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

doi:10.1016/j.envint.2022.107667

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

University of Copenhagen
National and Kapodistrian University of Athens
Utrecht University of Applied Sciences
Institute of Epidemiology II
Ulm University
Queen Mary University of London
Karolinska Institutet
Aarhus University Hospital
Vorarlberg Cancer Registry, Agency for Preventive and Social Medicine (aks), Bregenz, Austria
Imperial College London
University of Leicester
Heinrich Heine University Düsseldorf
Danish Cancer Society Research Center
Institute for Transfusion Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Danderyd University Hospital
University Paris-Saclay
University Medical Center Utrecht

Research output: Contribution to journal › Article › Academic › peer-review

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 (PM 2.5), nitrogen dioxide (NO 2), black carbon (BC), and ozone (O 3), 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/m 3: 1.25; 95% confidence interval: 1.01-1.55), NO 2 (1.13; 0.95-1.34 per 10 µg/m 3), and BC (1.12; 0.94-1.34 per 0.5 × 10 -5m -1), and a negative association with O 3 (0.74; 0.58-0.94 per 10 µg/m 3). Associations of PM 2.5, NO 2, 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 NO 2 (1.24; 0.95-1.62) or BC (1.28; 0.96-1.71), whereas associations with NO 2 or BC attenuated to null. O 3 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.

Original language	English
Article number	107667
Pages (from-to)	1-10
Number of pages	10
Journal	Environment International
Volume	171
Early online date	30 Nov 2022
DOIs	https://doi.org/10.1016/j.envint.2022.107667
Publication status	Published - Jan 2023

Bibliographical note

Publisher Copyright:
© 2022 The Authors

Funding

This study was supported by the Health Effects Institute (HEI) (#4954-RFA14-3/16-5-3) and the Novo Nordisk Foundation Challenge Programme [NNF17OC0027812]. The HEI is an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. While HEI has reviewed and approved the study design, it was not involved in data collection and analysis, decision to publish, or preparation of the manuscript. We give thanks to all participants in the pooled cohort studies and the respective study teams of the ELAPSE project for their hard work and effort. Accordingly, we especially thank Marjan Tewis for conducting data management tasks when creating the pooled cohort database. In addition, we specifically thank the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands, for their contribution to the ELAPSE project. SALT and TwinGene are sub-studies of The Swedish Twin Registry (STR), which is managed by Karolinska Institutet and receives additional funding through the Swedish Research Council (No. 2017-00641). The KORA study was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The Novo Nordisk Foundation, the Swedish Research Council, the German Federal Ministry of Education and Research, and the State of Bavaria were not involved in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This study was supported by the Health Effects Institute (HEI) (#4954-RFA14-3/16-5-3) and the Novo Nordisk Foundation Challenge Programme [NNF17OC0027812]. The HEI is an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. While HEI has reviewed and approved the study design, it was not involved in data collection and analysis, decision to publish, or preparation of the manuscript. We give thanks to all participants in the pooled cohort studies and the respective study teams of the ELAPSE project for their hard work and effort. Accordingly, we especially thank Marjan Tewis for conducting data management tasks when creating the pooled cohort database. In addition, we specifically thank the National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands, for their contribution to the ELAPSE project. SALT and TwinGene are sub-studies of The Swedish Twin Registry (STR), which is managed by Karolinska Institutet and receives additional funding through the Swedish Research Council (No. 2017-00641). The KORA study was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The Novo Nordisk Foundation, the Swedish Research Council, the German Federal Ministry of Education and Research, and the State of Bavaria were not involved in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funders	Funder number
National Institute for Public Health and the Environment
Novo Nordisk Foundation Challenge Programme	NNF17OC0027812
U.S. Environmental Protection Agency	R-82811201
Health Effects Institute	4954-RFA14-3/16-5-3
Bundesministerium für Bildung und Forschung
Karolinska Institutet
Vetenskapsrådet	2017-00641
Rijksinstituut voor Volksgezondheid en Milieu
Novo Nordisk Fonden
Deutsches Forschungszentrum für Gesundheit und Umwelt, Helmholtz Zentrum München

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 15 Life on Land

Keywords

Adults
Air pollution
Long-term exposure
Low-level exposure
Parkinson's Disease
Pooled-cohort study

Access to Document

10.1016/j.envint.2022.107667Licence: CC BY

1-s2.0-S0160412022005943-mainFinal published version, 1.98 MBLicence: CC BY

Cite this

Cole-Hunter, T., Zhang, J., So, R., Samoli, E., Liu, S., Chen, J., Strak, M., Wolf, K., Weinmayr, G., Rodopolou, S., Remfry, E., de Hoogh, K., Bellander, T., Brandt, J., Concin, H., Zitt, E., Fecht, D., Forastiere, F., Gulliver, J., ... Andersen, Z. J. (2023). Long-term air pollution exposure and Parkinson's disease mortality in a large pooled European cohort: An ELAPSE study. Environment International, 171, 1-10. Article 107667. https://doi.org/10.1016/j.envint.2022.107667

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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 (PM 2.5), nitrogen dioxide (NO 2), black carbon (BC), and ozone (O 3), 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/m 3: 1.25; 95\% confidence interval: 1.01-1.55), NO 2 (1.13; 0.95-1.34 per 10 µg/m 3), and BC (1.12; 0.94-1.34 per 0.5 × 10 -5m -1), and a negative association with O 3 (0.74; 0.58-0.94 per 10 µg/m 3). Associations of PM 2.5, NO 2, 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 NO 2 (1.24; 0.95-1.62) or BC (1.28; 0.96-1.71), whereas associations with NO 2 or BC attenuated to null. O 3 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. ",

keywords = "Adults, Air pollution, Long-term exposure, Low-level exposure, Parkinson's Disease, Pooled-cohort study",

author = "Thomas Cole-Hunter and Jiawei Zhang and Rina So and Evangelia Samoli and Shuo Liu and Jie Chen and Maciej Strak and Kathrin Wolf and Gudrun Weinmayr and Sophia Rodopolou and Elizabeth Remfry and \{de Hoogh\}, Kees and Tom Bellander and J{\o}rgen Brandt and Hans Concin and Emanuel Zitt and Daniela Fecht and Francesco Forastiere and John Gulliver and Barbara Hoffmann and Hvidtfeldt, \{Ulla A\} and Karl-Heinz J{\"o}ckel and Mortensen, \{Laust H\} and Matthias Ketzel and \{Yacam{\'a}n M{\'e}ndez\}, Diego and Karin Leander and Petter Ljungman and Elodie Faure and Pei-Chen Lee and Alexis Elbaz and Magnusson, \{Patrik K E\} and Gabriele Nagel and G{\"o}ran Pershagen and Annette Peters and Debora Rizzuto and Vermeulen, \{Roel C H\} and Sara Schramm and Massimo Stafoggia and Klea Katsouyanni and Bert Brunekreef and Gerard Hoek and Youn-Hee Lim and Andersen, \{Zorana J\}",

note = "Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2023",

month = jan,

doi = "10.1016/j.envint.2022.107667",

language = "English",

volume = "171",

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Cole-Hunter, T, Zhang, J, So, R, Samoli, E, Liu, S, Chen, J, Strak, M, Wolf, K, Weinmayr, G, Rodopolou, S, Remfry, E, de Hoogh, K, Bellander, T, Brandt, J, Concin, H, Zitt, E, Fecht, D, Forastiere, F, Gulliver, J, Hoffmann, B, Hvidtfeldt, UA, Jöckel, K-H, Mortensen, LH, Ketzel, M, Yacamán Méndez, D, Leander, K, Ljungman, P, Faure, E, Lee, P-C, Elbaz, A, Magnusson, PKE, Nagel, G, Pershagen, G, Peters, A, Rizzuto, D, Vermeulen, RCH, Schramm, S, Stafoggia, M, Katsouyanni, K, Brunekreef, B , Hoek, G, Lim, Y-H & Andersen, ZJ 2023, 'Long-term air pollution exposure and Parkinson's disease mortality in a large pooled European cohort: An ELAPSE study', Environment International, vol. 171, 107667, pp. 1-10. https://doi.org/10.1016/j.envint.2022.107667

TY - JOUR

T1 - Long-term air pollution exposure and Parkinson's disease mortality in a large pooled European cohort

T2 - An ELAPSE study

AU - Cole-Hunter, Thomas

AU - Zhang, Jiawei

AU - So, Rina

AU - Samoli, Evangelia

AU - Liu, Shuo

AU - Chen, Jie

AU - Strak, Maciej

AU - Wolf, Kathrin

AU - Weinmayr, Gudrun

AU - Rodopolou, Sophia

AU - Remfry, Elizabeth

AU - de Hoogh, Kees

AU - Bellander, Tom

AU - Brandt, Jørgen

AU - Concin, Hans

AU - Zitt, Emanuel

AU - Fecht, Daniela

AU - Forastiere, Francesco

AU - Gulliver, John

AU - Hoffmann, Barbara

AU - Hvidtfeldt, Ulla A

AU - Jöckel, Karl-Heinz

AU - Mortensen, Laust H

AU - Ketzel, Matthias

AU - Yacamán Méndez, Diego

AU - Leander, Karin

AU - Ljungman, Petter

AU - Faure, Elodie

AU - Lee, Pei-Chen

AU - Elbaz, Alexis

AU - Magnusson, Patrik K E

AU - Nagel, Gabriele

AU - Pershagen, Göran

AU - Peters, Annette

AU - Rizzuto, Debora

AU - Vermeulen, Roel C H

AU - Schramm, Sara

AU - Stafoggia, Massimo

AU - Katsouyanni, Klea

AU - Brunekreef, Bert

AU - Hoek, Gerard

AU - Lim, Youn-Hee

AU - Andersen, Zorana J

PY - 2023/1

Y1 - 2023/1

N2 - 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 (NO 2), black carbon (BC), and ozone (O 3), 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/m 3: 1.25; 95% confidence interval: 1.01-1.55), NO 2 (1.13; 0.95-1.34 per 10 µg/m 3), and BC (1.12; 0.94-1.34 per 0.5 × 10 -5m -1), and a negative association with O 3 (0.74; 0.58-0.94 per 10 µg/m 3). Associations of PM 2.5, NO 2, 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 NO 2 (1.24; 0.95-1.62) or BC (1.28; 0.96-1.71), whereas associations with NO 2 or BC attenuated to null. O 3 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.

AB - 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 (NO 2), black carbon (BC), and ozone (O 3), 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/m 3: 1.25; 95% confidence interval: 1.01-1.55), NO 2 (1.13; 0.95-1.34 per 10 µg/m 3), and BC (1.12; 0.94-1.34 per 0.5 × 10 -5m -1), and a negative association with O 3 (0.74; 0.58-0.94 per 10 µg/m 3). Associations of PM 2.5, NO 2, 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 NO 2 (1.24; 0.95-1.62) or BC (1.28; 0.96-1.71), whereas associations with NO 2 or BC attenuated to null. O 3 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.

KW - Adults

KW - Air pollution

KW - Long-term exposure

KW - Low-level exposure

KW - Parkinson's Disease

KW - Pooled-cohort study

UR - https://www.scopus.com/pages/publications/85143661053

U2 - 10.1016/j.envint.2022.107667

DO - 10.1016/j.envint.2022.107667

M3 - Article

C2 - 36516478

SN - 0160-4120

VL - 171

SP - 1

EP - 10

JO - Environment International

JF - Environment International

M1 - 107667

ER -

Long-term air pollution exposure and Parkinson's disease mortality in a large pooled European cohort: An ELAPSE study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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