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Biomedical subjects

D Arveiler

Publications and source records attributed to D Arveiler.

At least 37 records · Page 2Linked to original sources
PubMed2003

Physical activity patterns in 50-59 year men in France and Northern Ireland. Associations with socio-economic status and health behaviour.

BACKGROUND: This study aimed to compare physical activity patterns and their associations with socio-economic status (SES) and health behaviour in two countries at contrasting risk for coronary heart disease (CHD). METHODS: This paper is a cross-sectional analysis of 7359 French and 2398 Northern Irish 50-59 year men of the PRIME cohort. Net energy expenditure due to physical activity (PAE) was assessed by means of the MOSPA-Q taking high-intensity recreational activities into account. SES was evaluated by educational attainment and material conditions. Different behavioural factors (smoking, alcohol intake and healthy eating patterns) were considered. RESULTS: The prevalence of walking or cycling to work was greater in Northern Ireland (p < 10(-5)) whereas leisure PAE (p < 10(-5)) and high-intensity leisure-time activity (p < 10(-5)) were higher in France. Education was positively associated with leisure-time PAE in Northern Ireland but negatively in France. However education in both countries and material conditions in France were favourably associated with the regular practice of high-intensity recreational activities. Alcohol consumption was positively associated with leisure PAE in France only (p < 10(-3)). A weak negative association was also observed between smoking and leisure-time activities while healthy eating patterns were associated with greater physical activity in both countries. CONCLUSIONS: Physical activity patterns and their relationships with SES and alcohol consumption differ in France and in Northern Ireland. Our results underline the need to focus on low socio-economic groups for health promotion but, also, to adapt strategies to promote physical activity according to cultural differences between countries. Our results also show that healthy behaviours tend to cluster in middle-aged men.

Coronary Disease↗
PubMed2003

[Biological banks of the prospective cohort PRIME Study].

BACKGROUND: Cardiovascular disease is the leading cause of mortality in westernized countries. Learning more about the cause of coronary heart disease (CHD) is an essential step in the search for effective CHD prevention, both at the individual and population levels. Prospective cohort studies are particularly well suited to the study of risk markers. However, the high cost of mounting such studies, along with the newer hypotheses generated during the period of follow-up necessitates the use of plasma and serum banks for analyses of many biological parameters. METHODS: The prospective, cohort PRIME Study has recruited 10,592 men, aged 50-59 years in France and Northern Ireland, to establish new risk markers for CHD. A plasma serum bank was established comprising 240,000 samples, either in straws or tubes, which have been stored in liquid nitrogen for over 5 years. The use of straws was required to store the largest number of aliquots in the smallest possible space. Storage validation was carried out for a number of key parameters. The validity of freezing of plasma in straws was established for a number of key measurements under investigation. Simultaneously, a DNA bank was set up to facilitate genetic analyses. In contrast to the DNA bank, which enables the performance of a very large number of analyses on a small amount of material, the plasma/serum bank has to be managed very frugally, requiring laboratories to use the smallest volume possible in each analysis. RESULTS AND CONCLUSION: Problems and difficulties solved during building and use of biological banks are presented. The initial results obtained using this plasma bank have demonstrated its validity.

Blood Banks↗
PubMed2002

Ten-year trends of dietary intake in a middle-aged French population: relationship with educational level.

OBJECTIVE: To compare dietary intakes at a 10 y interval of a population aged 35-64 living in France. Trends in nutrient intake and food consumption were examined with a special emphasis on the relationships between educational level and dietary behaviour. DESIGN: Two independent surveys conducted in 1985-1987 (S1) and 1995-1997 (S2) in the framework of the WHO MONICA project. Dietary intake was assessed with a 3-day record method and a food frequency questionnaire. The samples analysed included 416 men and 446 women for S1, 393 men and 409 women for S2. RESULTS: A significant improvement of the quality of fat intake was observed between S1 and S2, independently of educational level, with an increase of the age adjusted P/S ratio from 0.42 to 0.50 in men (P=10(-4)) and from 0.41 to 0.50 in women (P=10(-4)), whereas the daily cholesterol intake dropped from 552.0 to 466.9 mg and from 447.2 to 384.6 mg in men and women, respectively (P=10(-4)). These variations were associated with a decrease in the consumption of high-fat foods and an increase in that of low-fat products (poultry, low-fat dairy foods, fish) in all educational classes. By contrast, the consumption of fruit and vegetables, which was highly associated with educational level, varied little over time. CONCLUSIONS: Our results indicate slight improvement in fat quality, independently of educational level, while fruit and vegetable intake, which appeared more dependent on educational level, was only poorly modified over the 10 y interval.

Adult↗
PubMed2002

Psychosocial risk factors for heart disease in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME).

BACKGROUND: France has a substantially lower level of premature mortality from cardiovascular diseases (CVD) relative to its comparators. Compared with Northern Ireland, France has one-half the rate, despite having a similar cardiovascular risk profile to Northern Ireland. In this prospective longitudinal study the psychosocial risk hypothesis for CVD was tested. METHOD: A cohort of 9758 men (7359 in France and 2399 in Northern Ireland) aged 50-59 years who were initially free of any CVD were recruited. At baseline the subjects completed a psychosocial questionnaire, measuring hostility, depression, social support, and the Type A behaviour pattern. At 5-years follow-up their clinical status was determined. RESULTS: Multivariate analysis indicated that, contrary to prediction, France had a substantially more negative psychosocial risk profile than Northern Ireland. The psychosocial risk factors were not successful at predicting at 5-years follow-up the hard clinical endpoint of definite fatal/non-fatal myocardial infarction. In the case of the softer clinical endpoint, angina pectoris/unstable angina, only depression predicted outcome with a small effect size. CONCLUSION: The findings provide little support for the psychosocial risk hypothesis. The psychosocial risk profile was more negative in France, the opposite of that predicted. The finding of a relationship between depression and angina may reflect a tendency for individuals who respond negatively on mood state to report more cardiac symptoms irrespective of physical disease state.

Depressive Disorder↗
PubMed2002

Types of alcoholic beverages and blood lipids in a French population.

STUDY OBJECTIVE: Prospective studies have shown a consistent relation between alcohol consumption and decreasing incidence of coronary artery disease. The protective effect of alcohol could be mediated through increased levels of HDL cholesterol (HDL-c). The aim of this study was to examine the relation between blood lipid levels and the consumption of different types of alcoholic beverages among 1581 men and 1535 women. DESIGN: Data from representative cross sectional surveys (1994-1997) in three different regions of France were used. The consumption of the different types of alcohol was quantified using a recall method according to a typical weekly consumption. MAIN RESULTS: The median daily alcohol intake was 24 g for men and 4 g for women. After adjustment for confounders, total alcohol showed a positive and significant association with HDL-c and triglycerides (TG) in both sexes. In multivariate analysis, wine was positively associated with HDL-c. Beer was positively associated with HDL-c in men and with triglycerides in men and women. When taking drinking patterns into account, wine drinkers had higher HDL-c levels than non-wine drinkers. Differences became non-significant after adjustment for confounders and particularly for socioeconomic parameters. CONCLUSIONS: In a French population sample, total alcohol was positively associated with HDL-c and triglycerides. The specific influence of any particular alcoholic beverage on blood lipids was not clearly demonstrated but wine preference found in a group with higher lifestyle standards was associated with a more favourable blood lipid profile.

Adult↗
PubMed2002

[Medical cost of cardiovascular risk factors prevention in France].

AIM: To assess the cost of the preventive measures against hypertension and dyslipidemia in French subjects aged 35-64 years. METHODS: Cross-sectional study conducted in 433 men and 424 women from the three French centres participating in the WHO-MONICA Project and receiving antihypertensive and/or hypolipidemic drug therapy. RESULTS: In both genders, beta-blockers and ACE inhibitors were the most frequently prescribed antihypertensive drugs, and half of treated hypertensive subjects still had blood pressure levels beyond the normal limits, this percentage being lower in men and in Bas-Rhin. Daily cost of antihypertensive treatment ranged between 0.58 (minimum) and 1.72 [symbol: see text] (maximum) in men and between 0.54 and 1.46 [symbol: see text] in women, with no differences between centers. Fibrates were the most frequently prescribed hypolipidemic drug, and daily cost of treatment ranged between 0.33 and 1.33 [symbol: see text] in men and between 0.36 and 1.26 [symbol: see text] in women; in men, costs were lower in the Communauté Urbaine de Lille. Slightly more than half of the hyperlipidemic subjects had their LDL levels within normal values; no differences were found between centers or genders. Finally, the daily cost of "therapeutic inefficiency" for hypertension and dyslipidemia for age group 35-64 years in France was estimated to be over one million [symbol: see text]. CONCLUSION: The cost of the antihypertensive and hypolipidemic drug treatment is high and efforts should be undertaken in order to increase the efficiency of prevention.

Adult↗
PubMed2001

Different alcohol drinking and blood pressure relationships in France and Northern Ireland: The PRIME Study.

To assess the effect of alcoholic beverages consumed on blood pressure levels by day of the week, baseline data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME), including 6523 male subjects who drank at least once a week (5156 in France and 1367 in Northern Ireland), were analyzed. In France, alcohol consumption was rather homogeneous throughout the week, with a slight increase during weekends, whereas in Northern Ireland, Fridays and Saturdays accounted for 66% of total alcohol consumption. After adjustment for age, body mass index, heart rate, tobacco smoking, educational level, marital status, and professional activity, blood pressure levels were higher in Northern Irish drinkers on Monday and decreased until Thursday, whereas blood pressure levels were constant throughout the week for French drinkers (day x country interactions, P<0.05). Conversely, no between-day differences were found regarding teetotalers in both countries. In drinkers, between-day differences and day x country interactions were suppressed after adjustment for the average alcohol consumption of the third day before measurement. We conclude that the binge-drinking pattern observed among Northern Irish drinkers leads to physiologically disadvantageous consequences regarding blood pressure levels, whereas no such fluctuations in blood pressure levels are found for regular consumption.

Alcohol Drinking↗
PubMed2001

Impact of sulfonylurea receptor 1 genetic variability on non-insulin-dependent diabetes mellitus prevalence and treatment: a population study.

The high affinity sulfonylurea receptor 1 (SUR1) is involved in the metabolism of glucose in pancreatic beta-cells. We investigated the impact of the SUR1 intron 16-3t-->c polymorphism on non-insulin-dependent diabetes mellitus (NIDDM) prevalence in a large representative sample of French men and women, 35-64 years old, and explored potential relationships between the SUR1 intron 16 -t-->c polymorphism and sulfonylurea therapy efficiency. This study took place in Lille (northern), Strasbourg (eastern), and Toulouse (southern France). One hundred and twenty-two subjects with NIDDM were registered. We stratified NIDDM subjects according to their medical treatment: sulfonylureas (n = 70) versus other treatments (n = 50). From the three populations, a control group was selected (n = 1,250). Subjects carrying the cc intron 16 genotype had an increased risk of NIDDM [odds ratio (OR) = 1.76, 95% confidence interval (CI) 1.10-2.80; P = 0.017]. Subjects bearing at least one -3c allele and treated with sulfonylurea agents had fasting plasma triglyceride concentrations 35% lower than subjects that were tt homozygous (P = 0.026), whereas no difference could be detected between genotypes in NIDDM subjects treated with other treatments. The SUR1 intron 16 -3t-->c polymorphism was associated with an increased susceptibility to NIDDM in this population study, and seems to modulate the sulfonylurea therapy efficiency on hypertriglyceridemia reduction. This observation may help to better target the various therapies available for treatment of NIDDM.

ATP-Binding Cassette Transporters↗
PubMed2001

Haemostasis in relation to dietary fat as estimated by erythrocyte fatty acid composition: the prime study.

We investigated whether haemostatic variables were related with dietary fatty acid composition as estimated by the fatty acid content of erythrocytes. Subjects were a subsample (n=283) of the participants in the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study. Factor VII, fibrinogen, tissue-type plasminogen activator antigen (tPA-ag), plasminogen activator inhibitor type 1 (PAI-1), D-dimer and von Willebrand factor (vWf) were measured and the fatty acid composition was determined in the phospholipids of total erythrocytes by gas chromatography. Statistical analyses were performed using multiple linear regression analyses with adjustment for age, center and body mass index. tPA-ag was significantly related to the n-3 fatty acids derived from fish. This was reflected in an inverse association of all n-3 fatty acids combined with tPA-ag (beta=-0.37 ng/ml/%, 95% confidence intervals: -0.45, -0.29, P<.01). Positive and significant associations of D-dimer with arachidic and eicosamonoenoic acid were observed (P<.01). No relationships were found between fatty acids and fibrinogen, vWf, PAI-1 or factor VII. The results of this study suggest that consumption of n-3 fatty acids derived from fish may favourably influence tPA-ag.

Body Mass Index↗
PubMed2001

Interleukin-6 gene polymorphisms and susceptibility to myocardial infarction: the ECTIM study. Etude Cas-Témoin de l'Infarctus du Myocarde.

There is growing evidence that interleukin (IL) 6 plays an important role in the atherosclerotic process because of its role in mediating immune and inflammatory responses and inducing cell proliferation. The present study examined whether molecular variations at the IL-6 locus are involved in the predisposition to myocardial infarction. The entire coding region, 1,158 bp of the 5' flanking region and 237 bp of the 3' flanking region of the IL-6 gene were screened. We detected three nucleotide substitutions in the 5' region at positions -174 (G/C), -572 (G/C), and -596 (G/A) from the transcription start site, and one insertion/deletion in the 3' region at position +528 after the Stop codon. These polymorphisms were genotyped in the Etude Cas-Témoin de l'Infarctus du Myocarde study comparing male patients (n=640) and age-matched controls (n=719) from Northern Ireland and France. The IL-6/G-174C and IL-6/G-596A polymorphisms were in nearly complete association. Carriers of the IL-6/-174 C allele were more frequent in patients than in controls. The population-adjusted odds ratio for myocardial infarction associated with genotype CC+CG vs. GG was estimated as 1.34. In French patients the number of coronary arteries with greater than 50% stenosis was assessed by angiography. The IL-6/-174 C allele was more frequent in patients with two or fewer stenosed vessels than in patients with three-vessel lesions. These results suggest that genetic variation at the IL-6 locus is associated with susceptibility to myocardial infarction, especially events occurring on less extended lesions. These findings would be compatible with a lower IL-6 secretion associated with the IL-6/-174 C allele, itself or in combination with other promoter polymorphisms, leading to more unstable plaques.

Adult↗
PubMed2001

Relationships between alcoholic beverages and cardiovascular risk factor levels in middle-aged men, the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction Study.

The relationships between alcoholic beverages and cardiovascular risk factors were assessed in 6730 men living in France or Northern Ireland. In France, all alcoholic beverages were significantly correlated with body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), high density lipoprotein (HDL) parameters, PAI-1 and Factor VII, whereas only wine was negatively related with fibrinogen levels. After adjusting for center, age, BMI, educational level, smoking and marital status, wine had a lesser effect on blood pressure, triglyceride, apo B and LpE:B levels than beer. Wine was associated with lower fibrinogen levels and beer with higher PAI-1 activity levels independent of the amount of alcohol consumed. In Northern Ireland, wine was negatively correlated with BMI, triglycerides, LpE:B and fibrinogen, whereas beer was positively correlated with SBP and DBP, triglycerides, HDL, apoprotein A-I and fibrinogen. Multivariate analysis showed wine to be positively associated with HDL parameters, and negatively with fibrinogen levels. Wine was also associated with higher LpA-I levels and lower fibrinogen levels independent of the amount of alcohol consumed. We conclude that alcohol consumption is related to lipid, lipoprotein and haemostatic variables, but the magnitude of the relationships depends on the type of alcoholic beverage. Also, some effects might be related to non-alcoholic components.

Alcohol Drinking↗
PubMed2001

Do cardiovascular risk factors in men depend on their spouses' occupational category?

OBJECTIVE: To analyse the relationships between major cardiovascular risk factors in French men and their spouses' occupational category (OC), taking their own OC into account. DESIGN: A large sample of volunteers working in the French National Electricity and Gas Company (GAZEL). As a check of the robustness, the same analysis was performed in a population-based survey (French multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) registers). SETTING: Any site of the company in France. Representative sample from the population of the three registers (Lille, Strasbourg, Toulouse). PARTICIPANTS: 9486 and 534 men respectively, in working activity, living in couple and aged 40 to 50 years. MAIN OUTCOME MEASURES: Self-reported arterial hypertension, diabetes, hypercholesterolemia, leisure time sedentary lifestyle, smoking status, body mass index (BMI) and alcohol consumption. RESULTS: In the GAZEL study, diabetes, smoking status, and alcohol consumption in men were associated with their own OC. In contrast, spouses' OC was independently associated with men's hypertension, hypercholesterolemia, sedentary lifestyle, and BMI: men whose spouses were unoccupied or workers have higher risk factors levels. In the MONICA study, the results were mostly comparable, at least for hypercholesterolemia, sedentary lifestyle, smoking status and alcohol consumption. CONCLUSION: Spouses' OC was independently associated with several cardiovascular risk factors in men. These results might indicate that socioeconomic status of the couple, and not only individual characteristics, should be taken into account for a better understanding of cardiovascular risk.

Adult↗
PubMed2001

Leisure-time physical activity and regular walking or cycling to work are associated with adiposity and 5 y weight gain in middle-aged men: the PRIME Study.

OBJECTIVE: To examine the influence of physical activity on body mass index (BMI), waist circumference (W) and body mass changes (DeltaBMI) in middle-aged men, with special regard to moderate-intensity activities. DESIGN: Longitudinal study of adults who participated in the PRIME Study. SUBJECTS: A cohort of 8865 men aged 50-59 y, free of coronary heart disease. MEASUREMENTS: BMI and W at baseline, body mass changes over a 5 y period. Detailed baseline assessment of net energy expenditure due to physical activity (PAE) in the preceding year, according to category of activity, by means of the MOSPA Questionnaire. PAE was expressed in weekly metabolic equivalent scores (MET h/week). RESULTS: After adjustment for confounders, the multiple regression analyses indicated that BMI, W and DeltaBMI were inversely associated with PAE spent in getting to work (P<10(-5), <10(-5) and 0.04, respectively) and practice of high-intensity (>or=6 MET) recreational activities (<0.01, <10(-5) and <0.01). Men who regularly spent more than 10 MET h/week in walking or cycling to work had a mean BMI, W and DeltaBMI respectively 0.3 kg/m(2), 1 cm and 0.06 kg/m(2) lower than those who did not expend energy in getting to work. In the subgroup of subjects who did not perform high-intensity activities, the level of recreational PAE was inversely associated with BMI and W but not with subsequent weight-gain. CONCLUSION: These findings indicate that, in middle-aged men, physical activities of moderate-intensity, which are probably easier to promote than more vigorous activities and, in particular, a more current daily activity, walking or cycling to work, may have a favourable effect on body fat markers and body mass gain.

Activities of Daily Living↗
PubMed2001

New polymorphisms in the interleukin-10 gene--relationships to myocardial infarction.

BACKGROUND: Interleukin-10 (IL-10) is a cytokine with anti-inflammatory and B-cell-stimulating activity. IL-10 is expressed in human atherosclerotic plaques and recent studies have shown the involvement of IL-10 in the atherosclerotic process. Therefore, we hypothesized that polymorphisms in the IL-10 gene might be associated with a predisposition to coronary heart disease. MATERIALS AND METHODS: To identify new polymorphisms in the human IL-10 gene, the entire coding sequence and the 3' flanking sequence of the gene were screened by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCR) followed by sequencing. The polymorphisms identified, and three others which have been previously described in the promoter region of the IL-10 gene (G-1082A, C-819T, C-592A), were then investigated in the ECTIM Study, a large population-based case-control study of myocardial infarction. RESULTS: Four new polymorphisms were identified: one in exon 1 (G+78/ex1A), which predicts a Glycine to Arginine change at position 15 in the putative signal peptide of the protein, two in the intron 3 (C+19/in3T, T+953/in3C) and one in the 3' flanking region (C+117T). All the IL-10 polymorphisms were in complete or nearly complete pairwise linkage disequilibrium. No case-control difference was found in genotype or allele frequencies for any of the polymorphisms. CONCLUSIONS: Our results suggest that IL-10 polymorphisms are not associated with an increased risk of myocardial infarction.

Adult↗
PubMed2001

Association studies between haemochromatosis gene mutations and the risk of cardiovascular diseases.

BACKGROUND: Haemochromatosis is a common genetic disorder, inherited as an autosomal recessive trait that results in a progressive accumulation of iron in most tissues of the body. Positive association studies have been recently published between cardiovascular diseases and heterozygosity for the major mutation C282Y in the haemochromatosis gene HFE. METHODS: In the present work, we have determined the HFE genotypes for C282Y and H63D in subjects from two case-control studies: the ECTIM and GENIC studies, designed to identify genetic variants associated with myocardial and brain infarction, respectively. In addition, we tested whether HFE mutations were associated with the degree of arteriosclerosis assessed non-invasively by Doppler ultrasonography on the carotid and femoral arteries, in a group of apparently healthy individuals (the AXA Study). RESULTS: The prevalence of 282Y, and 63D allele carriers, did not differ between cases and controls in the ECTIM and in the GENIC studies, while 63D but not 282Y carriers were more numerous among subjects with atherosclerotic plaques in the AXA Study. CONCLUSIONS: These three studies do not provide consistent evidence supporting the hypothesis that HFE mutations are associated with an increased risk of cardiovascular disease and with the development of arteriosclerosis.

Adolescent↗
PubMed2001

Characterization of polymorphic structure of cathepsin G gene: role in cardiovascular and cerebrovascular diseases.

Cathepsin G (CTSG), a serine protease released from activated neutrophils, may cause platelet activation, leading to intravascular thrombosis, thus contributing to cardiovascular and cerebrovascular disease. Applying the candidate gene approach, we screened the 5'-flanking region and the entire coding region of the CTSG gene for genetic variation by using polymerase chain reaction/single-strand conformation polymorphism analysis from 96 patients at high risk for myocardial infarction (MI). We identified 4 polymorphisms in the 5'-flanking region (G-618C, G-315A, C-179T, and C-160T) and 1 polymorphism in the coding region (Asn125Ser) of the gene and genotyped the participants in the Etude Cas-Temoins sur l'Infarctus du Myocarde (ECTIM Study), a case-control study for MI, and in the Etude du Profil Génétique de l'Infarctus Cérébral (GENIC Study), a case-control study for brain infarction (BI), for all identified genetic variants. The potential in vitro functionality of the 4 variants in the 5'-flanking region was investigated with transient transfection analyses in U937 cells with different allelic promoter constructs by using a luciferase assay. Our in vitro analyses did not reveal any differences for the investigated allelic constructs with respect to promoter activity, and none of the polymorphisms in the 5'-flanking region was associated with the available phenotypes in either study. Allele and genotype distributions of all identified polymorphisms did not globally differ between cases and controls in the ECTIM Study. However, in patients from the ECTIM Study, the Ser125 allele was significantly associated with elevated plasma fibrinogen levels (P=0.006), but this effect was not seen in controls (case-control heterogeneity, P=0.04). There was a significant interaction between CTSG Asn125Ser and the beta-fibrinogen gene polymorphism G-455A on plasma fibrinogen levels (P=0.04). In the GENIC Study, the odds ratio for BI associated with CTSG Ser125 carrying was 1.82 (95% CI 1.16 to 2.84, P=0.008) in patients without a history of cardiovascular or cerebrovascular diseases. Our results indicate that the CTSG Ser125 allele is associated with plasma fibrinogen levels in MI patients from the ECTIM Study and with BI in the GENIC Study. Further studies should be carried out to define the underlying mechanisms.

Adult↗
PubMed2001

[Air pollution and myocardial infarction. Strasbourg France, 1984-89].

BACKGROUND: Many studies have shown positive associations between urban air pollution, mortality and hospitalizations for cardiovascular diseases. This study tried to estimate short term effects of ambient air pollution on myocardial infarction on the basis of data collected in a morbidity registry. METHODS: The daily number of myocardial infarctions between 1984 and 1989 was supplied by the Monica registry (Bas-Rhin). The pollution variables were daily mean and maximum of hourly measures of carbon monoxyde (CO), sulfur dioxide (SO(2)), particles (PM13), nitrogen monoxyde (NO) and nitrogen dioxide (NO(2)), mean and maximum of hourly measures of ozone (O(3)) between 10 a.m. and 6 p.m. Other data were influenza epidemics, daily temperature and humidity. The analysis was a Poisson regression controlling for trend, season, meteorological factors and pollutant, using non parametric smoothing. Influence of day of week and influenza were controlled through dummy variables. RESULTS: For the hourly maximum of NO with a 5 day lag the association was statistically significant (square root relation): for an increase from percentile 25 (63 microg/m(3)) to percentile 75 (189 microg/m(3)), the RR was 1.087 (95% CI: 1.014-1.166). The association was significant during winter with a RR of 1.129 (95% CI: 1.028-1.241) for a percentile 25 (101 microg/m(3)) to percentile 75 (265 microg/m(3)) increase. A positive linear association was found with daily maximum of NO(2) during winter with a 5 day lag: the RR, for an increase from percentile 25 (59 microg/m(3)) to percentile 75 (107 microg/m(3)) was 1.095 (95% CI: 1.015-1.181). For the daily mean and maximum of O(3), a positive association was found but it was not robust. For other pollutants, no association was found. CONCLUSIONS: The association between NO(2) and coronary events, hospitalizations and mortality, has been shown in several studies but not in all. This secondary pollutant could be a proxy for small particles.

Air Pollutants↗