Long-term PM2.5 Exposure and Neurological Hospital Admissions in the Northeastern United States.
Long-term PM2.5 Exposure and Neurological Hospital Admissions in the Northeastern United States.
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DOI：
10.1289/ehp.1408973
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发表时间：
2016-01
影响因子：
10.4
通讯作者：
Zanobetti A
中科院分区：
文献类型：
--
作者：
Kioumourtzoglou MA;Schwartz JD;Weisskopf MG;Melly SJ;Wang Y;Dominici F;Zanobetti A
长期暴露于细颗粒物（颗粒物≤ 2.5 μm; PM2.5）一直与心脏和肺部疾病有关。最近，人们越来越关注空气污染对神经系统的影响，有证据表明对神经退行性疾病有潜在的有害影响。我们的目标是评估长期PM2.5暴露对事件时间的潜在影响，事件时间定义为美国东北部老年人群首次入院治疗痴呆症、阿尔茨海默病（AD）或帕金森病（PD）的时间。我们估计了PM2.5对美国东北部50个城市（1999-2010年）所有≥ 65岁的医疗保险登记者中痴呆症、AD和PD首次入院的影响。对于每个结果，我们首先对每个城市运行考克斯比例风险模型，调整既往心肺相关住院和年份，并按随访时间、年龄、性别和种族分层。然后，我们通过采用随机效应元回归来汇总特定城市的估计值。我们对大约980万名受试者进行了随访，并观察到长期PM2.5城市范围内的暴露与所有三种结果的显著相关性。具体而言，我们估计每年PM2.5浓度每增加1 μg/m3，痴呆的风险比（HR）为1.08（95% CI：1.05，1.11），AD的HR为1.15（95% CI：1.11，1.19），PD入院的HR为1.08（95% CI：1.04，1.12）。据我们所知，这是第一项研究长期暴露于PM2.5和首次住院治疗常见神经退行性疾病之间的关系。我们发现了强有力的证据表明这三种结果之间存在关联。我们的研究结果为进一步的研究提供了基础，因为这种暴露的影响可能对公共健康至关重要。2005年10月20日，李文辉. 2016.美国东北部长期PM2.5暴露和神经科住院率环境健康展望124：23-29; http：dx.doi.org/10.1289/ehp.1408973
Long-term exposure to fine particles (particulate matter ≤ 2.5 μm; PM2.5) has been consistently linked to heart and lung disease. Recently, there has been increased interest in examining the effects of air pollution on the nervous system, with evidence showing potentially harmful effects on neurodegeneration. Our objective was to assess the potential impact of long-term PM2.5 exposure on event time, defined as time to first admission for dementia, Alzheimer’s (AD), or Parkinson’s (PD) diseases in an elderly population across the northeastern United States. We estimated the effects of PM2.5 on first hospital admission for dementia, AD, and PD among all Medicare enrollees ≥ 65 years in 50 northeastern U.S. cities (1999–2010). For each outcome, we first ran a Cox proportional hazards model for each city, adjusting for prior cardiopulmonary-related hospitalizations and year, and stratified by follow-up time, age, sex, and race. We then pooled the city-specific estimates by employing a random effects meta-regression. We followed approximately 9.8 million subjects and observed significant associations of long-term PM2.5 city-wide exposure with all three outcomes. Specifically, we estimated a hazard ratio (HR) of 1.08 (95% CI: 1.05, 1.11) for dementia, an HR of 1.15 (95% CI: 1.11, 1.19) for AD, and an HR of 1.08 (95% CI: 1.04, 1.12) for PD admissions per 1-μg/m3 increase in annual PM2.5 concentrations. To our knowledge, this is the first study to examine the relationship between long-term exposure to PM2.5 and time to first hospitalization for common neurodegenerative diseases. We found strong evidence of association for all three outcomes. Our findings provide the basis for further studies, as the implications of such exposures could be crucial to public health. Kioumourtzoglou MA, Schwartz JD, Weisskopf MG, Melly SJ, Wang Y, Dominici F, Zanobetti A. 2016. Long-term PM2.5 exposure and neurological hospital admissions in the northeastern United States. Environ Health Perspect 124:23–29; http://dx.doi.org/10.1289/ehp.1408973