Gerard Hoek's research while affiliated with Utrecht University and other places

Publications (585)

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Background Air pollution (AP) contributes to a large disease burden and some populations are disproportionately exposed. It is unclear to what extent AP exposure differs across ethnic groups in the Netherlands and how this intersects with socioeconomic position (SEP). First, we identified differences in AP exposures between ethnic groups in the Net...
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Ambient air pollution is an established risk factor for premature mortality from chronic cardiovascular, respiratory and metabolic diseases, while evidence on neurodegenerative diseases and psychiatric disorders remains limited. We examined the association between long-term exposure to air pollution and mortality from dementia, psychiatric disorder...
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Background: Established risk factors for breast cancer include genetic disposition, reproductive factors, hormone therapy, and lifestyle-related factors such as alcohol consumption, physical inactivity, smoking, and obesity. More recently a role of environmental exposures, including air pollution, has also been suggested. The aim of this study, wa...
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Hyperlocal air quality maps are becoming increasingly common, as they provide useful insights into the spatial variation and sources of air pollutants. In this study, we produced several high-resolution concentration maps to assess the spatial differences of three traffic-related pollutants, Nitrogen dioxide (NO2), Black Carbon (BC) and Ultrafine P...
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Background Type 2 diabetes (T2D) is thought to be influenced by environmental stressors such as air pollution and noise. Although environmental factors are interrelated, studies considering the exposome are lacking. We simultaneously assessed a variety of exposures in their association with prevalent T2D by applying penalised regression Least Absol...
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Assessment of long-term human exposure to spatiotemporally highly variable air pollution requires accounting for human space–time activity. Individual exposure and space–time track data are not available over large populations and for long periods and a modelling approach is required. However, activity-based exposure models face here challenges in...
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Mobile measurements are increasingly used to develop spatially explicit (hyperlocal) air quality maps using land-use regression (LUR) models. The prevailing design of mobile monitoring campaigns results in the collection of short-term, on-road air pollution measurements during daytime on weekdays. We hypothesize that LUR models trained with such mo...
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Background: Particulate matter (PM) is classified as a group 1 human carcinogen. Previous experimental studies suggest that particles in diesel exhaust induce oxidative stress, inflammation and DNA damage in kidney cells, but the evidence from population studies linking air pollution to kidney cancer is limited. Methods: We pooled six European coho...
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Air pollution exposure during early-life is associated with altered brain development, but the precise periods of susceptibility are unknown. We aimed to investigate whether there are periods of susceptibility of air pollution between conception and preadolescence in relation to white matter microstructure and brain volumes at 9–12 years old. We us...
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Previous European land-use regression (LUR) models assumed fixed linear relationships between air pollution concentrations and predictors such as traffic and land use. We evaluated whether including spatially-varying relationships could improve European LUR models by using geographically weighted regression (GWR) and random forest (RF). We built se...
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Rationale Evidence regarding the role of long-term exposure to ultrafine particles (<0.1 μm, UFP) in asthma onset is scarce. Objectives We examined the association between exposure to UFP and asthma development in the Dutch PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort and assessed whether there is an association with UFP...
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We assessed mortality risks associated with source-specific fine particles (PM2.5) in a pooled European cohort of 323,782 participants. Cox proportional hazard models were applied to estimate mortality hazard ratios (HRs) for source-specific PM2.5 identified through a source apportionment analysis. Exposure to 2010 annual average concentrations of...
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Background The majority of studies has shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort. Methods Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1...
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Background Green space, air pollution and traffic noise exposure may be associated with mental health in adolescents. We assessed the associations of long-term exposure to residential green space, ambient air pollution and traffic noise with mental wellbeing from age 11 to 20 years. Methods We included 3059 participants of the Dutch PIAMA birth co...
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Background The amount of people affected by traffic-related air pollution and noise is continuously increasing, but limited research has been conducted on the association of these environmental exposures and functional brain connectivity in children. Objective This exploratory study aimed to analyze the associations between the exposure to traffic...
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Background The association between long-term exposure to air pollution and mortality from cardiorespiratory diseases is well established, yet the evidence for other diseases remains limited. Objectives To examine the associations of long-term exposure to air pollution with mortality from diabetes, dementia, psychiatric disorders, chronic kidney di...
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High-resolution air quality (AQ) maps based on street-by-street measurements have become possible through large-scale mobile measurement campaigns. Such campaigns have produced data-only maps and have been used to produce empirical models [i.e., land use regression (LUR) models]. Assuming that all road segments are measured, we developed a mixed mo...
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Rationale: Ambient air pollution exposure has been linked to mortality from chronic cardiorespiratory diseases, while evidence on respiratory infections remains more limited. Objectives: We examined the association between long-term exposure to air pollution and pneumonia related mortality in adults in a pool of eight European cohorts. Methods:...
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Background: The evidence linking ambient air pollution to bladder cancer is limited and mixed. Methods: We assessed the associations of bladder cancer incidence with residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC), warm season ozone (O3) and eight PM2.5 elemental components (copper, iron, potassium, nick...
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Introduction Cities have long been known to be society’s predominant engine of innovation and wealth creation, yet they are also hotspots of pollution and disease partly due to current urban and transport practices. The aim of the European Urban Burden of Disease project is to evaluate the health burden and its determinants related to current and f...
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Background Long-term exposure to ambient air pollution has been associated with premature mortality, but associations at concentrations lower than current annual limit values are uncertain. We analysed associations between low-level air pollution and mortality within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPS...
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Background Diabetes is a major health concern and is influenced by lifestyle, which can be affected by the neighbourhood environment. Specifically, a fast-food environment can influence eating behaviours and thus diabetes prevalence. Therefore, our aim was to assess the relationship between fast-food environment and diabetes prevalence for urban an...
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Background Characteristics of the urban environment may contain upstream drivers of obesity. However, research is lacking that considers the combination of environmental factors simultaneously. Objectives We aimed to explore what environmental factors of the urban exposome are related to body mass index (BMI), and evaluated the consistency of find...
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The current epidemics of cardiovascular and metabolic noncommunicable diseases have emerged alongside dramatic modifications in lifestyle and living environments. These correspond to changes in our “modern” postwar societies globally characterized by rural-to-urban migration, modernization of agricultural practices, and transportation, climate chan...
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Evidence for the association between long-term exposure to ambient particulate matter components and mortality from natural causes is sparse and inconsistent. We evaluated this association in six large administrative cohorts in the framework of the Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) project. We analyzed data from country...
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Undertaking citizen science research in Public Health involving human subjects poses significant challenges concerning the traditional process of ethical approval. It requires an extension of the ethics of protection of research subjects in order to include the empowerment of citizens as citizen scientists. This paper investigates these challenges...
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Background Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we in...
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Background Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by a...
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Objective To investigate the associations between air pollution and mortality, focusing on associations below current European Union, United States, and World Health Organization standards and guidelines. Design Pooled analysis of eight cohorts. Setting Multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) in six Euro...
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Background Large nation- and region-wide epidemiological studies have provided important insights into the health effects of long-term exposure to outdoor air pollution. Evidence from these studies for the long-term effects of ultrafine particles (UFP), however is lacking. Reason for this is the shortage of empirical UFP land use regression models...
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Background Particulate matter (PM) air pollution exposure has been linked to lung function in adolescents, but little is known about the relevance of specific PM components and ultrafine particles (UFP). Objectives To investigate the associations of long-term exposure to PM elemental composition and UFP with lung function at age 16 years. Methods...
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Background Epidemiological studies have associated biomass combustion with (respiratory) morbidity and mortality, primarily in indoor settings. Barbecuing results in high outdoor air pollution exposures, but the health effects are unknown. Objective The objective was to investigate short-term changes in respiratory health in healthy adults, associ...
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Hospitals host vulnerable people with potentially enhanced sensitivity to air pollutants. We measured particulate matter (PM) including PM1, PM2.5, and PM10 with a portable device in a hospital, a nearby reference building, and ambient air in Shiraz, Iran. Indoor/outdoor (I/O) ratio values were calculated to infer on the origin of size-fractioned P...
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Air pollution, noise, and green space are important environmental exposures, having been linked to a variety of specific health outcomes. However, there are few studies addressing overall early life development. To assess their effects, associations between developmental milestones for a large population of 0–4-year old children in The Netherlands...
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Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the ‘Effects of low-level air pollution: A study in Europe’ (ELAPSE) project, and...
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Background Everyday people are exposed to multiple environmental factors, such as surrounding green, air pollution and traffic noise. These exposures are generally spatially correlated. Hence, when estimating associations of surrounding green, air pollution or traffic noise with health outcomes, the other exposures should be taken into account. The...
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Background To investigate associations between annual average air pollution exposures and health, most epidemiological studies rely on estimated residential exposures because information on actual time-activity patterns can only be collected for small populations and short periods of time due to costs and logistic constraints. In the current study,...
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Several citizen science (CS) initiatives have been adopted in environmental science to monitor air and noise pollution, and water quality related to civic concerns. Nevertheless, CS projects in environmental epidemiology remain scarce. This is because little attention has been paid to evaluate associations of environmental exposures with health eff...
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By 2030, more than 80% of Europe's population will live in an urban environment. The urban exposome, consisting of factors such as where we live and work, where and what we eat, our social network, and what chemical and physical hazards we are exposed to, provides important targets to improve population health. The EXPANSE (EXposome Powered tools f...
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Background Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, although evidence is still insufficient. Within the multicentre project Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we examined the associations of long-term exposures to particulate matter with a diameter <2.5 µm (PM 2.5 ), nitroge...
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Aims/hypothesis Physical activity may increase a person’s inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and habitual physical activity with the incidence of type 2 diabet...
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Nonalcoholic fatty liver disease is the most prevalent pediatric chronic liver disease. Experimental studies suggest effects of air pollution and traffic exposure on liver injury. We present the first large-scale human study to evaluate associations of prenatal and childhood air pollution and traffic exposure with liver injury. Methods: Study pop...
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Green space, air pollution, and traffic noise exposure may be associated with stress levels in children. A flattened diurnal cortisol slope (the decline in cortisol concentrations from awakening to evening) is an indicator of chronic stress. We examined associations of green space, ambient air pollution, and traffic noise with the diurnal cortisol...
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Background: Inconsistent associations between long-term exposure to particles with an aerodynamic diameter ≤2.5 μm [fine particulate matter (PM2.5)] components and mortality have been reported, partly related to challenges in exposure assessment. Objectives: We investigated the associations between long-term exposure to PM2.5 elemental component...
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Background We evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). M...
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Background An association between long-term exposure to fine particulate matter (PM2.5) and lung cancer has been established in previous studies. PM2.5 is a complex mixture of chemical components from various sources and little is known about whether certain components contribute specifically to the associated lung cancer risk. The present study bu...
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Background Ambient air pollution is a major environmental cause of morbidity and mortality worldwide. Cities are generally hotspots for air pollution and disease. However, the exact extent of the health effects of air pollution at the city level is still largely unknown. We aimed to estimate the proportion of annual preventable deaths due to air po...
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Background Air pollution has been suggested as a risk factor for chronic obstructive pulmonary disease (COPD), but evidence is sparse and inconsistent. Objectives We examined the association between long-term exposure to low-level air pollution and COPD incidence. Methods Within the ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE)...
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Introduction To characterize air pollution exposure at a fine spatial scale, different exposure assessment methods have been applied. Comparison of associations with health from different exposure methods are scarce. The aim of this study was to evaluate associations of air pollution based on hybrid, land-use regression (LUR) and dispersion models...
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Objectives: To investigate if air pollution and greenness exposure from birth till adulthood affects adult asthma, rhinitis and lung function. Methods: We analysed data from 3428 participants (mean age 28) in the RHINESSA study in Norway and Sweden. Individual mean annual residential exposures to nitrogen dioxide (NO2), particulate matter (PM10...
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Background/aim Ambient air pollution has been associated with lung cancer, but the shape of the exposure-response function - especially at low exposure levels - is not well described. The aim of this study was to address the relationship between long-term low-level air pollution exposure and lung cancer incidence. Methods The “Effects of Low-level...
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Studies of the health effects of ultrafine particles (UFPs) in large nationwide cohorts are currently hampered by a lack of knowledge about spatial and spatiotemporal variations in regional background UFPs. We measured the UFP (10–300 nm) at 20 regional background locations (3 × 2 weeks) across the Netherlands and a reference site continuously over...
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Background: Long-term exposure to ambient air pollution has been linked to childhood-onset asthma, while evidence is still insufficient. Within the multicentre project "Effects of Low-Level Air Pollution: A Study in Europe" (ELAPSE), we examined the associations of long-term exposures to particulate matter with diameter<2.5 µm (PM2.5), nitrogen di...
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Studies reporting on associations between short-term exposure to outdoor fine (PM2.5), and ultrafine particles (UFP) and blood pressure and lung function have been inconsistent. Few studies have characterized exposure by personal monitoring, which especially for UFP may have resulted in substantial exposure measurement error. We investigated the as...
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Higher temperatures are associated with morbidity and mortality. Most epidemiological studies use outdoor temperature data, however, people spend most of their time indoors. Indoor temperatures and determinants of indoor temperatures have rarely been studied on a large scale. We measured living room and bedroom temperature in 113 homes of elderly s...
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We developed Europe-wide models of long-term exposure to eight elements (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) in particulate matter with diameter <2.5 μm (PM 2.5) using standardized measurements for one-year periods between October 2008 and April 2011 in 19 study areas across Europe, with supervised linear regressio...
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Background Studies investigating the relationship between exposure to air pollution and brain development using magnetic resonance images are emerging. However, most studies have focused only on prenatal exposures, and have included a limited selection of pollutants. Here, we aim to expand the current knowledge by studying pregnancy and childhood e...
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We investigated if greenness and air pollution exposure in parents’ childhood affect offspring asthma and hay fever, and if effects were mediated through parental asthma, pregnancy greenness/pollution exposure, and offspring exposure. We analysed 1106 parents with 1949 offspring (mean age 35 and 6) from the Respiratory Health in Northern Europe, Sp...
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Background: This paper presents a feasibility study of data linkage between global air pollution data and clinical medical data to assess the associations of PM2.5 with cardiovascular risk factors. Methods: Cardiovascular risk factor data were obtained from the SUrvey of Risk Factors (SURF) for coronary heart disease (CHD) patients from 10 count...
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As new scientific evidence on health effects of air pollution is generated, air quality guidelines need to be periodically updated. The objective of this review is to support the derivation of updated guidelines by the World Health Organization (WHO) by performing a systematic review of evidence of associations between long-term exposure to particu...