European Heart Journal

European Heart Journal 2001 22(14):1198-1204; doi:10.1053/euhj.2000.2483
Copyright © 2001 by the European Society of Cardiology.

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Particulate air pollution is associated with an acute phase response in men. Results from the MONICA–Augsburg Study

A Peters^a,f1, M Fröhlich^b, A Döring^a, T Immervoll^a, H.-E Wichmann^a, W.L Hutchinson^c, M.B Pepys^c and W Koenig^b

^a GSF-National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
^b Department of Internal Medicine II, Cardiology, University of Ulm Medical Center, Ulm, Germany
^c Department of Medicine, Royal Free and University College Medical School, London, U.K.

revised September 22, 2000; accepted October 4, 2000

Abstract

Aims Episodes of increased air pollution are associated with increases in hospital admissions for cardiovascular disease. Even modest acute phase responses are associated with increased risk of coronary heart disease. The study investigates whether induction of an acute phase response by exposure to air pollution may contribute to cardiovascular pathology.

Methods and Results A prospective cohort study based on a survey in 1984/85 with a 3-year follow-up was conducted in 631 randomly selected men aged 45 to 64 years free of cardiovascular disease at entry 1984/85. Serum C-reactive protein concentrations were determined by a high sensitivity immunoradiometric assay. C-reactive protein concentration was increased in association with the 1985 air pollution episode. In multivariate analyses, elevated concentrations were independently associated with concentrations of total suspended particles and the sulphur dioxide episode. At ambient concentrations of pollution, as noted during the 1985 air pollution episode, the odds of observing C-reactive protein concentrations above 5·7mg.l^–1(>90th percentile) tripled, and increases of 26µg.m^–3total suspended particles (mean of 5 days) raised the odds of C-reactive protein levels 50% above the 90th percentile.

Conclusions Exposure to current levels of particulate matter in the atmosphere elicits an acute phase response in randomly selected healthy middle-aged men, which may contribute to the increased cardiovascular risk caused by air pollution.

Key Words: Acute phase reaction, air pollution, cardiovascular disease, epidemiology, risk factors

^f1 Correspondence: Annette Peters, National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Postfach 1129, 85758 Oberschleissheim, Germany.

References

1. Bascom R, Bromberg PA, Costa DA. Health effects of outdoor air pollution. Am J Respir Crit Care Med. 1996;153:3–50[Abstract]
2. Schwartz J, Morris R. Air pollution and hospital admissions for cardiovascular disease in Detroit, Michigan. Am J Epidemiol. 1995;142:23–35[Abstract/Free Full Text]
3. Burnett RT, Dales R, Krewski D, Vincent R, Dann T, Brook JR. Associations between ambient particulate sulfate and admissions to Ontario hospitals for cardiac and respiratory diseases. Am J Epidemiol. 1995;142:15–22[Abstract/Free Full Text]
4. Schwartz J. Air pollution and hospital admissions for cardiovascular disease in Tucson. Epidemiology. 1997;8:371–377[CrossRef][ISI][Medline]
5. Schwartz J. Air pollution and hospital admissions for heart disease in eight US counties. Epidemiology. 1999;10:17–22[CrossRef][ISI][Medline]
6. Seaton A, MacNee W, Donaldson K, Godden D. Particulate air pollution and acute health effects. Lancet. 1995;345:176–178[CrossRef][ISI][Medline]
7. Pepys MB. The acute phase response and C-reactive protein. Weatherall DJ, Ledingham JGG, Warell DA. Oxford Textbook of Medicine. Oxford: Oxford University Press; 1995. p. 1527–1533
8. Danesh J, Whincup P, Walker M. Low grade inflammation and coronary heart disease: prospective study and up-dated meta-analyses. Br Med J. 2000;321:199–204[Abstract/Free Full Text]
9. Mattila KJ. Viral and bacterial infections in patients with acute myocardial infarction. J Intern Med. 1989;225:293–296[ISI][Medline]
10. Jousilahti P, Vartiainen E, Tuomilehto J, Puska P. Symptoms of chronic bronchitis and the risk of coronary disease. Lancet. 1996;348:567–572[CrossRef][ISI][Medline]
11. Spodick DH. Inflammation and the onset of myocardial infarction. Ann Intern Med. 1985;102:699–702[ISI][Medline]
12. de Leeuw FAAM, van Rheineck Leyssius HJ. Long-range transport modelling of air pollution episodes. Environ Health Perspect. 1989;79:53–59[ISI][Medline]
13. Wichmann HE, Mueller W, Allhoff P. Health Effects During a Smog Episode in West Germany in 1985. Environ Health Perspect. 1989;79:89–99[ISI][Medline]
14. Keil U, Stieber J, Döring A. The cardiovascular risk factor profile in the study area Augsburg: Results from the first MONICA survey 1984/85. Acta Med Scand. 1988;Suppl 728:119–128
15. Peters A, Döring A, Wichmann HE, Koenig W. Increased plasma viscosity during the 1985 air pollution episode: A link to mortality? Lancet. 1997;349:1582–1587[CrossRef][ISI][Medline]
16. MONICA manual. Geneva: WHO; 1990.
17. Koenig W, Sund M, Fröhlich M. C-reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA Augsburg Cohort Study, 1984 to 1992. Circulation. 1999;99:237–242[Abstract/Free Full Text]
18. Hutchinson WL, Koenig W, Fröhlich M, Sund M, Lowe GD, Pepys MB. Immunoradiometric assay of circulating C-reactive protein: age-related values in the adult general population. Clin Chem. 2000;46:934–938[Abstract/Free Full Text]
19. Peters A, Perz S, Döring A, Stieber J, Koenig W, Wichmann H-E. Increases in heart rate during an air pollution episode. Am J Epidemiol. 1999;150:1094–1098[Abstract/Free Full Text]
20. Wilkins, J, Gallimore, JR, Moore, EG, Pepys, MB, Rapid automated high sensitivity enzyme immunoassay for C-reactive protein, Clin Chem, 1998, 44, 1358, 61
21. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973–979[Abstract/Free Full Text]
22. Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation. 1998;98:731–733[Abstract/Free Full Text]
23. Haverkate F, Thompson SG, Pyke SDM, Gallimore JR, Pepys MB. Production of C-reactive protein and risk of coronary events in stable and unstable angina. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Lancet. 1997;349:462–466[CrossRef][ISI][Medline]
24. Gabay C, Kushner J. Acute phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–454[Free Full Text]
25. Baumann H, Gauldie J. The acute phase response. Immunol Today. 1994;25:74–80
26. Crystal RG. Alveolar Macrophages. Crystal RG, West JB. The Lung. New York: Raven Press Ltd; 1991. p. 527–535
27. Finkelstein JN, Johnston CJ, Barrett T, Oberdörster G. Particulate-cell interactions and pulmonary cytokine expression. Environ Health Perspect. 1997;105:1179–1182
28. Driscoll KE, Carter JM, Hassenbein DG, Howard BW. Cytokines and particle-induced inflammatory cell recruitment. Environ Health Perspect. 1997;105:1159–1164
29. Terashima T, Wiggs B, English D, Hogg JC, van Eeden SF. Phagocytosis of small carbon particles (PM10) by alveolar macrophages stimulates the release of polymorphonuclear leukocytes from bone marrow. Am J Respir Crit Care Med. 1997;155:1441–1447[Abstract]
30. Tan WC, Qiu D, Liam BL. The human bone marrow response to acute air pollution caused by forest fires. Am J Respir Crit Care Med. 2000;161:1213–1217[Abstract/Free Full Text]
31. Pope CA III, Dockery DW, Kanner RE, Villegas GM, Schwartz J. Oxygen saturation, pulse rate, and particulate air pollution. Am J Respir Crit Care Med. 1999;159:365–372[Abstract/Free Full Text]
32. Liao D, Creason J, Shy CM, Williams R, Watts R, Zweidinger R. Daily variation of particulate air pollution and poor cardiac autonomic control in the elderly. Environ Health Perspect. 1999;107:521–525[ISI][Medline]
33. Pope CA III, Verrier RL, Lovett EG. Heart rate variability associated with particulate air pollution. Am Heart J. 1999;138:890–899[CrossRef][ISI][Medline]
34. Gold DR, Litonjua A, Schwartz J. The relationship between particulate pollution and heart rate variability. Circulation. 2000;101:1267–1273[Abstract/Free Full Text]
35. Peters A, Perz S, Döring A, Stieber J, Koenig W, Wichmann HE. Activation of the autonomic nervous system and blood coagulation in association with an air pollution episode. Inhal Toxicol. 2000;12:51–61[CrossRef]

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