title: Association between long-term exposure to traffic-related air pollution and subclinical atherosclerosis: the REGICOR study.
abstract: BACKGROUND
  Epidemiological evidence of the effects of long-term exposure to air pollution on the chronic processes of atherogenesis is limited.
  
  
  OBJECTIVE
  We investigated the association of long-term exposure to traffic-related air pollution with subclinical atherosclerosis, measured by carotid intima media thickness (IMT) and ankle-brachial index (ABI).
  
  
  METHODS
  We performed a cross-sectional analysis using data collected during the reexamination (2007-2010) of 2,780 participants in the REGICOR (Registre Gironí del Cor: the Gerona Heart Register) study, a population-based prospective cohort in Girona, Spain. Long-term exposure across residences was calculated as the last 10 years' time-weighted average of residential nitrogen dioxide (NO2) estimates (based on a local-scale land-use regression model), traffic intensity in the nearest street, and traffic intensity in a 100 m buffer. Associations with IMT and ABI were estimated using linear regression and multinomial logistic regression, respectively, controlling for sex, age, smoking status, education, marital status, and several other potential confounders or intermediates.
  
  
  RESULTS
  Exposure contrasts between the 5th and 95th percentiles for NO2 (25 µg/m3), traffic intensity in the nearest street (15,000 vehicles/day), and traffic load within 100 m (7,200,000 vehicle-m/day) were associated with differences of 0.56% (95% CI: -1.5, 2.6%), 2.32% (95% CI: 0.48, 4.17%), and 1.91% (95% CI: -0.24, 4.06) percent difference in IMT, respectively. Exposures were positively associated with an ABI of > 1.3, but not an ABI of < 0.9. Stronger associations were observed among those with a high level of education and in men ≥ 60 years of age.
  
  
  CONCLUSIONS
  Long-term traffic-related exposures were associated with subclinical markers of atherosclerosis. Prospective studies are needed to confirm associations and further examine differences among population subgroups.
authors: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. marcelaepi@gmail.com
authors: Marcela
authors: M
authors: Rivera
authors: Xavier
authors: X
authors: Basagaña
authors: Inmaculada
authors: I
authors: Aguilera
authors: Maria
authors: M
authors: Foraster
authors: David
authors: D
authors: Agis
authors: Eric
authors: E
authors: de Groot
authors: Laura
authors: L
authors: Perez
authors: Michelle A
authors: MA
authors: Mendez
authors: Laura
authors: L
authors: Bouso
authors: Jaume
authors: J
authors: Targa
authors: Rafael
authors: R
authors: Ramos
authors: Joan
authors: J
authors: Sala
authors: Jaume
authors: J
authors: Marrugat
authors: Roberto
authors: R
authors: Elosua
authors: Nino
authors: N
authors: Künzli
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000633:toxicity*; D050197:Atherosclerosis / Q000139:chemically induced*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain; D001335:Vehicle Emissions
chemical_list: D000393:Air Pollutants; D001335:Vehicle Emissions
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