Denise Felber Dietrich | Swiss Federal Office for the Environment FOEV (original) (raw)

Papers by Denise Felber Dietrich

Environment International, 2012

Alterations in heart rate variability (HRV) are a potential link between exposure to traffic-rela... more Alterations in heart rate variability (HRV) are a potential link between exposure to traffic-related air pollution and cardiovascular mortality. We investigated whether long-term exposure to traffic-related PM(10) (TPM(10)) is associated with HRV in older subjects and/or in participants taking specific cardiovascular treatment or with self-reported heart disease. We included 1607 subjects from the general population aged 50 to 72 years. These participants from the SAPALDIA cohort underwent ambulatory 24-hr electrocardiogram monitoring. Associations of average annual exposure to TPM(10) over 10 years with HRV parameters from time and frequency domains were estimated using multivariable mixed linear models. Effect estimates are expressed as percent changes in geometric means. HRV was only associated with TPM(10) in participants under ACE inhibitor therapy (N=94). A 1 μg/m(3) increment, approximately equivalent to an interquartile range, in 10 year average TPM(10) was associated with decrements of 14.5% (95% confidence interval (CI), -25.9 to -1.3) in high frequency (HF) power, of 4.5% (-8.2 to -0.5) in the standard deviation of all normal-to-normal RR intervals (SDNN), of 10.6% (-18.5 to -1.9) in total power (TP) and an increase of 9.2% (0.8 to 20.2) in the LF/HF power ratio. In the absence of an overall effect our results suggest that alterations in HRV, a measure of autonomic control of the cardiac rhythm, may not be a central mechanism by which long-term exposure to TPM(10) increases cardiovascular mortality. Novel evidence on an effect in persons under ACE inhibitor treatment needs to be confirmed in future studies.

International Journal of Epidemiology, 2007

Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for ... more Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.

Sozial-und Praventivmedizin, 2005

Objectives: The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) was de... more Objectives: The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) was designed to investigate the health effects from long-term exposure to air pollution. Methods: The health assessment at recruitment (1991) and at the first reassessment (2001–3) consisted of an interview about respiratory health, occupational and other exposures, spirometry, a methacholine bronchial challenge test, end-expiratory carbon monoxide (CO) measurement and measurement for atopy. A bio bank for DNA and blood markers was established. Heart rate variability was measured using a 24-hour ECG (Holter) in a random sample of participants aged 50 years and older. Concentrations of nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3) and particulates in ambient air have been monitored in all study areas since 1991. Residential histories collected over the 11 year follow-up period coupled with GIS modelling will provide individual long-term air pollutant exposure estimates. Results: Of 9651 participants examined in 1991, 8715 could be traced for the cohort study and 283 died. Basic information about health status was obtained for 8047 individuals (86% of alive persons), 6528 individuals (70%) agreed to the health examination and 5973 subjects (62%) completed the entire protocol. Non-participants in the reassessment were on average younger than participants and more likely to have been smokers and to have reported respiratory symptoms in the first assessment. Average weight had increased by 5.5 kg in 11 years and 28% of smokers in 1991 had quit by the time of the reassessment. Die Schweizer SAPALDIA-Kohortenstudie (SAPALDIA 2) 1991–2003: Methoden und Teilnehmendencharakteristika Fragestellung: Die Schweizer Kohortenstudie Luftverschmutzung und Atemwegserkrankungen bei Erwachsenen (SAPALDIA) untersucht die gesundheitlichen Auswirkungen der Langzeitbelastung durch Luftschadstoffe in der Bevölkerung. Methoden: 1991 und 2002 wurden ein Interview zur respiratorischen Gesundheit und deren Risikofaktoren, eine Spirometrie, ein bronchialer Reagibilitätstest mit Methacholin, eine endexpiratorische Kohlenmonoxidmessung und Tests zur allergischen Sensibilisierung durchgeführt. Für SAPALDIA 2 wurde eine Biobank mit Blut-, Serum-, Plasma- und DNA-Proben eingerichtet. Eine Stichprobe der über 50-jährigen Teilnehmenden erhielt ein 24-Stunden EKG (Holter). Luftschadstoffkonzentrationen von Stickstoffdioxid (NO2), Schwefeldioxid (SO2), Ozon (O3) und Schwebstaub (PM10) wurden in allen acht Studiengebieten seit 1991 gemessen. Die seit SAPALDIA 1 erfassten Adressgeschichten und auf GIS-Technologie beruhenden Schadstoffverteilungsdaten für NO2 und PM10 werden die Schätzung der individuellen Langzeitbelastung jedes SAPALDIA-Teilnehmenden ermöglichen. Ergebnisse: Von der ursprünglichen Kohorte von 9 651 Teilnehmern in 1991 waren 283 verstorben und Adressen konnten von 8715 aufgefunden werden. Basisinformationen zum Gesundheitszustand von 8047 Personen (86% aller lebenden Personen) wurden erfasst, 6528 (70%) nahmen an der Untersuchung teil und für 5973 (62%) liegen vollständige SAPALDIA2-Untersuchungen vor. Nichtteilnehmende waren im Durchschnitt jünger, weniger gut ausgebildet, eher Raucher und hatten eher respiratorische Symptome. Die untersuchten Personen haben in den letzten 11 Jahren durchschnittlich 5,5 kg Körpergewicht zugelegt, 28% der RaucherInnen haben aufgehört zu rauchen. Etude de cohorte SAPALDIA (Etude Suisse sur la pollution atmosphérique et les maladies respiratoires chez l’adulte): méthodes et caractéristiques des participants Objectifs: L’étude SAPALDIA a pour objectif de mesurer les effets sur la santé d’une exposition à long terme aux polluants atmosphériques dans la population adulte. Méthodes: Les participants ont été interrogés en 1991 et en 2002 sur leur état de santé respiratoire et ses facteurs de risque. Ils ont passé les examens suivants: spirométrie, test de la réactivité bronchique et de l’atopie, mesure du CO en fin d’expiration. Une banque biologique a été créée. Un ECG (Holter) a été pratiqué auprès d’un échantillon de participants âgés de plus de 50 ans. Les concentrations des polluants atmosphériques (dioxyde d’azote (NO2), dioxyde de soufre (SO2), ozone, particules fines (PM10)) ont été mesurées dans huit régions de Suisse depuis 1991. L’exposition individuelle sur 11 ans sera déterminée à partir des adresses, de la distribution de NO2 et PM10 et les modèles GIS. Résultats: Sur les 9 651 participants examinés en 1991, 283 sont décédés, 87 15 ont été localisés, 8047 ont donné des informations sur leur état de santé (86% des personnes en vie), 6 528 participants (70 %) ont accepté d’effectuer l’examen de santé et 5 973 (62 %) ont réalisé entièrement le protocole. Les non participants étaient en moyenne plus jeunes, moins éduqués, plus fréquemment fumeurs et souffraient plus fréquemment de symptômes respiratoires. Les personnes examinées ont pris en moyenne 5,5 kg de poids en 11 ans. 28% des fumeurs ont cessé de fumer.

European Respiratory Journal, 2010

Europace, 2006

Aims (i) To report associations between cardiovascular risk factors and heart rate variability (H... more Aims (i) To report associations between cardiovascular risk factors and heart rate variability (HRV) in a general population and (ii) to provide normal values for various HRV measurements in a healthy European general population sample aged !50. Methods and results Twenty-four-hour electrocardiograms were recorded in 1742 randomly selected SAPALDIA (Swiss cohort study on Air Pollution and Lung Diseases in Adults) participants aged !50. In multivariate regression analyses, women (n ¼ 895) had a 6.1% lower standard deviation of all normal RR (NN) intervals (SDNN), a 11.4% lower total power (TP), and a 27.2% lower low-frequency (LF) power than men (n ¼ 847). Per unit increase in BMI, SDNN decreased by 0.7% and TP decreased by 1.2%. Persons with high blood pressure had a 9.2% lower LF than normotensive persons and current smokers a 15.5% lower LF than never smokers. Each hour of heavy physical exercise was associated with a 2.0% increase in SDNN, a 3.6% increase in the high frequency (HF) range power and a 4.2% increase in LF power. Higher levels of uric acid, high-sensitive C-reactive protein and non-HDL-cholesterol were associated with lower TP, HF and LF. Percentiles of TP and LF/HF as a function of age were calculated for an asymptomatic subsample of participants (n ¼ 499) free of cardioactive medications. Conclusion Heart rate variability in a general population sample shows expected associations with all known cardiovascular risk factors, although not identically for all HRV domains. Together with our percentile estimates for HRV as a function of age, these findings could assist scientists in interpreting 24 h HRV values and factors influencing them in an ageing population.

European Respiratory Journal, 2009

Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (... more Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (COPD) and extrapulmonary comorbidities. We measured high-sensitivity C-reactive protein (hs-CRP) in COPD and quantified the effect modification by body weight change and sex.

International Journal of Epidemiology, 2007

Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for ... more Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.

Quality of Life Research, 2010

Purpose To estimate the impact of traffic-related noise annoyance on health-related quality of li... more Purpose To estimate the impact of traffic-related noise annoyance on health-related quality of life (HrQoL) in a population-based study and potential effect modification by gender. Methods The study included 5,021 participants of the Swiss Cohort Study of Air Pollution and Lung Disease in Adults second survey. The association between traffic-related noise annoyance, measured on an 11-point scale, and HrQoL, based on SF-36 scores, was investigated by multivariate regression analysis. Effect sizes were calculated, and interactions by gender and chronic disease status examined. Results Thirteen percentage of the study population reported high annoyance due to traffic. Women were more likely to report high noise annoyance (adjOR 1.23; 95%CI 1.01–1.48). Except for general health, all SF-36 scores showed a significant negative association with noise annoyance. The respective effect sizes ranged between 0.13 and 0.54. Significant effect modification by gender and chronic disease status was present in specific SF-36 domains. Conclusion This paper presents first evidence of an inverse relationship of noise annoyance and HrQoL in a general population. Although the estimated effects are small to moderate for individuals, they may add up to a relevant public health impact.

European Journal of Applied Physiology, 2008

Many studies have demonstrated an association of both a sedentary lifestyle and a high body mass ... more Many studies have demonstrated an association of both a sedentary lifestyle and a high body mass index (BMI) with greater risk for cardiovascular disease. Within the prospective SAPALDIA cohort (Swiss cohort Study on Air Pollution and Lung Diseases in Adults), we investigated whether regular exercise was protective against reduced heart rate variability (HRV), a clinically relevant predictor of cardiovascular morbidity and mortality, and whether adverse effects of obesity and weight gain on HRV were modified by regular exercise. Twenty-four-hour electrocardiograms were recorded in 1,712 randomly selected SAPALDIA participants aged ≥50, for whom BMI was assessed in the years 1991 and 2001–2003. Other examinations included an interview investigating health status (especially respiratory and cardiovascular health and health relevant behaviours including physical activity) and measurements of blood pressure, body height and weight. The association between regular physical activity and HRV and interactions with BMI and BMI change was assessed in multivariable linear regression analyses. Compared to sedentary obese subjects, SDNN (standard deviation of all RR intervals) was 14% (95% CI: 8–20%) higher in sedentary normal weight subjects; 19% (CI: 12–27%) higher in normal weight subjects exercising regularly ≥2 h/week; and 19% (CI: 11–28%) higher in obese subjects exercising regularly ≥2 h/week. Compared with sedentary subjects who gained weight, those who gained weight but did exercise regularly had a 13% higher SDNN (CI: 7–20%). Regular physical exercise has strong beneficial effects on cardiac autonomic nervous function and thus appears to offset the negative effect of obesity on HRV.

Aims (i) To report associations between cardiovascular risk factors and heart rate variability (H... more Aims (i) To report associations between cardiovascular risk factors and heart rate variability (HRV) in a general population and (ii) to provide normal values for various HRV measurements in a healthy European general population sample aged !50. Methods and results Twenty-four-hour electrocardiograms were recorded in 1742 randomly selected SAPALDIA (Swiss cohort study on Air Pollution and Lung Diseases in Adults) participants aged !50. In multivariate regression analyses, women (n ¼ 895) had a 6.1% lower standard deviation of all normal RR (NN) intervals (SDNN), a 11.4% lower total power (TP), and a 27.2% lower low-frequency (LF) power than men (n ¼ 847). Per unit increase in BMI, SDNN decreased by 0.7% and TP decreased by 1.2%. Persons with high blood pressure had a 9.2% lower LF than normotensive persons and current smokers a 15.5% lower LF than never smokers. Each hour of heavy physical exercise was associated with a 2.0% increase in SDNN, a 3.6% increase in the high frequency (HF) range power and a 4.2% increase in LF power. Higher levels of uric acid, high-sensitive C-reactive protein and non-HDL-cholesterol were associated with lower TP, HF and LF. Percentiles of TP and LF/HF as a function of age were calculated for an asymptomatic subsample of participants (n ¼ 499) free of cardioactive medications. Conclusion Heart rate variability in a general population sample shows expected associations with all known cardiovascular risk factors, although not identically for all HRV domains. Together with our percentile estimates for HRV as a function of age, these findings could assist scientists in interpreting 24 h HRV values and factors influencing them in an ageing population.

Environmental Health Perspectives, 2008

BACKGROUND: Disturbances of heart rate variability (HRV) may represent one pathway by which secon... more BACKGROUND: Disturbances of heart rate variability (HRV) may represent one pathway by which second-hand smoke (SHS) and air pollutants affect cardiovascular morbidity and mortality. The mechanisms are poorly understood. OBJECTIVES: We investigated the hypothesis that oxidative stress alters cardiac autonomic control. We studied the association of polymorphisms in oxidant-scavenging glutathione S-transferase (GST) genes and their interactions with SHS and obesity with HRV. METHODS: A total of 1,133 nonsmokers > 50 years of age from a population-based Swiss cohort underwent ambulatory 24-hr electrocardiogram monitoring and reported on lifestyle and medical history. We genotyped GSTM1 and GSTT1 gene deletions and a GSTP1 (Ile105Val) single nucleotide polymorphism and analyzed genotype-HRV associations by multiple linear regressions. RESULTS: Homozygous GSTT1 null genotypes exhibited an average 10% decrease in total power (TP) and low-frequency-domain HRV parameters. All three polymorphisms modified the cross-sectional associations of HRV with SHS and obesity. Homozygous GSTM1 null genotypes with > 2 hr/day of SHS exposure exhibited a 26% lower TP [95% confidence interval (CI), 11 to 39%], versus a reduction of -5% (95% CI, -22 to 17%) in subjects with the gene and the same SHS exposure compared with GSTM1 carriers without SHS exposure. Similarly, obese GSTM1 null genotypes had, on average, a 22% (95% CI, 12 to 31%) lower TP, whereas with the gene present obesity was associated with only a 3% decline (95% CI, -15% to 10%) compared with nonobese GSTM1 carriers. CONCLUSIONS: GST deficiency is associated with significant HRV alterations in the general population. Its interaction with SHS and obesity in reducing HRV is consistent with an impact of oxidative stress on the autonomous nervous system. BACKGROUND: Disturbances of heart rate variability (HRV) may represent one pathway by which second-hand smoke (SHS) and air pollutants affect cardiovascular morbidity and mortality. The mechanisms are poorly understood. OBJECTIVES: We investigated the hypothesis that oxidative stress alters cardiac autonomic control. We studied the association of polymorphisms in oxidant-scavenging glutathione S-transferase (GST) genes and their interactions with SHS and obesity with HRV. METHODS: A total of 1,133 nonsmokers > 50 years of age from a population-based Swiss cohort underwent ambulatory 24-hr electrocardiogram monitoring and reported on lifestyle and medical history. We genotyped GSTM1 and GSTT1 gene deletions and a GSTP1 (Ile105Val) single nucleotide polymorphism and analyzed genotype-HRV associations by multiple linear regressions. RESULTS: Homozygous GSTT1 null genotypes exhibited an average 10% decrease in total power (TP) and low-frequency-domain HRV parameters. All three polymorphisms modified the cross-sectional associations of HRV with SHS and obesity. Homozygous GSTM1 null genotypes with > 2 hr/day of SHS exposure exhibited a 26% lower TP [95% confidence interval (CI), 11 to 39%], versus a reduction of -5% (95% CI, -22 to 17%) in subjects with the gene and the same SHS exposure compared with GSTM1 carriers without SHS exposure. Similarly, obese GSTM1 null genotypes had, on average, a 22% (95% CI, 12 to 31%) lower TP, whereas with the gene present obesity was associated with only a 3% decline (95% CI, -15% to 10%) compared with nonobese GSTM1 carriers. CONCLUSIONS: GST deficiency is associated with significant HRV alterations in the general population. Its interaction with SHS and obesity in reducing HRV is consistent with an impact of oxidative stress on the autonomous nervous system. KEY WORDS: cohort, glutathione S-transferase, heart rate variability, obesity, oxidative stress, polymorphism, SAPALDIA, second-hand smoke.

Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for ... more Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.

Environmental Health Perspectives, 2008

Environment International, 2012

Alterations in heart rate variability (HRV) are a potential link between exposure to traffic-rela... more Alterations in heart rate variability (HRV) are a potential link between exposure to traffic-related air pollution and cardiovascular mortality. We investigated whether long-term exposure to traffic-related PM(10) (TPM(10)) is associated with HRV in older subjects and/or in participants taking specific cardiovascular treatment or with self-reported heart disease. We included 1607 subjects from the general population aged 50 to 72 years. These participants from the SAPALDIA cohort underwent ambulatory 24-hr electrocardiogram monitoring. Associations of average annual exposure to TPM(10) over 10 years with HRV parameters from time and frequency domains were estimated using multivariable mixed linear models. Effect estimates are expressed as percent changes in geometric means. HRV was only associated with TPM(10) in participants under ACE inhibitor therapy (N=94). A 1 μg/m(3) increment, approximately equivalent to an interquartile range, in 10 year average TPM(10) was associated with decrements of 14.5% (95% confidence interval (CI), -25.9 to -1.3) in high frequency (HF) power, of 4.5% (-8.2 to -0.5) in the standard deviation of all normal-to-normal RR intervals (SDNN), of 10.6% (-18.5 to -1.9) in total power (TP) and an increase of 9.2% (0.8 to 20.2) in the LF/HF power ratio. In the absence of an overall effect our results suggest that alterations in HRV, a measure of autonomic control of the cardiac rhythm, may not be a central mechanism by which long-term exposure to TPM(10) increases cardiovascular mortality. Novel evidence on an effect in persons under ACE inhibitor treatment needs to be confirmed in future studies.

International Journal of Epidemiology, 2007

Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for ... more Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.

Sozial-und Praventivmedizin, 2005

Objectives: The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) was de... more Objectives: The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) was designed to investigate the health effects from long-term exposure to air pollution. Methods: The health assessment at recruitment (1991) and at the first reassessment (2001–3) consisted of an interview about respiratory health, occupational and other exposures, spirometry, a methacholine bronchial challenge test, end-expiratory carbon monoxide (CO) measurement and measurement for atopy. A bio bank for DNA and blood markers was established. Heart rate variability was measured using a 24-hour ECG (Holter) in a random sample of participants aged 50 years and older. Concentrations of nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3) and particulates in ambient air have been monitored in all study areas since 1991. Residential histories collected over the 11 year follow-up period coupled with GIS modelling will provide individual long-term air pollutant exposure estimates. Results: Of 9651 participants examined in 1991, 8715 could be traced for the cohort study and 283 died. Basic information about health status was obtained for 8047 individuals (86% of alive persons), 6528 individuals (70%) agreed to the health examination and 5973 subjects (62%) completed the entire protocol. Non-participants in the reassessment were on average younger than participants and more likely to have been smokers and to have reported respiratory symptoms in the first assessment. Average weight had increased by 5.5 kg in 11 years and 28% of smokers in 1991 had quit by the time of the reassessment. Die Schweizer SAPALDIA-Kohortenstudie (SAPALDIA 2) 1991–2003: Methoden und Teilnehmendencharakteristika Fragestellung: Die Schweizer Kohortenstudie Luftverschmutzung und Atemwegserkrankungen bei Erwachsenen (SAPALDIA) untersucht die gesundheitlichen Auswirkungen der Langzeitbelastung durch Luftschadstoffe in der Bevölkerung. Methoden: 1991 und 2002 wurden ein Interview zur respiratorischen Gesundheit und deren Risikofaktoren, eine Spirometrie, ein bronchialer Reagibilitätstest mit Methacholin, eine endexpiratorische Kohlenmonoxidmessung und Tests zur allergischen Sensibilisierung durchgeführt. Für SAPALDIA 2 wurde eine Biobank mit Blut-, Serum-, Plasma- und DNA-Proben eingerichtet. Eine Stichprobe der über 50-jährigen Teilnehmenden erhielt ein 24-Stunden EKG (Holter). Luftschadstoffkonzentrationen von Stickstoffdioxid (NO2), Schwefeldioxid (SO2), Ozon (O3) und Schwebstaub (PM10) wurden in allen acht Studiengebieten seit 1991 gemessen. Die seit SAPALDIA 1 erfassten Adressgeschichten und auf GIS-Technologie beruhenden Schadstoffverteilungsdaten für NO2 und PM10 werden die Schätzung der individuellen Langzeitbelastung jedes SAPALDIA-Teilnehmenden ermöglichen. Ergebnisse: Von der ursprünglichen Kohorte von 9 651 Teilnehmern in 1991 waren 283 verstorben und Adressen konnten von 8715 aufgefunden werden. Basisinformationen zum Gesundheitszustand von 8047 Personen (86% aller lebenden Personen) wurden erfasst, 6528 (70%) nahmen an der Untersuchung teil und für 5973 (62%) liegen vollständige SAPALDIA2-Untersuchungen vor. Nichtteilnehmende waren im Durchschnitt jünger, weniger gut ausgebildet, eher Raucher und hatten eher respiratorische Symptome. Die untersuchten Personen haben in den letzten 11 Jahren durchschnittlich 5,5 kg Körpergewicht zugelegt, 28% der RaucherInnen haben aufgehört zu rauchen. Etude de cohorte SAPALDIA (Etude Suisse sur la pollution atmosphérique et les maladies respiratoires chez l’adulte): méthodes et caractéristiques des participants Objectifs: L’étude SAPALDIA a pour objectif de mesurer les effets sur la santé d’une exposition à long terme aux polluants atmosphériques dans la population adulte. Méthodes: Les participants ont été interrogés en 1991 et en 2002 sur leur état de santé respiratoire et ses facteurs de risque. Ils ont passé les examens suivants: spirométrie, test de la réactivité bronchique et de l’atopie, mesure du CO en fin d’expiration. Une banque biologique a été créée. Un ECG (Holter) a été pratiqué auprès d’un échantillon de participants âgés de plus de 50 ans. Les concentrations des polluants atmosphériques (dioxyde d’azote (NO2), dioxyde de soufre (SO2), ozone, particules fines (PM10)) ont été mesurées dans huit régions de Suisse depuis 1991. L’exposition individuelle sur 11 ans sera déterminée à partir des adresses, de la distribution de NO2 et PM10 et les modèles GIS. Résultats: Sur les 9 651 participants examinés en 1991, 283 sont décédés, 87 15 ont été localisés, 8047 ont donné des informations sur leur état de santé (86% des personnes en vie), 6 528 participants (70 %) ont accepté d’effectuer l’examen de santé et 5 973 (62 %) ont réalisé entièrement le protocole. Les non participants étaient en moyenne plus jeunes, moins éduqués, plus fréquemment fumeurs et souffraient plus fréquemment de symptômes respiratoires. Les personnes examinées ont pris en moyenne 5,5 kg de poids en 11 ans. 28% des fumeurs ont cessé de fumer.

European Respiratory Journal, 2010

Europace, 2006

Aims (i) To report associations between cardiovascular risk factors and heart rate variability (H... more Aims (i) To report associations between cardiovascular risk factors and heart rate variability (HRV) in a general population and (ii) to provide normal values for various HRV measurements in a healthy European general population sample aged !50. Methods and results Twenty-four-hour electrocardiograms were recorded in 1742 randomly selected SAPALDIA (Swiss cohort study on Air Pollution and Lung Diseases in Adults) participants aged !50. In multivariate regression analyses, women (n ¼ 895) had a 6.1% lower standard deviation of all normal RR (NN) intervals (SDNN), a 11.4% lower total power (TP), and a 27.2% lower low-frequency (LF) power than men (n ¼ 847). Per unit increase in BMI, SDNN decreased by 0.7% and TP decreased by 1.2%. Persons with high blood pressure had a 9.2% lower LF than normotensive persons and current smokers a 15.5% lower LF than never smokers. Each hour of heavy physical exercise was associated with a 2.0% increase in SDNN, a 3.6% increase in the high frequency (HF) range power and a 4.2% increase in LF power. Higher levels of uric acid, high-sensitive C-reactive protein and non-HDL-cholesterol were associated with lower TP, HF and LF. Percentiles of TP and LF/HF as a function of age were calculated for an asymptomatic subsample of participants (n ¼ 499) free of cardioactive medications. Conclusion Heart rate variability in a general population sample shows expected associations with all known cardiovascular risk factors, although not identically for all HRV domains. Together with our percentile estimates for HRV as a function of age, these findings could assist scientists in interpreting 24 h HRV values and factors influencing them in an ageing population.

European Respiratory Journal, 2009

Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (... more Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (COPD) and extrapulmonary comorbidities. We measured high-sensitivity C-reactive protein (hs-CRP) in COPD and quantified the effect modification by body weight change and sex.

International Journal of Epidemiology, 2007

Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for ... more Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.

Quality of Life Research, 2010

Purpose To estimate the impact of traffic-related noise annoyance on health-related quality of li... more Purpose To estimate the impact of traffic-related noise annoyance on health-related quality of life (HrQoL) in a population-based study and potential effect modification by gender. Methods The study included 5,021 participants of the Swiss Cohort Study of Air Pollution and Lung Disease in Adults second survey. The association between traffic-related noise annoyance, measured on an 11-point scale, and HrQoL, based on SF-36 scores, was investigated by multivariate regression analysis. Effect sizes were calculated, and interactions by gender and chronic disease status examined. Results Thirteen percentage of the study population reported high annoyance due to traffic. Women were more likely to report high noise annoyance (adjOR 1.23; 95%CI 1.01–1.48). Except for general health, all SF-36 scores showed a significant negative association with noise annoyance. The respective effect sizes ranged between 0.13 and 0.54. Significant effect modification by gender and chronic disease status was present in specific SF-36 domains. Conclusion This paper presents first evidence of an inverse relationship of noise annoyance and HrQoL in a general population. Although the estimated effects are small to moderate for individuals, they may add up to a relevant public health impact.

European Journal of Applied Physiology, 2008

Many studies have demonstrated an association of both a sedentary lifestyle and a high body mass ... more Many studies have demonstrated an association of both a sedentary lifestyle and a high body mass index (BMI) with greater risk for cardiovascular disease. Within the prospective SAPALDIA cohort (Swiss cohort Study on Air Pollution and Lung Diseases in Adults), we investigated whether regular exercise was protective against reduced heart rate variability (HRV), a clinically relevant predictor of cardiovascular morbidity and mortality, and whether adverse effects of obesity and weight gain on HRV were modified by regular exercise. Twenty-four-hour electrocardiograms were recorded in 1,712 randomly selected SAPALDIA participants aged ≥50, for whom BMI was assessed in the years 1991 and 2001–2003. Other examinations included an interview investigating health status (especially respiratory and cardiovascular health and health relevant behaviours including physical activity) and measurements of blood pressure, body height and weight. The association between regular physical activity and HRV and interactions with BMI and BMI change was assessed in multivariable linear regression analyses. Compared to sedentary obese subjects, SDNN (standard deviation of all RR intervals) was 14% (95% CI: 8–20%) higher in sedentary normal weight subjects; 19% (CI: 12–27%) higher in normal weight subjects exercising regularly ≥2 h/week; and 19% (CI: 11–28%) higher in obese subjects exercising regularly ≥2 h/week. Compared with sedentary subjects who gained weight, those who gained weight but did exercise regularly had a 13% higher SDNN (CI: 7–20%). Regular physical exercise has strong beneficial effects on cardiac autonomic nervous function and thus appears to offset the negative effect of obesity on HRV.

Aims (i) To report associations between cardiovascular risk factors and heart rate variability (H... more Aims (i) To report associations between cardiovascular risk factors and heart rate variability (HRV) in a general population and (ii) to provide normal values for various HRV measurements in a healthy European general population sample aged !50. Methods and results Twenty-four-hour electrocardiograms were recorded in 1742 randomly selected SAPALDIA (Swiss cohort study on Air Pollution and Lung Diseases in Adults) participants aged !50. In multivariate regression analyses, women (n ¼ 895) had a 6.1% lower standard deviation of all normal RR (NN) intervals (SDNN), a 11.4% lower total power (TP), and a 27.2% lower low-frequency (LF) power than men (n ¼ 847). Per unit increase in BMI, SDNN decreased by 0.7% and TP decreased by 1.2%. Persons with high blood pressure had a 9.2% lower LF than normotensive persons and current smokers a 15.5% lower LF than never smokers. Each hour of heavy physical exercise was associated with a 2.0% increase in SDNN, a 3.6% increase in the high frequency (HF) range power and a 4.2% increase in LF power. Higher levels of uric acid, high-sensitive C-reactive protein and non-HDL-cholesterol were associated with lower TP, HF and LF. Percentiles of TP and LF/HF as a function of age were calculated for an asymptomatic subsample of participants (n ¼ 499) free of cardioactive medications. Conclusion Heart rate variability in a general population sample shows expected associations with all known cardiovascular risk factors, although not identically for all HRV domains. Together with our percentile estimates for HRV as a function of age, these findings could assist scientists in interpreting 24 h HRV values and factors influencing them in an ageing population.

Environmental Health Perspectives, 2008

BACKGROUND: Disturbances of heart rate variability (HRV) may represent one pathway by which secon... more BACKGROUND: Disturbances of heart rate variability (HRV) may represent one pathway by which second-hand smoke (SHS) and air pollutants affect cardiovascular morbidity and mortality. The mechanisms are poorly understood. OBJECTIVES: We investigated the hypothesis that oxidative stress alters cardiac autonomic control. We studied the association of polymorphisms in oxidant-scavenging glutathione S-transferase (GST) genes and their interactions with SHS and obesity with HRV. METHODS: A total of 1,133 nonsmokers > 50 years of age from a population-based Swiss cohort underwent ambulatory 24-hr electrocardiogram monitoring and reported on lifestyle and medical history. We genotyped GSTM1 and GSTT1 gene deletions and a GSTP1 (Ile105Val) single nucleotide polymorphism and analyzed genotype-HRV associations by multiple linear regressions. RESULTS: Homozygous GSTT1 null genotypes exhibited an average 10% decrease in total power (TP) and low-frequency-domain HRV parameters. All three polymorphisms modified the cross-sectional associations of HRV with SHS and obesity. Homozygous GSTM1 null genotypes with > 2 hr/day of SHS exposure exhibited a 26% lower TP [95% confidence interval (CI), 11 to 39%], versus a reduction of -5% (95% CI, -22 to 17%) in subjects with the gene and the same SHS exposure compared with GSTM1 carriers without SHS exposure. Similarly, obese GSTM1 null genotypes had, on average, a 22% (95% CI, 12 to 31%) lower TP, whereas with the gene present obesity was associated with only a 3% decline (95% CI, -15% to 10%) compared with nonobese GSTM1 carriers. CONCLUSIONS: GST deficiency is associated with significant HRV alterations in the general population. Its interaction with SHS and obesity in reducing HRV is consistent with an impact of oxidative stress on the autonomous nervous system. BACKGROUND: Disturbances of heart rate variability (HRV) may represent one pathway by which second-hand smoke (SHS) and air pollutants affect cardiovascular morbidity and mortality. The mechanisms are poorly understood. OBJECTIVES: We investigated the hypothesis that oxidative stress alters cardiac autonomic control. We studied the association of polymorphisms in oxidant-scavenging glutathione S-transferase (GST) genes and their interactions with SHS and obesity with HRV. METHODS: A total of 1,133 nonsmokers > 50 years of age from a population-based Swiss cohort underwent ambulatory 24-hr electrocardiogram monitoring and reported on lifestyle and medical history. We genotyped GSTM1 and GSTT1 gene deletions and a GSTP1 (Ile105Val) single nucleotide polymorphism and analyzed genotype-HRV associations by multiple linear regressions. RESULTS: Homozygous GSTT1 null genotypes exhibited an average 10% decrease in total power (TP) and low-frequency-domain HRV parameters. All three polymorphisms modified the cross-sectional associations of HRV with SHS and obesity. Homozygous GSTM1 null genotypes with > 2 hr/day of SHS exposure exhibited a 26% lower TP [95% confidence interval (CI), 11 to 39%], versus a reduction of -5% (95% CI, -22 to 17%) in subjects with the gene and the same SHS exposure compared with GSTM1 carriers without SHS exposure. Similarly, obese GSTM1 null genotypes had, on average, a 22% (95% CI, 12 to 31%) lower TP, whereas with the gene present obesity was associated with only a 3% decline (95% CI, -15% to 10%) compared with nonobese GSTM1 carriers. CONCLUSIONS: GST deficiency is associated with significant HRV alterations in the general population. Its interaction with SHS and obesity in reducing HRV is consistent with an impact of oxidative stress on the autonomous nervous system. KEY WORDS: cohort, glutathione S-transferase, heart rate variability, obesity, oxidative stress, polymorphism, SAPALDIA, second-hand smoke.

Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for ... more Background Exposure to environmental tobacco smoke (ETS) has been shown to increase the risk for cardiovascular diseases and death, and autonomic dysfunction (specifically, reduced heart rate variability (HRV)) is a predictor of increased cardiac risk. This study tests the hypothesis that ETS exposure reduces HRV in the general population and discusses possible pathways.

Environmental Health Perspectives, 2008