Fine Particle Exposure and Clinical Aggravation in Neurodegenerative Diseases in New York State.

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From: Environmental Health Perspectives(Vol. 129, Issue 2)
Publisher: National Institute of Environmental Health Sciences
Document Type: Report
Length: 8,692 words
Lexile Measure: 1410L

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Abstract :

BACKGROUND: Adult-onset neurodegenerative diseases affect millions and negatively impact health care systems worldwide. Evidence suggests that air pollution may contribute to aggravation of neurodegeneration, but studies have been limited. OBJECTIVE: We examined the potential association between long-term exposure to particulate matter [less than or equal to]2.5 [micro]m in aerodynamic diameter [fine particulate matter ([PM.sub.2.5])] and disease aggravation in Alzheimer's (AD) and Parkinson's (PD) diseases and amyotrophic lateral sclerosis (ALS), using first hospitalization as a surrogate of clinical aggravation. METHODS: We used data from the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS 2000-2014) to construct annual county counts of first hospitalizations with a diagnosis of AD, PD, or ALS (total, urbanicity-, sex-, and age-stratified). We used annual [PM.sub.2.5] concentrations estimated by a prediction model at a 1-[km.sup.2] resolution, which we aggregated to population-weighted county averages to assign exposure to cases based on county of residence. We used outcome-specific mixed quasi-Poisson models with county- specific random intercepts to estimate rate ratios (RRs) for a 1-y [PM.sub.2.5] exposure. We allowed for nonlinear exposure-outcome relationships using penalized splines and accounted for potential confounders. RESULTS: We found a positive nonlinear [PM.sub.2.5]-PD association that plateaued above 11 [micro]g/[m.sup.3] (RR= 1.09, 95% CI: 1.04, 1.14 for a [PM.sub.2.5] increase from 8.1 to 10.4 [micro]g/[m.sup.3]). We also found a linear [PM.sub.2.5]-ALS positive association (RR = 1.05, 95% CI: 1.01, 1.09 per 1-[micro]g/[m.sup.3] [PM.sub.2.5] increase), and suggestive evidence of an association with AD. We found effect modification by age for PD and ALS with a stronger positive association in patients CONCLUSION: Our findings suggest that annual increase in county-level [PM.sub.2.5] concentrations may contribute to clinical aggravation of PD and ALS. Importantly, the average annual [PM.sub.2.5] concentration in our study was 8.1 [micro]g/[m.sup.3], below the current American national standards, suggesting the standards may not adequately protect the aging population.

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Gale Document Number: GALE|A657071194