Epidemiological cohort studies have consistently found associations between long-term exposure to outdoor air pollution and a range of morbidity and mortality outcomes. Recent evaluations by the World Health Organization and the Global Burden of Disease study have suggested that these associations may be non-linear, and persist at very low concentrations. Therefore, we will investigate if long-term exposure to low concentrations of outdoor air pollution is related to adverse health effects. We will define ‘low’ using various cut-points defined by current EU, US and WHO limit values, air quality standards and guidelines, respectively. We will specifically test whether the exposure-response functions deviate significantly from linearity at low exposures.

 

1. To estimate long-term average exposure to PM_2.5, NO₂, O₃ and Black Carbon by developing new hybrid models that combine monitoring data, land-use, satellite observations and dispersion models of the pooled ESCAPE cohort and six large administrative cohorts.
2.  To investigate the shape of the relationship between long-term exposure to PM_2.5, NO₂, Black Carbon and O₃ and three broad health effect categories
   (a) natural and cause-specific mortality;
   (b) coronary and cerebrovascular events; and
   (c) lung cancer incidence
   using a number of different methods to characterize the exposure response function (linear, non-linear, threshold).
3. To investigate in the context of objective 2 the variability of the exposure-response function across population and different exposure assessment methods; as well as the impact of different methods for exposure measurement error; the role of co-occurring sentlicher Bedeutung.pollutants, and the effect of indirect approaches for confounder control in administrative cohorts.

Longitudinal analyses of event incidence. ESCAPE cohorts will be pooled and administrative cohorts will be analyzed separately. Meta-analysis techniques will be used to combine the estimates subsequently.

Ten selected well-characterized cohorts from the ESCAPE study plus one additional Danish cohort and seven large European administrative cohorts. Helmholtz Munich brings into ELAPSE the KORA cohort.

In total, eleven European countries participate in ELAPSE, thereof cities and regions from Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Norway, Sweden, Switzerland, and the UK.

• Institute for Risk Assessment Sciences (IRAS), Utrecht University, the Netherlands: Bert Brunekreef (project coordination)
• Partner Helmholtz Zentrum München - Institute of Epidemiology: Annette Peters, Kathrin Wolf, Alexandra Schneider, Josef Cyrys

Collaboration with 14 partners from 10 European countries.