Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: Results from the ESCAPE and TRANSPHORM projects

Meng Wang, Rob Beelen, Massimo Stafoggia, Ole Raaschou-Nielsen, Zorana Jovanovic Andersen, Barbara Hoffmann, Paul Fischer, Danny Houthuijs, Mark Nieuwenhuijsen, Gudrun Weinmayr, Paolo Vineis, Wei W. Xun, Konstantina Dimakopoulou, Evangelia Samoli, Tiina Laatikainen, Timo Lanki, Anu W. Turunen, Bente Oftedal, Per Schwarze, Geir AamodtJohanna Penell, Ulf De Faire, Michal Korek, Karin Leander, Göran Pershagen, Nancy L. Pedersen, Claes Göran Östenson, Laura Fratiglioni, Kirsten Thorup Eriksen, Mette Sørensen, Anne Tjønneland, Bas Bueno-de-Mesquita, Marloes Eeftens, Michiel L. Bots, Kees Meliefste, Ursula Krämer, Joachim Heinrich, Dorothea Sugiri, Timothy Key, Kees De Hoogh, Kathrin Wolf, Annette Peters, Josef Cyrys, Andrea Jaensch, Hans Concin, Gabriele Nagel, Ming Yi Tsai, Harish Phuleria, Alex Ineichen, Nino Künzli, Nicole Probst-Hensch, Emmanuel Schaffner, Alice Vilier, Françoise Clavel-Chapelon, Christophe Declerq, Fulvio Ricceri, Carlotta Sacerdote, Alessandro Marcon, Claudia Galassi, Enrica Migliore, Andrea Ranzi, Giulia Cesaroni, Chiara Badaloni, Francesco Forastiere, Michail Katsoulis, Antonia Trichopoulou, Menno Keuken, Aleksandra Jedynska, Ingeborg M. Kooter, Jaakko Kukkonen, Ranjeet S. Sokhi, Bert Brunekreef, Klea Katsouyanni, Gerard Hoek

Research output: Contribution to journalArticlepeer-review

85 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)97-106
Number of pages10
JournalEnvironment International
Publication statusPublished - May 2014


  • Cardiovascular mortality
  • Constituents
  • Long-term exposure
  • Particulate matter


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