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Volume 73 Supplement 1

Methods in Epidemiology Symposium

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Changing places to study the medium-term effects of air pollution: carotid arterial stiffness

Background and aim

A biomarker for cardiovascular disease, carotid arterial stiffness is linked with exposure to air pollution. In a panel study on short- to medium-term health effects of air pollution, we evaluated the association between NO2 exposure and indicators of carotid arterial stiffness.


Arterial stiffness was measured in 20 healthy volunteers (59-76 years of age) in three locations and at 11 timepoints during one year: seven times in Leuven (Belgium) and twice during each 10-day stay in Milan (Italy) and Vindeln (Sweden). Pulse Wave Velocity (PWV), distensibility (DC) and compliance (CC) were measured using Esaote MyLabOne ultrasound. Personal NO2 exposure, an indicator of traffic-related air pollution, was monitored during 5 consecutive days before each health assessment using passive samplers. Associations between arterial stiffness and exposure to NO2 were evaluated with linear mixed models, adjusting for sex, age, heart rate, arterial pressure, and time.


In Milan, NO2 was higher by about 40 μg/m3 and in Vindeln it was lower by about 15 μg/m3 than in Belgium. A 10 μg/m2 increase in NO2 was associated with an average increase in PWV of 0.087 m/s (95% confidence interval (CI): 0.016-0.157 m/s). Adjusting for personal and weather characteristics did not alter the result (+0.104 m/s; CI: 0.002-0.206). A 10 μg/m3 increase in NO2 was also associated with a decrease in DC (adjusted coefficient: -0.039 kPa-1; CI -0.061 - -0.017) and CC (-0.031 mm2/kPa; CI -0.055 - -0.008). Similar results were obtained when using PM10 (obtained from monitor stations, the average of lag0 to lag6) as the exposure variable.


Given that increased PWV and decreased DC and CC indicate greater arterial stiffness, we found in a real life intervention study that exposing healthy elderly to higher or lower air pollution results in concurrent changes in carotid arterial stiffness.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Scheers, H., Casas, L., Nawrot, T. et al. Changing places to study the medium-term effects of air pollution: carotid arterial stiffness. Arch Public Health 73 (Suppl 1), P21 (2015).

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