Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands.
Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands.
Environ Res. 2024 Oct 15;259:119552. doi: 10.1016/j.envres.2024.119552. Epub 2024 Jul 2.
Long-term exposure to ambient air pollution has been linked with all-cause mortality and cardiovascular and respiratory diseases. Suggestive associations between ambient air pollutants and neurodegeneration have also been reported, but due to the small effect and relatively rare outcomes evidence is yet inconclusive. Our aim was to investigate the associations between long-term air pollution exposure and mortality from neurodegenerative diseases.
A Dutch national cohort of 10.8 million adults aged ≥30 years was followed from 2013 until 2019. Annual average concentrations of air pollutants (ultra-fine particles (UFP), nitrogen dioxide (NO), fine particles (PM and PM) and elemental carbon (EC)) were estimated at the home address at baseline, using land-use regression models. The outcome variables were mortality due to amyotrophic lateral sclerosis (ALS), Parkinson's disease, non-vascular dementia, Alzheimer's disease, and multiple sclerosis (MS). Hazard ratios (HR) were estimated using Cox models, adjusting for individual and area-level socio-economic status covariates.
We had a follow-up of 71 million person-years. The adjusted HRs for non-vascular dementia were significantly increased for NO (1.03; 95% confidence interval (CI) 1.02-1.05) and PM (1.02; 95%CI 1.01-1.03) per interquartile range (IQR; 6.52 and 1.47 μg/m, respectively). The association with PM was also positive for ALS (1.02; 95%CI 0.97-1.07). These associations remained positive in sensitivity analyses and two-pollutant models. UFP was not associated with any outcome. No association with air pollution was found for Parkinson's disease and MS. Inverse associations were found for Alzheimer's disease.
Our findings, using a cohort of more than 10 million people, provide further support for associations between long-term exposure to air pollutants (PM and particularly NO) and mortality of non-vascular dementia. No associations were found for Parkinson and MS and an inverse association was observed for Alzheimer's disease.
长期暴露于环境空气污染与全因死亡率以及心血管和呼吸道疾病有关。环境空气污染物与神经退行性疾病之间也存在提示性关联，但由于影响较小且结果相对罕见，证据尚不明确。我们的目的是研究长期空气污染暴露与神经退行性疾病死亡率之间的关系。
一项针对 1080 万 30 岁以上成年人的荷兰全国队列研究，从 2013 年持续到 2019 年。在基线时，使用基于土地利用的回归模型，在家庭住址处估算了每年的空气污染物（超细颗粒物 (UFP)、二氧化氮 (NO)、细颗粒物 (PM 和 PM) 和元素碳 (EC))的年均浓度。结局变量为肌萎缩侧索硬化症 (ALS)、帕金森病、非血管性痴呆、阿尔茨海默病和多发性硬化症 (MS)导致的死亡率。使用 Cox 模型调整个体和区域社会经济地位协变量后，估计了危害比 (HR)。
我们的随访时间为 7100 万人年。NO（1.03；95%置信区间 [CI] 1.02-1.05）和 PM（1.02；95%CI 1.01-1.03）每四分位距（IQR；6.52 和 1.47μg/m）的调整后 HR 对于非血管性痴呆显著增加。PM 与 ALS 也呈正相关（1.02；95%CI 0.97-1.07）。在敏感性分析和双污染物模型中，这些关联仍然为阳性。UFP 与任何结局均无关。空气污染与帕金森病和 MS 之间无关联。相反，我们发现与 Alzheimer 病呈负相关。
我们的研究结果使用了超过 1000 万人的队列，进一步支持了长期暴露于空气污染物（PM，特别是 NO）与非血管性痴呆死亡率之间的关联。未发现与帕金森病和 MS 相关的关联，而对于阿尔茨海默病则观察到了负相关。
