Chronic exposure to particulate air pollution and progression of subclinical atherosclerosis (AIRCIMT)

Long-term particulate matter (PM) air pollution and residential exposure to high traffic are linked to the incidence of acute cardiovascular events. It has been proposed that fine PM may have a biologic role in the development of atherosclerosis as the underlying pathology of cardiovascular disease. In AIRCIMT, we investigate the association between long-term exposure to air pollution and the presence and extent of progression of subclinical atherosclerosis in a prospective cohort study of almost 5000 participants from the Heinz Nixdorf Recall Study located in the Ruhr Area of Western Germany. Available markers of subclinical atherosclerosis are the carotid intima-media thickness (CIMT), coronary calcification (CAC) and thoracic calcification (TAC), as well as the ankle-brachial-index (ABI).


  • to investigate the association between long-term exposure to air pollution and the presence and extent of progression of subclinical atherosclerosis using different clinical markers
  • to investigate confounding and effect measure modification by co-exposure with environmental noise
  • to identify relevant biologic mechanisms for air pollution-introduced health effects, we investigate gene-environment (GxE) interactions involving pathways of atherogenesis (Co-PI André Scherag and colleagues)

Study design

Population-based prospective cohort study

Study area

Cities of Mülheim, Essen and Bochum in the West-German Ruhr Area

Study population

4814 participants 45-57 years of age at baseline (2000-2003)

Funding DFG HO 3314/2-1, DFG HO 3314/2-3
Duration Phase 1 2011-2014, Phase 2 2015-2021
Team Frauke Hennig, Anna Buschka, Barbara Hoffmann (PI)
External collaborators André Scherag (Uni Jena), Karl Heinz Jöckel, Raimund Erbel and Henrike Geisel (Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen), Amir Mahabadi (Westdeutsches Herzzentrum Universitätsklinikum Essen), Hagen Kälsch (Alfried Krupp Hospital, Essen), Stefan Möhlenkamp (Bethanien, Moers)

Selected Publications 

  • Hennig F, Geisel MH, Kälsch H, Lucht S, Mahabadi AA, Moebus S, Erbel R, Lehmann N, Jöckel K-H, Scherag A, Hoffmann B, on behalf of the Heinz Nixdorf Recall Study Investigative Group. Air pollution and progression of atherosclerosis in different vessel beds - Results from a prospective cohort study in the Ruhr Area, Germany. Environmental Health Perspectives. 2020;128(10):107003. doi: 10.1289/EHP7077.

  • Kälsch H, A Mahabadi A, Moebus S, Reinsch N, Budde T, Hoffmann B, Stang A, Jöckel K-H, Erbel R and Lehmann N on behalf of the Heinz Nixdorf Recall Study Investigators. Association of Progressive Thoracic Aortic Calcification with Future Cardiovascular Events and All-Cause Mortality - Ability to Improve Risk Prediction? Results of the Heinz Nixdorf Recall (HNR) Study. European Heart Journal-Cardiovascular Imaging 2019; 20(6):709-717. doi:10.1093/ehjci/jey173

  • Geisel MH, Bauer M, Hennig F, Hoffmann B, Lehmann N, Möhlenkamp S, Kroger K, Kara K, Müller T, Moebus S, Erbel R, Scherag A, Jöckel KH, Mahabadi AA, investigative group of the Heinz Nixdorf Recall study. Comparison of coronary artery calcification, carotid intima-media thickness and ankle-brachial index for predicting 10-year incident cardiovascular events in the general population. Eur Heart J 2017. Mar 30. doi: 10.1093/eurheartj/ehx120. [Epub ahead of print]

  • Heßler N, Geisel MH, Coassin S, Erbel R, Heilmann S, Hennig F, Hoffmann B, Jöckel KH, Moebus S, Moskau-Hartmann S, Nürnberg G, Nürnberg P, Vens M, Klockgether T, Kronenberg F, Scherag A, Ziegler A. Linkage and Association Analysis Identifies TRAF1 Influencing Common Carotid Intima-Media Thickness. Stroke. 2016;47(12):2904-2909. DOI: 10.1161/STROKEAHA.116.013943.

  • Kälsch H, Hennig F, Moebus S, Möhlenkamp S, Dragano N, Jakobs H, et al. 2014. Are air pollution and traffic noise independently associated with atherosclerosis: the Heinz Nixdorf Recall Study. Eur Heart J. 2014;35(13):853-60. DOI: 10.1093/eurheartj/eht426.

  • Künzli N, Perez L, von Klot S, Baldassarre D, Bauer M, Basagana X, Breton C, Dratva J, Elosua R, de Faire U, Fuks K, de Groot E, Marrugat J, Penell J, Seissler J, Peters A, Hoffmann B. Investigating air pollution and atherosclerosis in humans: concepts and outlook. Prog Cardiovasc Dis 2011; 53:334-43. DOI: 10.1016/j.pcad.2010.12.006.

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