长期交通相关空气污染物暴露与丹麦肌萎缩侧索硬化症诊断：贝叶斯分层分析。

Long-term Traffic-related Air Pollutant Exposure and Amyotrophic Lateral Sclerosis Diagnosis in Denmark: A Bayesian Hierarchical Analysis.

机构信息

From the Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY.

The Earth Institute, Columbia University, New York, NY.

出版信息

Epidemiology. 2022 Nov 1;33(6):757-766. doi: 10.1097/EDE.0000000000001536. Epub 2022 Jul 29.

DOI:10.1097/EDE.0000000000001536

PMID:35944145

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9560992/

Abstract

BACKGROUND

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Limited evidence suggests ALS diagnosis may be associated with air pollution exposure and specifically traffic-related pollutants.

METHODS

In this population-based case-control study, we used 3,937 ALS cases from the Danish National Patient Register diagnosed during 1989-2013 and matched on age, sex, year of birth, and vital status to 19,333 population-based controls free of ALS at index date. We used validated predictions of elemental carbon (EC), nitrogen oxides (NO x ), carbon monoxide (CO), and fine particles (PM 2.5 ) to assign 1-, 5-, and 10-year average exposures pre-ALS diagnosis at study participants' present and historical residential addresses. We used an adjusted Bayesian hierarchical conditional logistic model to estimate individual pollutant associations and joint and average associations for traffic-related pollutants (EC, NO x , CO).

RESULTS

For a standard deviation (SD) increase in 5-year average concentrations, EC (SD = 0.42 µg/m 3 ) had a high probability of individual association with increased odds of ALS (11.5%; 95% credible interval [CrI] = -1.0%, 25.6%; 96.3% posterior probability of positive association), with negative associations for NO x (SD = 20 µg/m 3 ) (-4.6%; 95% CrI = 18.1%, 8.9%; 27.8% posterior probability of positive association), CO (SD = 106 µg/m 3 ) (-3.2%; 95% CrI = 14.4%, 10.0%; 26.7% posterior probability of positive association), and a null association for nonelemental carbon fine particles (non-EC PM 2.5 ) (SD = 2.37 µg/m 3 ) (0.7%; 95% CrI = 9.2%, 12.4%). We found no association between ALS and joint or average traffic pollution concentrations.

CONCLUSIONS

This study found high probability of a positive association between ALS diagnosis and EC concentration. Further work is needed to understand the role of traffic-related air pollution in ALS pathogenesis.

摘要

背景

肌萎缩侧索硬化症（ALS）是一种致命的神经退行性疾病。有限的证据表明，ALS 的诊断可能与空气污染暴露有关，特别是与交通相关的污染物有关。

方法

在这项基于人群的病例对照研究中，我们使用了丹麦国家患者登记处 1989 年至 2013 年间诊断的 3937 例 ALS 病例，并按年龄、性别、出生年份和生存状态与 19333 名无 ALS 的人群对照进行匹配。我们使用元素碳（EC）、氮氧化物（NOx）、一氧化碳（CO）和细颗粒物（PM2.5）的验证预测值来分配研究参与者目前和历史居住地址在 ALS 诊断前 1 年、5 年和 10 年的平均暴露量。我们使用调整后的贝叶斯分层条件逻辑模型来估计个体污染物的关联以及交通相关污染物（EC、NOx、CO）的联合和平均关联。

结果

对于 5 年平均浓度的标准差（SD）增加，EC（SD=0.42μg/m3）与 ALS 发病几率增加有很高的关联（11.5%；95%可信区间[CrI]为-1.0%，25.6%；96.3%的后验概率为阳性关联），而 NOx（SD=20μg/m3）呈负相关（-4.6%；95% CrI 为 18.1%，8.9%；27.8%的后验概率为阳性关联），CO（SD=106μg/m3）呈负相关（-3.2%；95% CrI 为 14.4%，10.0%；26.7%的后验概率为阳性关联），而非元素碳细颗粒物（非 EC PM2.5）（SD=2.37μg/m3）呈中性关联（0.7%；95% CrI 为 9.2%，12.4%）。我们没有发现 ALS 与联合或平均交通污染浓度之间的关联。