Zhao Naizhuo, Pinault Lauren, Toyib Olaniyan, Vanos Jennifer, Tjepkema Michael, Cakmak Sabit
Division of Clinical Epidemiology, McGill University Health Center, Montreal, QC, Canada.
Health Stataistics Division, Statistics Canada, Ottawa, ON, Canada.
Environ Int. 2021 Dec;157:106817. doi: 10.1016/j.envint.2021.106817. Epub 2021 Aug 9.
BACKGROUND: There is increasing interest in the health effects of air pollution. However, the relationships between ozone exposure and mortality attributable to neurological diseases remain unclear. OBJECTIVES: To assess associations of long-term exposure to ozone with death from Parkinson's disease, dementia, stroke, and multiple sclerosis. METHODS: Our analyses were based on the 2001 Canadian Census Health and Environment Cohort. Census participants were linked with vital statistics records through 2016, resulting in a cohort of 3.5 million adults/51,045,700 person-years, with 8,500/51,300/43,300/1,300 deaths from Parkinson's/dementia/stroke/multiple sclerosis, respectively. Ten-year average ozone concentrations estimated by chemical transport models and adjusted by ground measurements were assigned to subjects based on postal codes. Cox proportional hazards models were used to calculate hazard ratios (HRs) for deaths from the four neurological diseases, adjusting for eight common demographic and socioeconomic factors, seven environmental indexes, and six contextual covariates. RESULTS: The fully adjusted HRs for Parkinson's, dementia, stroke, and multiple sclerosis mortalities related to one interquartile range increase in ozone (10.1 ppb), were 1.09 (95% confidence interval 1.04-1.14), 1.08 (1.06-1.10), 1.06 (1.04-1.09), and 1.35 (1.20-1.51), respectively. The covariates did not influence significance of the ozone-mortality associations, except airshed (i.e., broad region of Canada). During the period of 2001-2016, 5.66%/5.01%/ 3.77%/19.11% of deaths from Parkinson's/dementia/stroke/multiple sclerosis, respectively, were attributable to ozone exposure. CONCLUSIONS: We found positive associations between ozone exposure and mortality due to Parkinson's, dementia, stroke, and multiple sclerosis.
背景:空气污染对健康的影响日益受到关注。然而,臭氧暴露与神经疾病所致死亡率之间的关系仍不明确。 目的:评估长期暴露于臭氧与帕金森病、痴呆症、中风和多发性硬化症死亡之间的关联。 方法:我们的分析基于2001年加拿大人口普查健康与环境队列。通过2016年将人口普查参与者与人口动态统计记录相联系,形成了一个包含350万成年人/51045700人年的队列,其中分别有8500/51300/43300/1300人死于帕金森病/痴呆症/中风/多发性硬化症。根据邮政编码,将化学传输模型估算并经地面测量调整后的十年平均臭氧浓度分配给研究对象。采用Cox比例风险模型计算四种神经疾病死亡的风险比(HR),并对八个常见的人口统计学和社会经济因素、七个环境指标以及六个背景协变量进行了调整。 结果:与臭氧增加一个四分位数间距(10.1 ppb)相关的帕金森病、痴呆症、中风和多发性硬化症死亡的完全调整后HR分别为1.09(95%置信区间1.04 - 1.14)、1.08(1.06 - 1.10)、1.06(1.04 - 1.09)和1.35(1.20 - 1.51)。除了气团(即加拿大的广大区域)外,协变量并未影响臭氧与死亡率关联的显著性。在2001 - 2016年期间,分别有5.66%/5.01%/3.77%/19.11%的帕金森病/痴呆症/中风/多发性硬化症死亡可归因于臭氧暴露。 结论:我们发现臭氧暴露与帕金森病、痴呆症、中风和多发性硬化症导致的死亡率之间存在正相关。
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