@article{3058053,
    title = "Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: Results from the ESCAPE and TRANSPHORM projects",
    author = "Wang, M. and Beelen, R. and Stafoggia, M. and Raaschou-Nielsen, O. and Andersen, Z.J. and Hoffmann, B. and Fischer, P. and Houthuijs, D. and Nieuwenhuijsen, M. and Weinmayr, G. and Vineis, P. and Xun, W.W. and Dimakopoulou, K. and Samoli, E. and Laatikainen, T. and Lanki, T. and Turunen, A.W. and Oftedal, B. and Schwarze, P. and Aamodt, G. and Penell, J. and De Faire, U. and Korek, M. and Leander, K. and Pershagen, G. and Pedersen, N.L. and Östenson, C.-G. and Fratiglioni, L. and Eriksen, K.T. and Sørensen, M. and Tjønneland, A. and Bueno-de-Mesquita, B. and Eeftens, M. and Bots, M.L. and Meliefste, K. and Krämer, U. and Heinrich, J. and Sugiri, D. and Key, T. and De Hoogh, K. and Wolf, K. and Peters, A. and Cyrys, J. and Jaensch, A. and Concin, H. and Nagel, G. and Tsai, M.-Y. and Phuleria, H. and Ineichen, A. and Künzli, N. and Probst-Hensch, N. and Schaffner, E. and Vilier, A. and Clavel-Chapelon, F. and Declerq, C. and Ricceri, F. and Sacerdote, C. and Marcon, A. and Galassi, C. and Migliore, E. and Ranzi, A. and Cesaroni, G. and Badaloni, C. and Forastiere, F. and Katsoulis, M. and Trichopoulou, A. and Keuken, M. and Jedynska, A. and Kooter, I.M. and Kukkonen, J. and Sokhi, R.S. and Brunekreef, B. and Katsouyanni, K. and Hoek, G.",
    journal = "Environment International",
    year = "2014",
    volume = "66",
    pages = "97-106",
    publisher = "Elsevier Ireland Ltd",
    issn = "0160-4120",
    doi = "10.1016/j.envint.2014.01.026",
    keywords = "Air pollution;  Atmospheric movements;  Regression analysis;  Silicon, Cardiovascular mortality;  Constituents;  ESCAPE;  Long term exposure;  Particulate Matter;  TRANSPHORM, Particles (particulate matter), copper;  iron;  nickel;  potassium;  silicon;  sulfur;  vanadium;  zinc, cardiovascular disease;  health impact;  health risk;  mortality;  particulate matter, adult;  aged;  article;  cardiovascular mortality;  cardiovascular risk;  chemical analysis;  cohort analysis;  comparative study;  concentration (parameters);  correlation analysis;  disease association;  environmental exposure;  hazard assessment;  hazard ratio;  health hazard;  human;  long term exposure;  major clinical study;  outcome assessment;  particle size;  particulate matter;  priority journal;  proportional hazards model;  sensitivity analysis, Europe, Cardiovascular mortality;  Constituents;  ESCAPE;  Long-term exposure;  Particulate matter;  TRANSPHORM, Adult;  Aged;  Cardiovascular Diseases;  Cohort Studies;  Environmental Exposure;  Europe;  Female;  Humans;  Male;  Middle Aged;  Particulate Matter;  Proportional Hazards Models",
    abstract = "Background: Associations between long-term exposure to ambient particulate matter (PM) and cardiovascular (CVD) mortality have been widely recognized. However, health effects of long-term exposure to constituents of PM on total CVD mortality have been explored in a single study only. Aims: The aim of this study was to examine the association of PM composition with cardiovascular mortality. Methods: We used data from 19 European ongoing cohorts within the framework of the ESCAPE (European Study of Cohorts for Air Pollution Effects) and TRANSPHORM (Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter) projects. Residential annual average exposure to elemental constituents within particle matter smaller than 2.5 and 10μm (PM2.5 and PM10) was estimated using Land Use Regression models. Eight elements representing major sources were selected a priori (copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc). Cohort-specific analyses were conducted using Cox proportional hazards models with a standardized protocol. Random-effects meta-analysis was used to calculate combined effect estimates. Results: The total population consisted of 322,291 participants, with 9545 CVD deaths. We found no statistically significant associations between any of the elemental constituents in PM2.5 or PM10 and CVD mortality in the pooled analysis. Most of the hazard ratios (HRs) were close to unity, e.g. for PM10 Fe the combined HR was 0.96 (0.84-1.09). Elevated combined HRs were found for PM2.5 Si (1.17, 95% CI: 0.93-1.47), and S in PM2.5 (1.08, 95% CI: 0.95-1.22) and PM10 (1.09, 95% CI: 0.90-1.32). Conclusion: In a joint analysis of 19 European cohorts, we found no statistically significant association between long-term exposure to 8 elemental constituents of particles and total cardiovascular mortality. •Few studies explored long term effects of particle composition exposure to cardiovascular mortality.•We included a large population of 322,291 subjects from 19 cohorts in 12 countries of Europe.•Standardized cohort specific analyses were conducted individually and the results were pooled in meta-analysis.•We found no significant association between elemental constituents representing major sources and cardiovascular mortality.•Positive though non-significant associations were found for S and Si. © 2014 Elsevier Ltd."
}