Environment International (Jan 2023)
Long-term air pollution exposure and Parkinson’s disease mortality in a large pooled European cohort: An ELAPSE study
- Thomas Cole-Hunter,
- Jiawei Zhang,
- Rina So,
- Evangelia Samoli,
- Shuo Liu,
- Jie Chen,
- Maciej Strak,
- Kathrin Wolf,
- Gudrun Weinmayr,
- Sophia Rodopolou,
- Elizabeth Remfry,
- Kees de Hoogh,
- Tom Bellander,
- Jørgen Brandt,
- Hans Concin,
- Emanuel Zitt,
- Daniela Fecht,
- Francesco Forastiere,
- John Gulliver,
- Barbara Hoffmann,
- Ulla A. Hvidtfeldt,
- Karl-Heinz Jöckel,
- Laust H. Mortensen,
- Matthias Ketzel,
- Diego Yacamán Méndez,
- Karin Leander,
- Petter Ljungman,
- Elodie Faure,
- Pei-Chen Lee,
- Alexis Elbaz,
- Patrik K.E. Magnusson,
- Gabriele Nagel,
- Göran Pershagen,
- Annette Peters,
- Debora Rizzuto,
- Roel C.H. Vermeulen,
- Sara Schramm,
- Massimo Stafoggia,
- Klea Katsouyanni,
- Bert Brunekreef,
- Gerard Hoek,
- Youn-Hee Lim,
- Zorana J. Andersen
Affiliations
- Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Rina So
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Sophia Rodopolou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Elizabeth Remfry
- Wolfson Institute of Population Health, Queen Mary University of London, United Kingdom
- Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
- Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate, interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
- Hans Concin
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria
- Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria
- Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; MRC Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, United Kingdom
- John Gulliver
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
- Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
- Ulla A. Hvidtfeldt
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
- Laust H. Mortensen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Statistics Denmark, Copenhagen, Denmark
- Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford GU2 7XH, United Kingdom
- Diego Yacamán Méndez
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
- Elodie Faure
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESP UMR1018, 94805 Villejuif, France
- Pei-Chen Lee
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESP UMR1018, 94805 Villejuif, France; Department of Public Health, National Cheng Kung University, Tainan, Taiwan
- Alexis Elbaz
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESP UMR1018, 94805 Villejuif, France
- Patrik K.E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Ludwig Maximilians Universität München, München, Germany
- Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
- Roel C.H. Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
- Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy
- Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, United Kingdom
- Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Zorana J. Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Corresponding author.
- Journal volume & issue
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Vol. 171
p. 107667
Abstract
Background: The link between exposure to ambient air pollution and mortality from cardiorespiratory diseases is well established, while evidence on neurodegenerative disorders including Parkinson’s Disease (PD) remains limited. Objective: We examined the association between long-term exposure to ambient air pollution and PD mortality in seven European cohorts. Methods: Within the project ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE), we pooled data from seven cohorts among six European countries. Annual mean residential concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC), and ozone (O3), as well as 8 PM2.5 components (copper, iron, potassium, nickel, sulphur, silicon, vanadium, zinc), for 2010 were estimated using Europe-wide hybrid land use regression models. PD mortality was defined as underlying cause of death being either PD, secondary Parkinsonism, or dementia in PD. We applied Cox proportional hazard models to investigate the associations between air pollution and PD mortality, adjusting for potential confounders. Results: Of 271,720 cohort participants, 381 died from PD during 19.7 years of follow-up. In single-pollutant analyses, we observed positive associations between PD mortality and PM2.5 (hazard ratio per 5 µg/m3: 1.25; 95% confidence interval: 1.01–1.55), NO2 (1.13; 0.95–1.34 per 10 µg/m3), and BC (1.12; 0.94–1.34 per 0.5 × 10-5m-1), and a negative association with O3 (0.74; 0.58–0.94 per 10 µg/m3). Associations of PM2.5, NO2, and BC with PD mortality were linear without apparent lower thresholds. In two-pollutant models, associations with PM2.5 remained robust when adjusted for NO2 (1.24; 0.95–1.62) or BC (1.28; 0.96–1.71), whereas associations with NO2 or BC attenuated to null. O3 associations remained negative, but no longer statistically significant in models with PM2.5. We detected suggestive positive associations with the potassium component of PM2.5. Conclusion: Long-term exposure to PM2.5, at levels well below current EU air pollution limit values, may contribute to PD mortality.
