We carried out random effects meta-analyses by cohort type.Results: In over 15 million participants, increased levels of NO2 and BC were associated with increased higher stroke incidence in both cohort types. Increased Normalized Difference Vegetation Index (NDVI) was associated with a lower stroke incidence in both cohort types, whereas an increase in impervious surface was associated with an increase in stroke incidence. The first PC of the air pollution domain (PM2.5, NO2 and BC) was associated with an increase in stroke incidence. For the built environment, higher levels of NDVI and lower levels of impervious surfaces were associated with a protective effect [%change in HR per 1 unit = −2.0 (95 %CI, −5.9;2.0) and −1.1(95 %CI, −2.0; −0.3) for traditional adult and administrative cohorts, respectively]. No clear patterns were observed for distance to blue spaces or temperature parameters.Conclusions: We observed increased HRs for stroke with exposure to PM2.5, NO2 and BC, lower levels of greenness and higher impervious surface in single and combined exposure models.

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Av lärosätet: Umeå universitet; Karolinska Institutet

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Mixtures of long-term exposure to ambient air pollution, built environment and temperature and stroke incidence across Europe

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