SummaryThere is growing evidence regarding the long-term health effects of ultrafine particles (UFP) with a diameter smaller than 100 nm. Across various organ systems and disease categories, the most consistent associations with long-term UFP exposure have been observed for cardiovascular outcomes (both clinical and subclinical), metabolic diseases (diabetes and diabetes biomarkers), inflammatory biomarkers, and cancer. In the NAKO study in Augsburg and Regensburg in Southern Germany, the long-term exposure to particle number concentration (PNC) was associated with increased odds of hypertension, myocardial infarction, chronical obstructive pulmonary disease (COPD), as well as elevated glucose and leukocyte levels. The annual PNC exposure in this research was estimated using supervised land use regression models. Unlike prior NAKO analyses, our study leverages the ULTRAFLEB model’s high-resolution data to assess fine-scale spatial variability in source-specific UFP exposure across the Berlin region. The Ultrafine Particle Exposure by Airports in Berlin (ULTRAFLEB) hybrid model provides at a 50×50 m spatial resolution, source-specific UFP concentration from aviation, road traffic, and background for large parts of Berlin. We aim to investigate the association between long-term total and source-specific UFP exposure and cardiometabolic diseases, COPD and biomarkers in the NAKO Berlin cohort using different UFP models as well as source-specific exposures. Our analysis will examine established outcomes (hypertension, dyslipidemia, diabetes, history of myocardial infarction, history of stroke, coronary heart disease, peripheral arterial disease, COPD) and subclinical markers (blood glucose level, lipids, hs-CRP, blood cells count, electrocardiogram (ECG) signs of atrial fibrillation), with comparisons to previous NAKO findings from Augsburg/Regensburg. Using advanced statistical models, we will account for confounders and explore effect modification by age, sex, and pre-existing conditions to identify vulnerable populations. Additionally, we will explore the role of atherosclerosis in the association between UFP exposure and cardiometabolic clinical outcomes. We will examine whether long-term UFP exposure is associated with adverse cardiometabolic outcomes and related biomarkers, in line with existing evidence. However, given Berlin’s unique urban structure (e.g., high traffic density, airport emissions), we anticipate potentially stronger associations compared to Southern Germany, particularly for traffic-related UFP sources. These findings may contribute to public health policies targeting UFP reduction in urban environments.

Keywords Ultrafine-particles air-pollution cardiometabolic-health

InstitutionsCenter For Health And Society, HHU, Helmholtz Zentrum München, Heinrich-Heine-Universität Düsseldorf, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt