Air pollution and Parkinson disease: a GIS-based approach

描述(申请人提供)：越来越多的证据表明，长期暴露在空气污染中对人体健康有害。然而，人们对空气污染对神经系统结果的影响知之甚少，几乎没有人做过任何工作来确定空气污染是否会导致帕金森病的风险。对于大多数帕金森病患者来说，环境因素被认为是导致疾病风险的重要因素，暴露于杀虫剂、除草剂和农用化学品的人患帕金森病的风险增加，而吸烟的人患帕金森病的风险降低。杀虫剂和吸烟等环境因素在帕金森病流行病学中的观察作用表明，接触环境化学品，如空气污染中发现的那些，也可能影响帕金森病的风险。这项申请包括一个培训计划和研究部分，重点是在环境健康研究和地理信息系统(GIS)方面对候选人进行培训，以研究暴露于空气污染与帕金森病风险、死亡率和进展之间的关系。该研究项目将使用两项正在进行的大型前瞻性队列研究，即护士健康研究(NHS)和卫生专业人员后续研究(HPFS)，以考察PM10、PM2.5、PM10-2.5以及交通空气污染对帕金森病发病率、死亡率和进展的影响。这位候选人还将研究空气污染与饮食和生活方式因素之间的相互作用，包括吸烟、抗氧化剂的摄取、咖啡因的摄取和非甾体抗炎药物的使用。选定的人群是这项研究的理想人群，因为他们的规模大，跟踪时间长，关于饮食和生活方式因素的前瞻性信息，以及大多数队列参与者的地理编码地址，使候选人处于探索空气污染对帕金森病影响的独特位置。培训计划的重点是使候选人为成为神经疾病环境流行病学领域的独立调查员做好准备，特别注重地理信息系统技术和PD。培训计划包括地理信息系统和空气污染模拟的课程，环境流行病学和生物统计学的研究研讨会，以及与导师和顾问的私人会议，以及参加神经学和环境流行病学的国际会议，以介绍拟议的研究结果。 公共卫生相关性：帕金森病(PD)是一种神经退行性疾病，目前尚无治愈方法，对患者、他们的家庭和社会的生活质量有很大的负面影响。有强有力的证据表明，接触杀虫剂和除草剂的人患帕金森病的风险更高，但其他环境污染物的作用很少被探索。空气污染正在成为慢性疾病的一个重要决定因素，初步证据表明，它可以促进炎症和神经退变，但空气污染与帕金森病之间的关系尚未得到调查。该项目将利用30多年来从大量美国卫生专业人员那里收集的纵向数据来检查空气污染对帕金森病风险和进展的影响。此外，在该项目的支持下，将对一名青年科学家进行使用新方法的培训，如地理信息系统、最先进的空气污染模型和环境健康研究方法，以在神经系统疾病的环境流行病学方面开展富有成效的职业生涯。

DESCRIPTION (provided by applicant): An accumulating body of evidence suggests that chronic exposure to air pollution has detrimental effects on human health. However, very little is known about the effects of air pollution on neurological outcomes and almost no work has been done to determine if air pollution could contribute to risk of Parkinson disease. For the majority of PD patients, environmental factors are believed to contribute substantially to risk of disease and PD risk has been shown to be increased among persons exposed to pesticides, herbicides and agricultural chemicals, and decreased among tobacco smokers. The observed role of environmental factors such as pesticides and smoking in PD epidemiology suggests that exposure to environmental chemicals, such as those found in air pollution could also influence the risk of PD. This application includes a training plan and research component focused on training the candidate in environmental health research and in Geographic Information Systems (GIS) in order to study the association between exposure to air pollution and risk, mortality and progression of PD. The research project will use two large ongoing prospective cohort studies, the Nurses Health Study (NHS) and the Health Professionals Follow-up Study (HPFS) to examine the effects of PM10, PM2.5, PM10-2.5 as well as traffic air pollution on PD incidence, mortality and progression. The candidate will also study interactions between air pollution and dietary and lifestyle factors including smoking, intake of antioxidants, caffeine intake and use of NSAID anti-inflammatory medications. The chosen populations are ideal for this study because of their large size, long follow-up, prospective information on dietary and lifestyle factors, and the availability of geocoded addresses for the majority of the cohort participants, putting the candidate in a unique position to explore the impact of air pollution on PD. The training plan is focused on preparing the candidate for a career as an independent investigator in the field of environmental epidemiology of neurological disease, with a particular focus on GIS technology and PD. The training plan includes coursework in GIS and air pollution modeling, research seminars in environmental epidemiology and biostatistics, as well as private sessions with mentors and advisors, and travel to international meetings in both neurology and environmental epidemiology to present the results of proposed research. PUBLIC HEALTH RELEVANCE: Parkinson disease (PD) is a neurodegenerative disease with no known cure that has a large negative impact on the quality of life of those affected, their families, and society. There is strong evidence that individuals exposed to pesticides and herbicides have a higher risk of developing PD, but the role of other environmental pollutants has been little explored. Air pollution is emerging as an important determinant of chronic diseases, and preliminary evidence suggests that it can promote inflammation and neurodegeneration, but the relation between air pollution and PD has not been investigated. This project will take advantage of longitudinal data collected for over 30 years from large populations of US health professionals to examine the effects of air pollution on the risk and progression of PD. Further, with support from this project, a young scientist will be trained in the use of novel methods such as Geographical Information Systems (GIS) and state-of-the art air pollution modeling and environmental health research methods, to launch a productive career in the environmental epidemiology of neurological disease.