Long-Term Exposure to Ambient Air Pollution and Incidence of Cerebrovascular Events: Results from 11 European Cohorts within the ESCAPE Project

BACKGROUND: Few studies have investigated effects of air pollution on the incidence of cerebrovascular events.OBJECTIVES: We assessed the association between long-term exposure to multiple air pollutants and the incidence of stroke in European cohorts.METHODS: Data from 11 cohorts were collected, and occurrence of a first stroke was evaluated. Individual air pollution exposures were predicted from land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE). The exposures were: PM2.5 [particulate matter (PM) = 2.5 m in diameter], coarse PM (PM between 2.5 and 10 m), PM10 (PM = 60 years of age (HR = 1.40, 95% CI: 1.05, 1.87), among neversmokers (HR = 1.74, 95% CI: 1.06, 2.88), and among participants with PM2.5 exposure < 25 g/m(3) (HR = 1.33, 95% CI: 1.01, 1.77).CONCLUSIONS: We found suggestive evidence of an association between fine particles and incidence of cerebrovascular events in Europe, even at lower concentrations than set by the current air quality limit value.