ESCAPE - European Study of Cohorts for Air Pollution Effects

Structure

The ESCAPE project is organized as a set of seven, interlinked work packages, each led by one of the project partners.

Work package Work package title Lead scientist
1 Coordination Bert Brunekreef and Rob Beelen, Institute for Risk Assessment Sciences (IRAS), Utrecht University, the Netherlands
2 Exposure assessment Gerard Hoek and Rob Beelen, Institute for Risk Assessment Sciences (IRAS), Utrecht University, The Netherlands and Kees de Hoogh, Imperial College London, United Kingdom
3 Pregnancy outcomes and birth cohorts Göran Pershagen, Karolinska Institute, Sweden
4 Respiratory disease Nino Künzli, Swiss Tropical and Public Health Institute Basel, Switzerland
5 Cardiovascular disease Annette Peters, Helmholtz Research Center for Environmental Health, Germany
6 Cancer incidence and mortality Paolo Vineis, Imperial College London, United Kingdom
7 Impact and dissemination Bert Brunekreef, Institute for Risk Assessment Sciences (IRAS), Utrecht University, the Netherlands

1. Coordination

The objective of this work package is to coordinate the ESCAPE project.

2. Exposure assessment

The exposure assessment work package will develop tools for air pollution exposure assessment, and provide these to the four endpoint work packages for implementation. The work package will employ a mixture of measurements and modelling to estimate air pollution exposure of study participants. In addition, noise will be assessed in selected cohort studies.

The planned exposure measurements have the following aims:

  • To document the spatial variation of long-term average ambient PM, PM composition and NOx concentrations in a number of European cities/areas
  • To develop and validate site-specific stochastic models that link the measurements to geographic and land use data such as road network and usage, elevation, population density
  • To validate site-specific dispersion model calculations against ambient measurements
  • To collect and store ambient samples of PM10 and PM2.5 for later analysis of chemical composition and toxicity using state of the art in vitro methods
  • To establish the distribution of exposure for truly prospective analyses in ongoing cohort studies with planned observations of health and disease status in the future
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3. Pregnancy outcomes and birth cohorts

In this work package, studies on adverse pregnancy outcomes and birth cohort studies of development of childhood disease such as asthma and allergy will be included. This work package will concentrate on studies that have recruited subjects from the mid 1990s onwards. As the health events to be considered occur at the beginning of life or early in life, relevant exposure time windows are by definition current or recent, which is different from the work packages dealing with middle aged or elderly adults. In addition to assessment of long term exposure to air pollution, studies on pregnancy outcome will also aim to estimate short term exposure during specific periods of foetal life.

The aims of this work package are:

  • To quantify the impact of ambient air pollution on adverse pregnancy outcomes
  • To quantify the impact of ambient air pollution on development of asthma, allergy, lung function and infections in children during the first ten years of life
  • To quantify the impact of ambient air pollution on cognitive function development in children during the first five years of life
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4. Respiratory disease

This work package hypothesizes that long-term exposure to traffic-related air pollution is associated with the prevalence of chronic bronchitis symptoms; the prevalence and incidence of COPD, objectively defined with lung function; the level and change of forced expiratory lung volumes, namely FVC and FEV1; the incidence of adult asthma. Moreover, based on current knowledge of the most relevant underlying mechanisms we hypothesize that these associations are modified by endogenous and/or exogenous factors relevant in the defence and/or amplification of oxidative stress and systemic inflammation.

The aims of the work package are:

  • To investigate the effect of ambient air pollution on the prevalence of chronic bronchitis symptoms
  • To investigate the effect of ambient air pollution on the prevalence and incidence of COPD
  • To investigate the effect of ambient air pollution on the level and change of FVC and FEV1
  • To investigate the effect of ambient air pollution on the incidence of asthma
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5. Cardiovascular disease

This work package will fill the gaps in knowledge concerning the development of susceptibility to the incidence of cardiovascular disease events within European populations. In particular, the extent to which long-term exposure to air pollution induces inflammation and atherosclerosis, the main underlying condition determining the risk of acute coronary artery disease events, is of importance for determining the overall public health impact and for developing prevention strategies for at risk populations if measures for reducing ambient air pollution might be lagging behind.

The aims of the work package are:

  • To quantify the impact of ambient air pollution on markers of inflammation, and gene-environment interaction
  • To quantify the impact of ambient air pollution on the risk for build-up of preclinical atherosclerosis measured by intima-media thickness (IMT) of the carotid artery
  • To quantify the impact of ambient air pollution on blood pressure and prevalence of hypertension
  • To quantify the impact of ambient air pollution on incident coronary events
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6. Cancer incidence and mortality

This work package will estimate the effect of ambient air pollution on life expectancy using data from several cohorts in Europe. In addition, most of the cohorts have been recruited in areas where Cancer Registries are operating, so that cancer incidence will be also investigated in most of them.

The aims of this work package are:

  • To quantify the impact of ambient air pollution on cancer incidence
  • To quantify the impact of ambient air pollution on cardiovascular disease mortality
  • To quantify the impact of ambient air pollution on respiratory mortality
  • To estimate the risk of death attributable to air pollution under a range of European circumstances
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7. Impact and dissemination

The aims of this work package are to:

  • Develop and maintain ESCAPE project website
  • Discuss and report policy relevant conclusions from the ESCAPE study
  • Provide materials for patient groups that inform them about risks of air pollution to their health
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Figure: Organization of the ESCAPE project management (click to enlarge) To top of page

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