SummaryEnvironmental exposures, including ambient air pollution, non-optimal air temperatures, and traffic noise, have been associated with cardiovascular mortality and morbidity in epidemiological studies. One potential mechanism linking environmental exposures to cardiovascular events is imbalanced autonomic control of the heart. So far, the short-term and long-term effects of environmental exposures on cardiac autonomic function and cardiac electrical conduction are not fully clear yet, and the potential joint effects of exposures have rarely been investigated. This project aims to assess relationships between short- and long-term environmental exposures and cardiac autonomic function in the NAKO Somnowatch group. Specifically, we will examine associations of short-term effects of air pollution [fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2) and ozone (O3)] and temperature and their interaction using daily data with cardiac autonomic function. In addition, we will examine associations of annual mean air pollutant concentrations [PM2.5, PM10, NO2, black carbon (BC) and O3], annual and seasonal mean and standard deviation (SD) of air temperature, and annual mean traffic noise with cardiac autonomic function, as measured by changes in heart rate variability (HRV), heart rate turbulence (HRT) and Deceleration Capacity (DC). Furthermore, we will explore the joint effects of these exposures as well as effect modification by sociodemographic status, lifestyles, dietary patterns, medical history and greenness. In this analysis, we will use the exposure data at the residential addresses of the NAKO Somnowatch group participants estimated by German-wide spatial and spatial-temporal models. The associations with cardiac autonomic function, will be examined by linear and logistic regression models with adjustment for potential confounding factors such as age, sex, socioeconomic status, and lifestyle factors. In addition to single-exposure models, multi-exposure analysis will be conducted to assess the joint effects of air pollution, air temperature, and traffic noise. The effect modification by individual characteristics will be investigated by including an interaction term between the exposure and modifier (single-modifier) and subgroup analysis (multi-modifier). We will use NAKO Somnowatch group participants data who have collected long-term (24 hours) ECG data, possessing relevant indicators of cardiac autonomic function. Hence, we will use the data from these participants to investigate the correlation between environmental exposure and cardiac autonomic function. Simultaneously, in another project, we will use short-term ( 10 seconds) ECG data collected from NAKO general participants to explore the relationship between environmental exposure and cardiac electrical conduction.

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InstitutionsHelmholtz Munich, Technische Universität München, Helmholtz Zentrum München, Martin-Luther-Universität Halle-Wittenberg, DKFZ Heidelberg, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Universitäres Herz- und Gefäßzentrum, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt