07:22pm Sunday 22 October 2017

Particulate Air Pollution Leads to Increased Heart Attack Risk

Moreover, this association can already be observed in levels of particulate exposure below the current specified European limit values. These are the results of a European research team led by scientists of Helmholtz Zentrum München in a population study published in the British Medical Journal.

Particulate Air Pollution Leads to Increased Heart Attack Risk

Prof. Dr. Annette Peters, Dr. Kathrin Wolf (Source: Helmholtz Zentrum München)

The ESCAPE study * investigates the effects of air pollution on health. In eleven participating population groups in Finland, Sweden, Denmark, Italy and Germany the association between air pollution and incidence of coronary events has now been determined. The results show that high particulate matter concentration at the residence location may increase the risk for an acute coronary event.

The scientists, including the team led by Prof. Dr. Annette Peters and Dr. Kathrin Wolf of the Institute of Epidemiology II (EPI II) at Helmholtz Zentrum München, evaluated data from more than 100,000 participants. At enrollment, all study participants were free from cardiovascular diseases. The participants were followed for incident coronary events for an average period of 11.5 years. Event incidence was then compared to concentrations of particulate matter with a diameter less than 10 micrometers (PM10) and inhalable particles smaller than 2.5 micrometers (PM2.5), and nitrogen oxides (NOx) at the residence location.

During the study period, a total of 5,157 individuals suffered a heart attack or unstable angina pectoris, both generally caused by calcification of the coronary vessels. An increase of 5 µg/m³ of annual concentration of PM2.5 or 10 µg/m³ of PM10 in the ambient air led to a 13 and 12 percent increased risk of heart attack, respectively. And the risk remained elevated even at levels below the current EU limit values of 25 µg/m³ for PM2.5 and 40 µg/m³ for PM10.

“Our results show that exposure to particulate matter poses a significant health risk – and an even greater risk than previously thought,” said Professor Peters, lead author of the study. “The adverse health effects that occurred at exposure levels below the current specified limits are particularly alarming. The study therefore supports the demands to lower these limits.”

This study “has specific relevance to the management of air quality in Europe,” say Professors Michael Brauer and John Mancini from the University of British Columbia, in an accompanying editorial.

Environmental and lifestyle factors contribute significantly to the development of widespread diseases in Germany, such as cardiovascular disease and diabetes mellitus. The aim of Helmholtz Zentrum München is to develop new approaches for the diagnosis, treatment and prevention of major common diseases.

Video: Prof. Annette Peters about health risks associated with long-term exposure to particulate matter

Further information

Original publication:
Cesaroni, G. et al. (2014), Long-term exposure to ambient air pollution and incidence of acute coronary events -Analysis of eleven European cohorts from the ESCAPE Project, The British Medical Journal, 2014; 348 doi: dx.doi.org/10.1136/bmj.f7412

Link to publication
Link to BMJ editorial
Link to BMJ press release

* ESCAPE: The European Study of Cohorts for Air Pollution will investigate long-term effects on human health of exposure to air pollution in Europe. 

One cohort study participating in ESCAPE is the research platform Cooperative Health Research in the Augsburg Region (KORA). For more than 20 years, KORA has been collecting and analyzing data on the health of thousands of people living in the Augsburg region. The objective is to elucidate the effects of environmental factors, behavior and genes. KORA focuses on the development and course of chronic diseases, in particular myocardial infarction and diabetes mellitus. Risk factors are analyzed with regard to individual health behavior (e.g. smoking, diet, exercise), environmental factors (e.g. air pollution, noise) and genetics. From the perspective of health care research, questions regarding the utilization of health care resources and the cost of health care are also studied.

As German Research Center for Environmental Health, Helmholtz Zentrum München pursues the goal of developing personalized medical approaches for the prevention and therapy of major common diseases such as diabetes mellitus and lung diseases. To achieve this, it investigates the interaction of genetics, environmental factors and lifestyle. The Helmholtz Zentrum München has about 2,100 staff members and is headquartered in Neuherberg in the north of Munich. Helmholtz Zentrum München is a member of the Helmholtz Association, a community of 18 scientific-technical and medical-biological research centers with a total of about 34,000 staff members.

The Institute of Epidemiology II (EPI II) focuses on the assessment of environmental and lifestyle risk factors which jointly affect major chronic diseases such as diabetes, heart disease and mental health. Research builds on the unique resources of the KORA cohort, the KORA myocardial infarction registry, and the KORA aerosol measurement station. Aging-related phenotypes have been added to the KORA research portfolio within the frame of the Research Consortium KORA-Age. The institute’s contributions are specifically relevant for the population as modifiable personal risk factors are being researched that could be influenced by the individual or by improving legislation for the protection of public health.


Scientific contact
Prof. Annette Peters, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstr. 1, 85764 Neuherberg – Tel. +49 89 3187-4566 – E-Mail

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