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 (PM_2.5), nitrogen dioxide (NO₂), black carbon (BC), and ozone (O₃), as well as 8 PM_2.5 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 PM_2.5 (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 PM_2.5, NO₂, and BC with PD mortality were linear without apparent lower thresholds. In two-pollutant models, associations with PM_2.5 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 PM_2.5. We detected suggestive positive associations with the potassium component of PM_2.5.

Conclusion

Long-term exposure to PM_2.5, at levels well below current EU air pollution limit values, may contribute to PD mortality.

中文翻译：

---

欧洲大型队列中的长期空气污染暴露和帕金森病死亡率：一项 ELAPSE 研究

背景

暴露于环境空气污染与心肺疾病死亡率之间的联系已得到充分证实，但关于包括帕金森氏病 (PD) 在内的神经退行性疾病的证据仍然有限。

客观的

我们在七个欧洲队列中检查了长期暴露于环境空气污染与 PD 死亡率之间的关联。

方法

在“低水平空气污染的影响：欧洲研究”(ELAPSE) 项目中，我们汇集了来自六个欧洲国家的七个队列的数据。细颗粒物 (PM _2.5 )、二氧化氮 (NO ₂ )、黑碳 (BC) 和臭氧 (O ₃ ) 以及 8 PM _2.5成分（铜、铁、钾、镍、硫）的年平均住宅浓度、硅、钒、锌），2010 年使用全欧洲混合土地利用回归模型估算。PD 死亡率被定义为 PD、继发性帕金森病或 PD 痴呆的潜在死亡原因。我们应用 Cox 比例风险模型来调查空气污染与 PD 死亡率之间的关联，并针对潜在的混杂因素进行调整。

结果

在 271,720 名队列参与者中，381 人在 19.7 年的随访期间死于 PD。在单一污染物分析中，我们观察到 PD 死亡率与 PM _2.5（每 5 µg/m ³的风险比：1.25；95% 置信区间：1.01–1.55）、NO ₂（1.13；0.95–1.34 每 10 µg/ m ³ ) 和 BC（1.12；0.94–1.34 每 0.5 × 10 ^-5 m ^-1），与 O ₃呈负相关（0.74；0.58–0.94 每 10 µg/m ³）。PM _2.5、NO ₂和 BC 与 PD 死亡率呈线性关联，没有明显的下限阈值。在双污染物模型中，与 PM _2.5的关联在针对 NO ₂ (1.24; 0.95–1.62) 或 BC (1.28; 0.96–1.71) 进行调整后仍然稳健，而与 NO ₂或 BC 的关联减弱为零。O _{3关联仍然为负，但在具有 PM 2.5}的模型中不再具有统计学意义。_{我们检测到与 PM 2.5}钾成分的暗示性正相关。

结论

长期暴露于远低于当前欧盟空气污染限值的PM _{2.5可能会导致 PD 死亡率。}