The Atherosclerosis and Risk of Cardiovascular Consequences of Air Pollution (ARCA) Project. Study Design and Preliminary Data

Background and Objective: Besides being recognized as a relevant risk factor for respiratory and neoplastic diseases, air pollution is emerging as an important determinant of atherosclerosis and cardiovascular diseases. The main outcome of this study is to investigate the relationship between air pollution and cardiovascular disease in a large cohort of subjects enrolled in Taranto, Italy. The first step of the enrollment campaign regards subjects highly exposed to air pollution, and here we present preliminary data for this study group. Methods: Up to 2000 workers at the largest steel-works in Italy, ILVA, Taranto, Italy, are undergoing a comprehensive assessment covering the following domains: sociodemographic data, health status, physical activity level, working history, medical diagnoses, drugs, nutritional status, cardiovascular and respiratory signs, and laboratory analyses. The following instrumental work up is also performed: 12-leads electrocardiogram, 24h electrocardiography, echocardiography, flow-mediated dilation (FMD), carotid echocolordoppler, spirometry. The first follow-up is scheduled within 3 years. Since the recruitment is ongoing, here we present descriptive data about the first 352 subjects enrolled. Results: The mean age of this group is 40.1±10.3 years. The prevalence of selected abnormal cardiovascular markers is as follows: FMD<5%=89.8%; c-reactive protein (PCR)>5 mg/l=20.2%; deceleration time>200 cm/sec=19.0%; E/A ratio<1=12.2%; microalbuminuria>20 mg/l=7.4%; intima-media thickness (IMT)>0.09=6.8%. Conclusion: The prevalence of selected markers of atherosclerosis and cardiovascular disease is distinctly high in this group of young-adult subjects highly exposed to air pollution. The final database of the ARCA project will provide further insight into the mechanisms underlying these findings.