Exposure to air pollution during childhood and risk of developing schizophrenia: a national cohort study
Exposure to air pollution during childhood and risk of developing schizophrenia: a national cohort study
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DOI：
10.1016/s2542-5196(20)30004-8
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发表时间：
2020-02-01
影响因子：
25.7
通讯作者：
Pedersen, Carsten B.
中科院分区：
文献类型：
--
作者：
Antonsen, Sussie;Mok, Pearl L. H.;Pedersen, Carsten B.
背景环境空气污染影响神经功能，但其与精神分裂症风险的关系尚不清楚。我们调查了儿童期暴露于氮氧化物（NOx）和二氧化氮（NO2），以及PM10和PM2.5，以及随后的精神分裂症风险。方法1980 - 1984年出生于丹麦的人（N=230 844），他们在10岁生日时居住在该国，并且有两个丹麦出生的父母从他们的10岁生日开始随访，直到精神分裂症诊断或2016年12月31日。平均每日暴露于每种污染物（NO2，NOx，PM10和PM2.5）在所有个人的居住地址从出生到他们的10岁生日建模。使用生存分析技术计算发病率比、累积发病率和人群归因风险。结果我们分析了2018年8月1日至2019年11月15日之间的数据。在纳入的230844名受试者中，有2189名队列成员在随访期间被诊断出患有精神分裂症。儿童时期住宅NO2和NOx暴露浓度较高与随后精神分裂症风险升高相关。与暴露于平均日浓度低于14.5 μ g/m3的人群相比，暴露于NO2日平均浓度超过26.5 μ g/m3的人群的风险增加了1.62倍（95%CI 1.41-1.87）。当出生至10岁期间暴露于NO2日平均浓度超过26.5 μ g/m3时，37岁时患精神分裂症的绝对风险为1.45%。（95% CI 1.30-1.62%），男性和1.03%（0.90-1.17），而当暴露于低于14.5微克/立方米（3）的平均日浓度时，男性和女性的风险分别为0.80%（95%CI 0.69-0.92%）和0.67%（0.57-0.79）。暴露于PM2.5或PM10和精神分裂症的风险之间的关联不太一致。解释如果空气污染和精神分裂症之间的关联是因果关系，减少环境空气污染，包括NO2和NOx可能有潜在的相当大的影响，降低精神分裂症的发病率在人口水平。需要进一步调查以确定因果关系。版权所有（c）2020作者。由Elsevier Ltd.出版，这是一篇开放获取文章，CC BY-NC-ND 4.0许可证。
Background Ambient air pollution affects neurological function, but its association with schizophrenia risk is unclear. We investigated exposure to nitrogen oxides (NOx) as a whole and nitrogen dioxide (NO2) specifically, as well as PM10, and PM2.5, during childhood and subsequent schizophrenia risk.Methods People born in Denmark from 1980 to 1984 (N=230 844), who were residing in the country on their tenth birthday, and who had two Danish-born parents were followed-up from their tenth birthday until schizophrenia diagnosis or Dec 31, 2016. Mean daily exposure to each pollutant (NO2, NOx, PM10, and PM2.5) at all of an individual's residential addresses from birth to their tenth birthday was modelled. Incidence rate ratios, cumulative incidence, and population attributable risks were calculated using survival analysis techniques.Findings We analysed data between Aug 1, 2018, and Nov 15, 2019. Of 230 844 individuals included, 2189 cohort members were diagnosed with schizophrenia during follow-up. Higher concentrations of residential NO2 and NOx exposure during childhood were associated with subsequent elevated schizophrenia risk. People exposed to daily mean concentrations of more than 26.5 mu g/m(3) NO2 had a 1.62 (95% CI 1.41-1.87) times increased risk compared with people exposed to a mean daily concentration of less than 14.5 mu g/m(3). The absolute risks of developing schizophrenia by the age of 37 years when exposed to daily mean concentrations of more than 26.5 mu g/m(3) NO2 between birth and 10 years were 1.45% (95% CI 1.30-1.62%) for men and 1.03% (0.90-1.17) for women, whereas when exposed to a mean daily concentration of less than 14.5 mu g/m(3), the risk was 0.80% (95% CI 0.69-0.92%) for men and 0.67% (0.57-0.79) for women. Associations between exposure to PM2.5 or PM10 and schizophrenia risk were less consistent.Interpretation If the association between air pollution and schizophrenia is causal, reducing ambient air pollution including NO2 and NOx could have a potentially considerable effect on lowering schizophrenia incidence at the population level. Further investigations are necessary to establish a causal relationship. Copyright (c) 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.