Kioumourtzoglou Marianthi-Anna, Schwartz Joel D, Weisskopf Marc G, Melly Steven J, Wang Yun, Dominici Francesca, Zanobetti Antonella
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Environ Health Perspect. 2016 Jan;124(1):23-9. doi: 10.1289/ehp.1408973. Epub 2015 May 15.
Long-term exposure to fine particles (particulate matter ≤ 2.5 μm; PM2.5) has been consistently linked to heart and lung disease. Recently, there has been increased interest in examining the effects of air pollution on the nervous system, with evidence showing potentially harmful effects on neurodegeneration.
Our objective was to assess the potential impact of long-term PM2.5 exposure on event time, defined as time to first admission for dementia, Alzheimer's (AD), or Parkinson's (PD) diseases in an elderly population across the northeastern United States.
We estimated the effects of PM2.5 on first hospital admission for dementia, AD, and PD among all Medicare enrollees ≥ 65 years in 50 northeastern U.S. cities (1999-2010). For each outcome, we first ran a Cox proportional hazards model for each city, adjusting for prior cardiopulmonary-related hospitalizations and year, and stratified by follow-up time, age, sex, and race. We then pooled the city-specific estimates by employing a random effects meta-regression.
We followed approximately 9.8 million subjects and observed significant associations of long-term PM2.5 city-wide exposure with all three outcomes. Specifically, we estimated a hazard ratio (HR) of 1.08 (95% CI: 1.05, 1.11) for dementia, an HR of 1.15 (95% CI: 1.11, 1.19) for AD, and an HR of 1.08 (95% CI: 1.04, 1.12) for PD admissions per 1-μg/m3 increase in annual PM2.5 concentrations.
To our knowledge, this is the first study to examine the relationship between long-term exposure to PM2.5 and time to first hospitalization for common neurodegenerative diseases. We found strong evidence of association for all three outcomes. Our findings provide the basis for further studies, as the implications of such exposures could be crucial to public health.
Kioumourtzoglou MA, Schwartz JD, Weisskopf MG, Melly SJ, Wang Y, Dominici F, Zanobetti A. 2016. Long-term PM2.5 exposure and neurological hospital admissions in the northeastern United States. Environ Health Perspect 124:23-29; http://dx.doi.org/10.1289/ehp.1408973.
长期暴露于细颗粒物（粒径≤2.5μm的颗粒物；PM2.5）一直与心肺疾病相关。最近，人们对研究空气污染对神经系统的影响兴趣日增，有证据表明其对神经退行性变有潜在有害影响。
我们的目的是评估长期暴露于PM2.5对事件时间的潜在影响，事件时间定义为美国东北部老年人群首次因痴呆、阿尔茨海默病（AD）或帕金森病（PD）入院的时间。
我们估计了美国东北部50个城市（1999 - 2010年）中所有年龄≥65岁的医疗保险参保者暴露于PM2.5对首次因痴呆、AD和PD住院的影响。对于每个结局，我们首先针对每个城市运行Cox比例风险模型，对既往心肺相关住院情况和年份进行调整，并按随访时间、年龄、性别和种族分层。然后我们采用随机效应元回归合并特定城市的估计值。
我们随访了约980万受试者，并观察到长期全市范围暴露于PM2.5与所有这三种结局均存在显著关联。具体而言，我们估计，每立方米空气中年PM2.5浓度每增加1μg，痴呆的风险比（HR）为1.08（95%置信区间：1.05, 1.11），AD为1.15（95%置信区间：1.11, 1.19），PD入院为1.08（95%置信区间：1.04, 1.12）。
据我们所知，这是第一项研究长期暴露于PM2.5与常见神经退行性疾病首次住院时间之间关系的研究。我们发现所有这三种结局均有很强的关联证据。我们的发现为进一步研究提供了基础，因为此类暴露的影响可能对公共卫生至关重要。
基奥穆尔佐格洛MA，施瓦茨JD，魏斯科普夫MG，梅利SJ，王Y，多米尼奇F，扎诺贝蒂A。2016年。美国东北部长期暴露于PM2.5与神经科住院情况。《环境健康展望》124：23 - 29；http://dx.doi.org/10.1289/ehp.1408973 。
