April 20, 2026European Heart Journal
Particulate air pollution is associated with an acute phase response in men. Results from the MONICA–Augsburg Study
Key result
Exposure to ambient air pollution episodes tripled the odds of having elevated C-reactive protein concentrations (>90th percentile) in healthy middle-aged men.
Why the study?
Does exposure to particulate air pollution increase serum C-reactive protein concentrations in healthy middle-aged men?
Population
631 randomly selected men aged 45 to 64 years free of cardiovascular disease at entry 1984/85
Comparison
Exposure to air pollution vs Lower levels of air pollution / baseline
Design
Cohort
Follow-up
3-year
Authors
Discussion
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Implication
May explain air pollution's CV risk via inflammation in healthy men; leaves open causality and benefit of exposure reduction.
Key Points
- The study aims to determine whether air pollution exposure induces acute phase responses that contribute to cardiovascular disease risk.
- Conducted a prospective cohort study with 631 men aged 45-64 years free of cardiovascular disease.
- Measured serum C-reactive protein levels using high sensitivity immunoradiometric assay after a 3-year follow-up.
- Analyzed the association between C-reactive protein levels and air pollutants like total suspended particles and sulphur dioxide.
- C-reactive protein concentrations increased during the 1985 air pollution episode.
- The odds of elevated C-reactive protein levels above 5.7 mg/l tripled with ambient pollution levels.
- An increase of 26 µg/m³ in total suspended particles raised the odds of C-reactive protein levels by 50% above the 90th percentile.
Study Design
Type
Cohort (n=631)
Structured PICO
Does exposure to particulate air pollution increase serum C-reactive protein concentrations in healthy middle-aged men?
P
Population
631 randomly selected men aged 45 to 64 years free of cardiovascular disease at entry 1984/85
I
Intervention
Exposure to air pollution (1985 air pollution episode, total suspended particles, sulphur dioxide)
C
Comparator
Lower levels of air pollution / baseline
O
Outcome
Serum C-reactive protein concentrationssurrogate
Main Result
Effect estimate: OR 3.0
Exposure to particulate air pollution elicits an acute phase response (elevated CRP) in healthy middle-aged men, potentially explaining the link between air pollution and cardiovascular risk.
Cite This Study
Annette Peters (2001) conducted a cohort in Healthy (free of cardiovascular disease) (n=631). Air pollution (total suspended particles and sulphur dioxide) vs. Lower ambient pollution levels was evaluated on C-reactive protein concentrations above 5.7 mg/L (>90th percentile) (OR 3.0). Exposure to ambient air pollution episodes tripled the odds of having elevated C-reactive protein concentrations (>90th percentile) in healthy middle-aged men.