SummaryA growing number of studies have shown a long-term association between air pollution and all-cause mortality and cardiovascular mortality. Nevertheless, research on the long-term associations between other environmental exposures and these outcomes is still lacking. It is also unclear whether people with cardiometabolic disease are more vulnerable to the adverse effects of environmental factors. Therefore, we aim to investigate the association between several long-term environmental exposures and mortality and cardiometabolic morbidity. We will use geocoded data of multiple long-term environmental exposures, e.g., air pollution, traffic noise, ambient air temperature, greenness and built environment indicators, which were assessed in the EXPANSE project (EXposome Powered tools for healthy living in urbAN Settings). Environmental factors are provided and linked to NAKO participants’ residencies by the Environmental data unit. The outcomes of interest are all-cause and cause-specific mortality and prevalent and incident cardiometabolic disease. First, we will apply single-exposure models to quantify the effects of each exposure on the outcomes of interest. The secondary aim of this project is to assess the potential modification of the environmental exposure – mortality associations by pre-existing cardiometabolic disease. The NAKO study can contribute substantial evidence on the association of environmental exposures with mortality and cardiometabolic (multi-) morbidity due to its high exposure contrasts and longitudinal health data. Moreover, it allows the assessment of the potential modifying role of prevalent cardiometabolic disease on these associations.

Keywords CVD Morbidität air-pollution air-temperature exposome greenness metabolic-diseases mortality traffic-noise

InstitutionsHelmholtz Zentrum München, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt