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Short-term effects of air temperature on blood markers of coagulation and inflammation in potentially susceptible individuals
  1. Claudia Luise Schäuble1,
  2. Regina Hampel1,
  3. Susanne Breitner1,2,
  4. Regina Rückerl1,
  5. Richard Phipps3,
  6. David Diaz-Sanchez4,
  7. Robert B Devlin4,
  8. Jacqueline D Carter4,
  9. Joleen Soukup4,
  10. Robert Silbajoris4,
  11. Lisa Dailey4,
  12. Wolfgang Koenig5,
  13. Josef Cyrys1,6,
  14. Uta Geruschkat1,
  15. Petra Belcredi1,
  16. Ute Kraus1,2,
  17. Annette Peters1,
  18. Alexandra E Schneider1
  1. 1Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
  2. 2Institute of Biometrics and Epidemiology, Ludwig-Maximilians-University of Munich, Munich, Germany
  3. 3Department of Environmental Medicine-Lung Biology and Disease Program, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
  4. 4Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Durham, North Carolina, USA
  5. 5Department of Cardiology, University of Ulm, Ulm, Germany
  6. 6ESC-Environmental Science Center, University of Augsburg, Augsburg, Germany
  1. Correspondence to Regina Hampel, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstaedter Landstr. 1, 85764 Neuherberg, Germany; regina.hampel{at}


Objectives Changes in air temperature are associated with an increase in cardiovascular events, but the role of procoagulant and proinflammatory blood markers is still poorly understood. The authors investigated the association between air temperature and fibrinogen, plasminogen activator inhibitor type 1, interleukin-6 and high-sensitivity C reactive protein in two potentially susceptible groups.

Methods This prospective panel study was conducted between March 2007 and December 2008 in Augsburg, Germany. The study population comprised 187 participants with type 2 diabetes mellitus or impaired glucose tolerance and 87 participants with genetic polymorphisms on the detoxification and inflammation pathways. Overall, 1766 repeated blood measurements were collected. Hourly meteorology data were available from a central measurement site. The association between temperature and blood markers was analysed with additive mixed models.

Results For type 2 diabetes mellitus and impaired glucose tolerance participants, the authors observed immediate, lagged and cumulative increases in fibrinogen (range of percentage changes in geometric mean: 0.6%–0.8%) and plasminogen activator inhibitor type 1 (6.0%–10.1%) in association with a 5°C temperature decrement. Participants with a body mass index above 30 kg/m2 as well as females showed particularly strong fibrinogen effects. In participants with the special genetic background, 5°C decreases in the 5-day average of temperature led to a change of 8.0% (95% CI 0.5% to 16.2%) in interleukin-6 and of −8.4% (95% CI −15.8% to −0.3%) in high-sensitivity C reactive protein, the latter driven by physically active individuals.

Conclusions The authors observed different temperature effects on blood markers in two potentially susceptible groups probably indicating varying underlying biological mechanisms. This study results might provide a link between temperature and cardiovascular events.

  • Air temperature
  • coagulation
  • inflammation
  • epidemiology
  • environment
  • cardiovascular
  • statistics
  • epidemiology
  • meta-analysis
  • longitudinal studies
  • time series study
  • climate
  • Bayesian statistics
  • volatile organic compounds (VOCs)
  • polyaromatic hydrocarbons (PAHs)
  • PM10-PM2.5-ultrafine
  • respiratory
  • public health
  • particulates
  • organic dusts
  • diesel fumes
  • noise
  • risk assessment
  • mortality studies
  • mathematical models
  • exposure monitoring
  • climate
  • aerosols
  • diabetes mellitus

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  • CLS and RH shared first authorship.

  • Funding This research has been funded wholly or in part by the United States Environmental Protection Agency through STAR (Science to Achieve Results) grant RD 832415 to the University of Rochester. It has not been subjected to the Agency's required peer and policy review and therefore does not necessarily reflect the views of the Agency and no official endorsement should be inferred. This study was supported in part by a grant from the German Federal Ministry of Education and Research (BMBF) to the German Centre for Diabetes Research (DZD e.V.). The KORA research platform (KORA, Cooperative Health Research in the Region of Augsburg) and the MONICA Augsburg studies were initiated and financed by the Helmholtz Zentrum München, German Research Centre for Environmental Health (formerly GSF, National Research Centre for Environment and Health), which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by Ethics Commission of the Bavarian Chamber of Physicians (Bayerische Landesaerztekammer).

  • Provenance and peer review Not commissioned; externally peer reviewed.