Fine Particle Exposure and Clinical Aggravation in Neurodegenerative Diseases in New York State.
Environ Health Perspect. 2021 Feb ;129(2):27003. Epub 2021 Feb 8. PMID: 33555200
BACKGROUND: Adult-onset neurodegenerative diseases affect millions and negatively impact health care systems worldwide. Evidence suggests that air pollution may contribute to aggravation of neurodegeneration, but studies have been limited.
OBJECTIVE: We examined the potential association between long-term exposure to particulate matterin aerodynamic diameter [fine particulate matter ()] and disease aggravation in Alzheimer's (AD) and Parkinson's (PD) diseases and amyotrophic lateral sclerosis (ALS), using first hospitalization as a surrogate of clinical aggravation.
METHODS: We used data from the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS 2000-2014) to construct annual county counts of first hospitalizations with a diagnosis of AD, PD, or ALS (total, urbanicity-, sex-, and age-stratified). We used annualconcentrations estimated by a prediction model at aresolution, which we aggregated to population-weighted county averages to assign exposure to cases based on county of residence. We used outcome-specific mixed quasi-Poisson models with county-specific random intercepts to estimate rate ratios (RRs) for a 1-yexposure. We allowed for nonlinear exposure-outcome relationships using penalized splines and accounted for potential confounders.
RESULTS: We found a positive nonlinearassociation that plateaued above(, 95% CI: 1.04, 1.14 for aincrease from 8.1 to). We also found a linearpositive association (, 95% CI: 1.01, 1.09 perincrease), and suggestive evidence of an association with AD. We found effect modification by age for PD and ALS with a stronger positive association in patientsof age but found insufficient evidence of effect modification by sex or urbanization level for any of the outcomes.
CONCLUSION: Our findings suggest that annual increase in county-levelconcentrations may contribute to clinical aggravation of PD and ALS. Importantly, the average annualconcentration in our study was, below the current American national standards, suggesting the standards may not adequately protect the aging population. https://doi.org/10.1289/EHP7425.