Andersen Zorana J, Zhang Jiawei, Jørgensen Jeanette T, Samoli Evangelia, Liu Shuo, Chen Jie, Strak Maciej, Wolf Kathrin, Weinmayr Gudrun, Rodopolou Sophia, Remfry Elizabeth, de Hoogh Kees, Bellander Tom, Brandt Jørgen, Concin Hans, Zitt Emanuel, Fecht Daniela, Forastiere Francesco, Gulliver John, Hoffmann Barbara, Hvidtfeldt Ulla A, Monique Verschuren W M, Jöckel Karl-Heinz, So Rina, Cole-Hunter Tom, Mehta Amar J, Mortensen Laust H, Ketzel Matthias, Lager Anton, Leander Karin, Ljungman Petter, Severi Gianluca, Boutron-Ruault Marie-Christine, Magnusson Patrik K E, Nagel Gabriele, Pershagen Göran, Peters Annette, Rizzuto Debora, van der Schouw Yvonne T, Schramm Sara, Stafoggia Massimo, Katsouyanni Klea, Brunekreef Bert, Hoek Gerard, Lim Youn-Hee
Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Environ Int. 2022 Dec;170:107581. doi: 10.1016/j.envint.2022.107581. Epub 2022 Oct 12.
Ambient air pollution is an established risk factor for premature mortality from chronic cardiovascular, respiratory and metabolic diseases, while evidence on neurodegenerative diseases and psychiatric disorders remains limited. We examined the association between long-term exposure to air pollution and mortality from dementia, psychiatric disorders, and suicide in seven European cohorts. Within the multicenter project 'Effects of Low-Level Air Pollution: A Study in Europe' (ELAPSE), we pooled data from seven European cohorts from six countries. Based on the residential addresses, annual mean levels of fine particulate matter (PM), nitrogen dioxide (NO), black carbon (BC), ozone (O), and 8 PM components were estimated using Europe-wide hybrid land-use regression models. We applied stratified Cox proportional hazard models to investigate the associations between air pollution and mortality from dementia, psychiatric disorders, and suicide. Of 271,720 participants, 900 died from dementia, 241 from psychiatric disorders, and 164 from suicide, during a mean follow-up of 19.7 years. In fully adjusted models, we observed positive associations of NO (hazard ratio [HR] = 1.38; 95 % confidence interval [CI]: 1.13, 1.70 per 10 µg/m), PM (HR = 1.29; 95 % CI: 0.98, 1.71 per 5 µg/m), and BC (HR = 1.37; 95 % CI: 1.11, 1.69 per 0.5 × 10/m) with psychiatric disorders mortality, as well as with suicide (NO: HR = 1.13 [95 % CI: 0.92, 1.38]; PM: HR = 1.19 [95 % CI: 0.76, 1.87]; BC: HR = 1.08 [95 % CI: 0.87, 1.35]), and no association with dementia mortality. We did not detect any positive associations of O and 8 PM components with any of the three mortality outcomes. Long-term exposure to NO, PM, and BC may lead to premature mortality from psychiatric disorders and suicide.
环境空气污染是导致慢性心血管疾病、呼吸系统疾病和代谢性疾病过早死亡的既定风险因素，而关于神经退行性疾病和精神障碍的证据仍然有限。我们研究了七个欧洲队列中空气污染长期暴露与痴呆症、精神障碍和自杀死亡率之间的关联。在多中心项目“低水平空气污染的影响：欧洲研究”（ELAPSE）中，我们汇总了来自六个国家的七个欧洲队列的数据。根据居住地址，使用全欧洲范围的混合土地利用回归模型估算了细颗粒物（PM）、二氧化氮（NO）、黑碳（BC）、臭氧（O）和8种PM成分的年平均水平。我们应用分层Cox比例风险模型来研究空气污染与痴呆症、精神障碍和自杀死亡率之间的关联。在271,720名参与者中，在平均19.7年的随访期间，900人死于痴呆症，241人死于精神障碍，164人死于自杀。在完全调整的模型中，我们观察到NO（风险比[HR]=1.38；95%置信区间[CI]：每10µg/m为1.13，1.70）、PM（HR=1.29；95%CI：每5µg/m为0.98，1.71）和BC（HR=1.37；9%CI：每0.5×10/m为）与精神障碍死亡率以及自杀率呈正相关（NO：HR=1.13[95%CI：0.92，1.38]；PM：HR=1.19[CI：0.76，1.87]；BC：HR=1.08[95%CI：0.87，1.3]），与痴呆症死亡率无关联。我们未检测到O和8种PM成分与三种死亡结局中的任何一种呈正相关。长期暴露于NO、PM和BC可能导致精神障碍和自杀过早死亡。
