The effects of long-term air exposure to particulate matter and nitrogen oxides on human health continue to be only partially understood. Most insights originate from U.S. studies and are thus more representative of the North American region. ESCAPE (European Study of Cohorts for Air Pollution Effects, www.escapeproject.eu) is a study subsidized by the 7th EU framework programme that connects health data of existing cohorts together with air pollution exposure estimates using the latest scientific methods. Measurements of particulate matter and nitrogen oxide levels taken at locations throughout 40 regions of Europe have been combined with GIS data to generate land use regression models. With these models, it is possible to estimate exposure levels at a place of residence. These exposures are then used to investigate potential associations between air pollution exposure and a variety of health effects, including low birth weight, childhood asthma and allergies, respiratory illnesses, cardiovascular disorders, adult mortality, and cancer incidence.

As a part of this European-wide project, our group determines the exposure of airborne pollutants in the Ruhr area and their relationship with markers of cardiovascular disease and cardiovascular end points of the Heinz Nixdorf Recall study.

Objectives

• to develop a flexible methodology for assessment of long-term population exposure to air pollution focused primarily on fine particles, particle composition, and nitrogen oxides.
• to apply the exposure assessment methodology on existing cohort studies of mortality and chronic disease in Europe that have been selected based on their potential to quantify relationships between long-term exposure and health response precisely.
• specifically, to investigate exposure-response relationships and thresholds for (a) adverse perinatal health outcomes, and development of diseases such as asthma in children; (b) respiratory disease endpoints in adults; (c) cardiovascular disease endpoints in adults; (d) all-cause and cause-specific mortality, and cancer incidence.
• to develop a database for quantitative estimates of the health impacts of long-term exposure to air pollution for all of these health endpoints for the European population.

Study design

Longitudinal cohort studies with subsequent meta-analysis.

Main report

Final Report Summary - ESCAPE (European study of cohorts for air pollution effects). European Commission; 2022.

Selected Publications

• Fuks KB, Weinmayr G, Basagana X, Gruzieva O, Hampel R, Oftedal B, Sorensen, M, Wolf K, Aamodt G, Aasvang GM, Aguilera I, Becker T, Beelen R, Brunekreef B, Caracciolo B, Cyrys J, Elosua R, Eriksen KT, Foraster M, Fratiglioni L, Hilding A, Houthuijs D, Korek M, Künzli N, Marrugat J, Nieuwenhuijsen M, Ostenson CG, Penell J, Pershagen G, Raaschou-Nielsen O, Swart WJR, Peters A, Hoffmann B. Long-Term Exposure to Ambient Air Pollution and Traffic Noise and Incident Hypertension in seven cohorts of the European Study of Cohorts for Air Pollution Effects (ESCAPE). Euro Heart J. 2017;13(38):983-990. DOI: 10.1093/eurheartj/ehw413.

• Wolf K, Stafoggia M, Cesaroni G, et al. Long-term Exposure to Particulate Matter Constituents and the Incidence of Coronary Events in 11 European Cohorts. Epidemiology [electronic article]. 2015;26(4):1. DOI: 10.1097/EDE.0000000000000300.

• Perez L, Wolf K, Hennig F, Penell J, Basagana X, Aguilera I, Agis D, Beelen R, Brunekreef B, Cyrys J, Fuks KB, Adam M, Baldassare D, Cirach M, Elosua R, Dratva J, Hampel R, Koenig W, Marrugat J, De Faire U, Pershagen G, Probst-Hensch NM, de Nazelle A, Nieuwenhuijsen MJ, Rathmann W, Rivera M, Seissler J, Schindler C, Thierry J, Hoffmann B, Peters A, Künzli N. Air Pollution and Atherosclerosis: A Cross-Sectional Analysis of Four European Cohort Studies in the ESCAPE Study. Environ. Health Perspect. 2015;123:597–605.

• Fuks K, Weinmayr G, Foraster M, Dratva J, Hampel R, Houthuijs D, Oftedal B, Oudin A, Panasevich S, Penell J, Sommar J, Sørensen M, Tiittanen P, Wolf, Xun W, Aguilera I, Basagaña X, Beelen R, Bots M, Brunekreef B, Bueno-de-Mesquita B, Caracciolo B, Cirach M, de Faire U, de Nazelle A, Eeftens M, Elosua R, Erbel R, Forsberg B, Fratiglioni L, Gaspoz J, Michel FACP, Hilding A; Jula A, Korek M, Krämer U, Künzli N, Lanki T, Leander K, Magnusson P, Marrugat J, Nieuwenhuijsen M, Östenson CG, Pedersen N, Pershagen G, Phuleria H, Probst-Hensch N, Raaschou-Nielsen O, Schaffner E, Schikowski T, Schindler C, Schwarze P, Søgaard A, Sugiri D, Swart W, Tsai MY, Turunen A, Vineis P, Peters A, Hoffmann B. Long-term exposure to traffic-related air pollution and arterial blood pressure: an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE). EHP 2014;122(9):896-905. DOI: 10.1289/ehp.1307725.

• Cesaroni G, Forastiere F, Stafoggia M, Andersen ZJ, Badaloni C, Beelen R, Caracciolo B, De Faire U, Erbel R, Eriksen KT, Fratiglioni L, Galassi C, Hampel R, Heier M, Hennig F, Hilding A, Hoffmann B, Houthuijs D, Jöckel KH, Korek M, Lanki T, Leander K, Magnusson PKE, Migliore E, Östenson CG, Overvad K. Long-term exposure to ambient air pollution and incidence of acute coronary events -Analysis of eleven European cohorts from the ESCAPE Project. BMJ 2014; 348:f7412.

• Stafoggia M, Cesaroni G, Peters A, Andersen ZJ, Badaloni C, Beelen R, Caracciolo B, Cyrys J, de Faire U, de Hoogh K, Eriksen KT, Fratiglioni L, Galassi C, Gigante B, Havulinna AS, Hennig F, Hilding A, Hoek G, Hoffmann B, Houthuijs D, Korek M, Lanki T, Leander K, Magnusson PK, Meisinger C, Migliore E, Overvad K, Östenson CG, Pedersen NL, Pekkanen J, Penell J, Pershagen G, Pundt N, Pyko A, Raaschou-Nielsen O, Ranzi A, Ricceri F, Sacerdote C, Swart WJ, Turunen AW, Vineis P, Weimar C, Weinmayr G, Wolf K, Brunekreef B, Forastiere F. Long-term exposure to ambient air pollution and incidence of cerebrovascular events: results from 11 European cohorts within the ESCAPE project. Environ Health Perspect 2014;122:919–925. DOI: 10.1289/ehp.1307301.

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