Abstract Title:

C-reactive protein (CRP) and long-term air pollution with a focus on ultrafine particles.

Abstract Source:

Int J Hyg Environ Health. 2018 04 ;221(3):510-518. Epub 2018 Jan 31. PMID: 29428699

Abstract Author(s):

Veronika Pilz, Kathrin Wolf, Susanne Breitner, Regina Rückerl, Wolfgang Koenig, Wolfgang Rathmann, Josef Cyrys, Annette Peters, Alexandra Schneider,

Article Affiliation:

Veronika Pilz


BACKGROUND: Long-term exposure to ambient air pollution contributes to the global burden of disease by particularly affecting cardiovascular (CV) causes of death. We investigated the association between particle number concentration (PNC), a marker for ultrafine particles, and other air pollutants and high sensitivity C-reactive protein (hs-CRP) as a potential link between air pollution and CV disease.

METHODS: We cross-sectionally analysed data from the second follow up (2013 and 2014) of the German KORA baseline survey which was conducted in 1999-2001. Residential long-term exposure to PNC and various other size fractions of particulate matter (PMwith size of<10 μm in aerodynamic diameter, PM2.5-10 μm or PM < 2.5 μm, respectively), soot (PMabs: absorbance of PM), nitrogen oxides (nitrogen dioxide NOor oxides NO, respectively) and ozone (O) were estimated by land-use regression models. Associations between annual air pollution concentrations and hs-CRP were modeled in 2252 participants using linear regression models adjusted for several confounders. Potential effect-modifiers were examined by interaction terms and two-pollutant models were calculated for pollutants with Spearman inter-correlation<0.70.

RESULTS: Single pollutant models for PNC, PM, PM, PMabs, NOand NOshowed positive but non-significant associations with hs-CRP. For PNC, an interquartile range (2000 particles/cm) increase was associated with a 3.6% (95% CI: -0.9%, 8.3%) increase in hs-CRP. A null association was found for PM. Effect estimates were higher for women, non-obese participants, for participants without diabetes and without a history of cardiovascular disease whereas ex-smokers showed lower estimates compared to smokers or non-smokers. For O, the dose-response function suggested a non-linear relationship. In two-pollutant models, adjustment for PMstrengthened the effect estimates for PNC and PM(6.3% increase per 2000 particles/cm[95% CI: 0.4%; 12.5%] and 7.3% per 16.5 μg/m[95% CI: 0.4%; 14.8%], respectively).

CONCLUSION: This study adds to a scarce but growing body of literature showing associations between long-term exposure to ultrafine particles and hs-CRP, one of the most intensely studied blood biomarkers for cardiovascular health. Our results highlight the role of ultrafine particles within the complex mixture of ambient air pollution and their inflammatory potential.

Study Type : Human Study

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