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Natalie Riedel,
Kateryna Fuks,
Barbara Hoffmann,
Simone Weyers,
Johannes Siegrist,
Raimund Erbel, Anja Viehmann,
Andreas Stang,
Joachim Scheiner,
Nico Dragano,
Heinz Nixdorf Recall Study Group
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ABSTRACT: BACKGROUND: Until now, insomnia has not been much of interest in epidemiological neighbourhood studies, although literature provides evidence enough for insomnia-related mechanisms being potentially dependent on neighbourhood contexts. Besides, studies have shown differences in sleep along individual social characteristics that might render residents more vulnerable to neighbourhood contextual exposures. Given the role of exposure duration and changes in the relationship between neighbourhoods and health, we studied associations of neighbourhood unemployment and months under residential turnover with insomnia by covering ten years of residential history of nearly 3,000 urban residents in the Ruhr Area, Germany. METHODS: Individual data were retrieved from the Heinz Nixdorf Recall Study, a population-based study of randomly chosen participants from adjacent cities, which contains self-rated insomnia symptoms and individual social characteristics. Participants' residential addresses were retrospectively assessed using public registries. We built individually derived exposure measures informing about mean neighbourhood unemployment rates and months under high residential turnover. These measures were major predictors in multivariate logistic regressions modelling the association between social neighbourhood characteristics and insomnia in the whole sample and subgroups defined by low income, low education, social isolation, and change of residence. Traffic-related noise, age, gender, economic activity, and education were considered as covariates. RESULTS: Nearly 12 per cent of the participants complained about insomnia. Associations of neighbourhood unemployment with insomnia were more consistent than those of residential turnover in the whole sample (adjusted OR 1.42, 95% CI 1.00-2.03 for neighbourhood unemployment and OR 1.33, 95% CI 0.78-2.25 for residential turnover in the highest exposure categories). In low-income and socially isolated participants, neighbourhood unemployment odds of reporting insomnia were particularly elevated (adjusted OR 2.90, 95% CI 1.39-6.02 and OR 3.32, 95% CI 1.11-9.96, respectively). Less educated participants displayed relatively high odds of reporting insomnia throughout all upper neighbourhood unemployment exposure categories. Change of residence weakened associations, whereas undisrupted exposure sharpened them by trend. CONCLUSIONS: Our findings hint at multiple stressors being effective in both the neighbourhood context and individual resident, possibly reflecting precarious life situations undermining residents' sleep and health chances. Moreover, our results suggest a temporal dependency in the association between neighbourhood and insomnia.
BMC Public Health 09/2012; 12(1):810. · 2.00 Impact Factor
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Kateryna Fuks,
Susanne Moebus,
Sabine Hertel, Anja Viehmann,
Michael Nonnemacher,
Nico Dragano,
Stefan Möhlenkamp,
Hermann Jakobs,
Christoph Kessler,
Raimund Erbel,
Barbara Hoffmann
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ABSTRACT: Recent studies have shown an association of short-term exposure to fine particulate matter (PM) with transient increases in blood pressure (BP), but it is unclear whether long-term exposure has an effect on arterial BP and hypertension.
We investigated the cross-sectional association of residential long-term PM exposure with arterial BP and hypertension, taking short-term variations of PM and long-term road traffic noise exposure into account.
We used baseline data (2000-2003) on 4,291 participants, 45-75 years of age, from the Heinz Nixdorf Recall Study, a population-based prospective cohort in Germany. Urban background exposure to PM with aerodynamic diameter ≤ 2.5 μm (PM(2.5)) and ≤ 10 μm (PM(10)) was assessed with a dispersion and chemistry transport model. We used generalized additive models, adjusting for short-term PM, meteorology, traffic proximity, and individual risk factors.
An interquartile increase in PM2.5 (2.4 μg/m(3)) was associated with estimated increases in mean systolic and diastolic BP of 1.4 mmHg [95% confidence interval (CI): 0.5, 2.3] and 0.9 mmHg (95% CI: 0.4, 1.4), respectively. The observed relationship was independent of long-term exposure to road traffic noise and robust to the inclusion of many potential confounders. Residential proximity to high traffic and traffic noise exposure showed a tendency toward higher BP and an elevated prevalence of hypertension.
We found an association of long-term exposure to PM with increased arterial BP in a population-based sample. This finding supports our hypothesis that long-term PM exposure may promote atherosclerosis, with air-pollution-induced increases in BP being one possible biological pathway.
Environmental Health Perspectives 08/2011; 119(12):1706-11. · 7.04 Impact Factor
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Sabine Hertel, Anja Viehmann,
Susanne Moebus,
Klaus Mann,
Martina Bröcker-Preuss,
Stefan Möhlenkamp,
Michael Nonnemacher,
Raimund Erbel,
Hermann Jakobs,
Michael Memmesheimer,
Karl-Heinz Jöckel,
Barbara Hoffmann
European Journal of Epidemiology 02/2011; 26(2):181-2. · 4.71 Impact Factor
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Sabine Hertel, Anja Viehmann,
Susanne Moebus,
Klaus Mann,
Martina Bröcker-Preuss,
Stefan Möhlenkamp,
Michael Nonnemacher,
Raimund Erbel,
Hermann Jakobs,
Michael Memmesheimer,
Karl-Heinz Jöckel,
Barbara Hoffmann
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ABSTRACT: Daily to monthly variations in fine particulate matter have been linked to systemic inflammatory responses. It has been hypothesized that smaller particles resulting from combustion processes confer higher toxicity. We aim to analyze the association between short-term exposure to ultrafine and fine particles and systemic inflammation. We use baseline data (2000-2003) of the Heinz Nixdorf Recall Study, a population-based cohort study of 4,814 participants in the Ruhr Area in Germany. A chemistry transport model was applied to model daily surface concentrations of particulate air pollutants on a grid of 1 km(2). Exposure included particle number (PN) and particulate matter mass concentration with an aerodynamic diameter < or = 2.5 microm (PM(2.5)) and < or = 10 microm (PM(10)). Generalized additive models were used to explore the relation of air pollutants using single day lags and averaging times of up to 28 days with high-sensitivity C-reactive protein (hs-CRP). We adjusted for meteorology, season, time trend, and personal characteristics. Median hs-CRP level in the 3,999 included participants was 1.5 mg/l. Median daily concentration of PN was 8,414 x 10(4)/ml (IQR 4,580 x 10(4)/ml), of PM(2.5) 14.5 microg/m(3) (IQR 11.5 microg/m(3)) and of PM(10) 18.5 microg/m(3) (IQR 13.9 microg/m(3)). A positive association between PN and hs-CRP could be observed only for single day lags and for averaged PN concentrations with higher estimates for longer averaging times. The highest hs-CRP-increase of 7.1% (95%-CI: 1.9, 12.6%) was found for the 21-day average. These results support the hypothesis that short-term exposure to traffic-related particles might lead to detrimental cardiovascular health effects via an inflammatory mechanism.
European Journal of Epidemiology 08/2010; 25(8):581-92. · 4.71 Impact Factor
