title: Long-term residential exposure to urban air pollution, and repeated measures of systemic blood markers of inflammation and coagulation.
abstract: BACKGROUND
  In several studies, exposure to fine particulate matter (PM) has been associated with inflammation, with inconsistent results. We used repeated measurements to examine the association of long-term fine and ultrafine particle exposure with several blood markers of inflammation and coagulation.
  
  
  METHODS
  We used baseline (2000-2003) and follow-up (2006-2008) data from the Heinz Nixdorf Recall Study, a German population-based prospective cohort of 4814 participants. A chemistry transport model was applied to model daily surface concentrations of PM air pollutants (PM10, PM2.5) and particle number on a grid of 1 km(2). Applying mixed regression models, we analysed associations of long-term (mean of 365 days prior to blood draw) particle exposure at each participant's residence with the level of high-sensitivity C reactive protein (hs-CRP), fibrinogen, platelet and white cell count (WCC), adjusting for short-term PM exposure (moving averages of 1-7 days), personal characteristics, season, ambient temperature (1-5 days), ozone and time trend.
  
  
  RESULTS
  We analysed 6488 observations: 3275 participants with baseline data and 3213 with follow-up data. An increase of 2.4 µg/m(3) in long-term PM2.5 was associated with an adjusted increase of 5.4% (95% CI 0.6% to 10.5%) in hs-CRP and of 2.3% (95% CI 1.4% to 3.3%) in the platelet count. Fibrinogen and WCC were not associated with long-term particle exposure.
  
  
  CONCLUSIONS
  In this population-based cohort, we found associations of long-term exposure to PM with markers of inflammation (hs-CRP) and coagulation (platelets). This finding supports the hypothesis that inflammatory processes might contribute to chronic effects of air pollution on cardiovascular disease.
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Viehmann
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Hertel
authors.affiliation: IUF-Leibniz Institute of Environmental Medicine Research and Medical Faculty, Deanery of Medicine, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Kateryna
authors.initials: K
authors.lastname: Fuks
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
authors.forename: Lewin
authors.initials: L
authors.lastname: Eisele
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.affiliation: Department of Cardiology, Bethanien Hospital Moers, Moers, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Nonnemacher
authors.affiliation: Rhenish Institute for Environmental Research at the University of Cologne, Cologne, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Jakobs
authors.affiliation: Department of Cardiology, West German Heart Centre of Essen, University Hospital of Essen, Essen, Germany.
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.affiliation: IUF-Leibniz Institute of Environmental Medicine Research and Medical Faculty, Deanery of Medicine, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D015415:Biomarkers; D001777:Blood Coagulation; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005858:Germany; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects*; D010976:Platelet Count; D011446:Prospective Studies; D012111:Residence Characteristics
chemical_list: D000393:Air Pollutants; D015415:Biomarkers; D052638:Particulate Matter; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: High-sensitivity C-reactive protein (hs-CRP); fibrinogen; inflammation; particulate matter; platelet count