title: Long-term exposure to air pollution and markers of inflammation, coagulation, and endothelial activation: a repeat-measures analysis in the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: BACKGROUND
  Air pollution is associated with cardiovascular disease, and systemic inflammation may mediate this effect. We assessed associations between long- and short-term concentrations of air pollution and markers of inflammation, coagulation, and endothelial activation.
  
  
  METHODS
  We studied participants from the Multi-Ethnic Study of Atherosclerosis from 2000 to 2012 with repeat measures of serum C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, D-dimer, soluble E-selectin, and soluble Intercellular Adhesion Molecule-1. Annual average concentrations of ambient fine particulate matter (PM2.5), individual-level ambient PM2.5 (integrating indoor concentrations and time-location data), oxides of nitrogen (NOx), nitrogen dioxide (NO2), and black carbon were evaluated. Short-term concentrations of PM2.5 reflected the day of blood draw, day prior, and averages of prior 2-, 3-, 4-, and 5-day periods. Random-effects models were used for long-term exposures and fixed effects for short-term exposures. The sample size was between 9,000 and 10,000 observations for CRP, IL-6, fibrinogen, and D-dimer; approximately 2,100 for E-selectin; and 3,300 for soluble Intercellular Adhesion Molecule-1.
  
  
  RESULTS
  After controlling for confounders, 5 µg/m increase in long-term ambient PM2.5 was associated with 6% higher IL-6 (95% confidence interval = 2%, 9%), and 40 parts per billion increase in long-term NOx was associated with 7% (95% confidence interval = 2%, 13%) higher level of D-dimer. PM2.5 measured at day of blood draw was associated with CRP, fibrinogen, and E-selectin. There were no other positive associations between blood markers and short- or long-term air pollution.
  
  
  CONCLUSIONS
  These data are consistent with the hypothesis that long-term exposure to air pollution is related to some markers of inflammation and fibrinolysis.
authors.affiliation: From the aDepartment of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA; bDepartment of Family and Preventive Medicine, University of California San Diego, San Diego, CA; cSchool of Public Health, Drexel University, Philadelphia, PA; dDepartment of Pathology, College of Medicine, University of Vermont, Burlington, VT; and eDepartment of Biostatistics, University of Washington, Seattle, WA.
authors.forename: Anjum
authors.initials: A
authors.lastname: Hajat
authors.forename: Matthew
authors.initials: M
authors.lastname: Allison
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
authors.forename: Nancy Swords
authors.initials: NS
authors.lastname: Jenny
authors.forename: Neal W
authors.initials: NW
authors.lastname: Jorgensen
authors.forename: Adam A
authors.initials: AA
authors.lastname: Szpiro
authors.forename: Sverre
authors.initials: S
authors.lastname: Vedal
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000009:adverse effects*; D050197:Atherosclerosis / Q000139:chemically induced* / Q000453:epidemiology; D001777:Blood Coagulation / Q000187:drug effects*; D002097:C-Reactive Protein / Q000032:analysis; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000139:chemically induced*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000009:adverse effects; D009589:Nitrogen Oxides; D052638:Particulate Matter / Q000009:adverse effects; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D019040:E-Selectin; D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D009589:Nitrogen Oxides; D052638:Particulate Matter; C036309:fibrin fragment D; D018799:Intercellular Adhesion Molecule-1; D005340:Fibrinogen; D002097:C-Reactive Protein; D009585:Nitrogen Dioxide