Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Air Quality and Chronic Stress: A Representative Study of Air Pollution (PM2.5, PM10) in Germany.
With rising attention on climate change and the aftermath of burning fossil fuels, there is much concern regarding the effects of air pollution on physical and psychologic health. However, the relationship between chronic stress and air pollution is relatively unexplored in humans.
By combining German representative data with national pollution data and using step-wise regression analyses, this study investigates how air pollution (PM2.5 and PM10) impacts ones' chronic stress levels (TICS).
Results show PM2.5 fine-dust particles significantly affect chronic stress, while PM10 has no such effect. Air pollution (PM2.5), age and income together explain 3% of variation in chronic stress in a nationally representative sample.
Further studies must test pollutants such as NO2 and O3 as well as investigate the potential accumulated effect of pollution and stress combined on human health.
Department of Family Medicine, MyongJi Hospital, Hanyang University Medical Center, Korea
Long-Term Exposure to Air Pollutants and Cancer Mortality: A Meta-Analysis of Cohort Studies.
The aim of this study was to examine the relationship between main air pollutants and all cancer mortality by performing a meta-analysis. We searched PubMed, EMBASE (a biomedical and pharmacological bibliographic database of published literature produced by Elsevier), and the reference lists of other reviews until April 2018. A random-effects model was employed to analyze the meta-estimates of each pollutant. A total of 30 cohort studies were included in the final analysis. Overall risk estimates of cancer mortality for 10 µg/m³ per increase of particulate matter (PM)2.5, PM10, and NO₂ were 1.17 (95% confidence interval (CI): 1.11⁻1.24), 1.09 (95% CI: 1.04⁻1.14), and 1.06 (95% CI: 1.02⁻1.10), respectively. With respect to the type of cancer, significant hazardous influences of PM2.5 were noticed for lung cancer mortality and non-lung cancer mortality including liver cancer, colorectal cancer, bladder cancer, and kidney cancer, respectively, while PM10 had harmful effects on mortality from lung cancer, pancreas cancer, and larynx cancer. Our meta-analysis of cohort studies indicates that exposure to the main air pollutants is associated with increased mortality from all cancers.
Hard to believe but according to Google more than 5.5 million people worldwide are dying prematurely every year as a result of air pollution. (Most of these deaths are occurring in the rapidly developing economies of China and India. The main cause is the emission of small particles from power plants, factories, vehicle exhausts and from the burning of coal and wood. The data was compiled as part of the Global Burden of Disease project. Indoor pollution is also often caused from fuels burned indoors for cooking (typically in developing countries) and cause many, many deaths and a host of serious illnesses every year as well.
Epidemiology of Allergic and Respiratory Diseases Department, IPLESP, Medical School Saint-Antoine, Sorbonne Université and INSERM, Paris
Long-Term Effect of Outdoor Air Pollution on Mortality and Morbidity: A 12-Year Follow-Up Study for Metropolitan France
Short-term effects of air pollution are documented more than long-term effects.
We investigated 12-year impacts of ambient air pollutants on cardiovascular and respiratory morbidity and mortality at the departmental level in metropolitan France.
Daily air pollution data at 2-km resolution, including concentrations of particulate matter of 10 µm or 2.5 µm in diameter or less (PM10 and PM2.5), nitrogen dioxide (NO₂), and ozone (O₃), were accrued from the CHIMERE database for 1999 and 2000. Simultaneously, morbidity (hospitalizations) and mortality data were collected in 2012 using the ESPS (Enquête Santé et Protection Sociale/Health, Health Care and Insurance Survey) survey data and the CepiDc (Centre d'Épidémiologie sur les Causes Médicales de Décès/French Epidemiology Centre on Medical Causes of Death) database. Based on Poisson regression analyses, the long-term effect was estimated. A higher risk of all-cause mortality was observed using CépiDc database, with a relative risk of 1.024 (95% CI: 1.022, 1.026) and 1.029 (95% CI: 1.027, 1.031) for a 10 µg/m³ increase in PM2.5 and PM10, respectively. Mortality due to cardiovascular and respiratory diseases likewise exhibited long-term associations with both PM2.5 and PM10. Using ESPS survey data, a significant risk was observed for both PM2.5 and PM10 in all-cause mortality and all-cause morbidity. Although a risk for higher all-cause mortality and morbidity was also present for NO₂, the cause-specific relative risk due to NO₂ was found to be lesser, as compared to PM. Nevertheless, cardiovascular and respiratory morbidity were related to NO₂, along with PM2.5 and PM10. However, the health effect of O₃ was seen to be substantially lower in comparison to the other pollutants.
Our study confirmed that PM has a long-term impact on mortality and morbidity. Exposure to NO₂ and O₃ could also lead to increased health risks.
2018 Dec 27Petr75 wrote: ↑Fri Jul 13, 2018 12:12 pm
2017 Sep 27
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Netherlands
Long-Term Air Pollution Exposure and Amyotrophic Lateral Sclerosis in Netherlands: A Population-based Case-control Study
Recently, there has been increasing evidence that exposure to air pollution is linked to neurodegenerative diseases, but little is known about the association with amyotrophic lateral sclerosis (ALS).
Based on a large population-based case-control study, we report evidence for the association between long-term exposure to traffic-related air pollution and increased susceptibility to ALS. Our findings further support the necessity for regulatory public health interventions to combat air pollution levels and provide additional insight into the potential pathophysiology of ALS.
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
Short-term air pollution exposure and emergency department visits for amyotrophic lateral sclerosis: A time-stratified case-crossover analysis.
Amyotrophic lateral sclerosis (ALS) is a progressive and devastating neurodegenerative disease, eventually leading to respiratory failure. Although the only currently available therapeutic interventions merely slow the disease progression, few studies have examined risk factors associated with ALS exacerbation and progression.
To investigate the association between exposure to short-term air pollution and acute exacerbation of ALS requiring emergency department (ED) visit.
We identified from the national emergency database of Korea 617 patients who visited EDs in Seoul with ALS as a primary cause during the period 2008-2014. We estimated short-term exposure to particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO). We conducted a conditional logistic regression with a time-stratified case-crossover design to examine the association between ED visits for ALS and short-term exposure to interquartile range (IQR) increase and upper quartile levels of air pollutants on the day of the ED visit, compared to the control days matched to day of the week, month, and year.
The risk of ED visits for ALS was significantly associated with an IQR increase of PM2.5 [Odds ratio (OR) = 1.21; 95% confidence interval (CI): 1.08, 1.35], PM10 [OR = 1.13; 95% CI: 1.02, 1.25], SO2 [OR = 1.19; 95% CI: 1.01, 1.41], and CO [OR = 1.19; 95% CI: 1.03, 1.36]. Exposure to the highest quartiles of PM2.5 and PM10 showed higher associations with ED visits for ALS [OR = 1.40; 95% CI: 1.06, 1.85 and OR = 1.33; 95% CI: 1.00, 1.77].
We provide new evidence that exposure to short-term air pollution may increase the risk of acute exacerbation of ALS. Further studies are warranted to understand the underlying mechanisms.
Department of Epidemiology, Lazio Regional Health Serv, Rome, Italy
Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
Estimation of daily PM10 and PM2.5 concentrations in Italy, 2013-2015, using a spatiotemporal land-use random-forest model.
Particulate matter (PM) air pollution is one of the major causes of death worldwide, with demonstrated adverse effects from both short-term and long-term exposure. Most of the epidemiological studies have been conducted in cities because of the lack of reliable spatiotemporal estimates of particles exposure in nonurban settings. The objective of this study is to estimate daily PM10 (PM < 10 μm), fine (PM < 2.5 μm, PM2.5) and coarse particles (PM between 2.5 and 10 μm, PM2.5-10) at 1-km2 grid for 2013-2015 using a machine learning approach, the Random Forest (RF). Separate RF models were defined to: predict PM2.5 and PM2.5-10 concentrations in monitors where only PM10 data were available (stage 1); impute missing satellite Aerosol Optical Depth (AOD) data using estimates from atmospheric ensemble models (stage 2); establish a relationship between measured PM and satellite, land use and meteorological parameters (stage 3); predict stage 3 model over each 1-km2 grid cell of Italy (stage 4); and improve stage 3 predictions by using small-scale predictors computed at the monitor locations or within a small buffer (stage 5). Our models were able to capture most of PM variability, with mean cross-validation (CV) R2 of 0.75 and 0.80 (stage 3) and 0.84 and 0.86 (stage 5) for PM10 and PM2.5, respectively. Model fitting was less optimal for PM2.5-10, in summer months and in southern Italy. Finally, predictions were equally good in capturing annual and daily PM variability, therefore they can be used as reliable exposure estimates for investigating long-term and short-term health effects.
Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
Particulate Matter Emissions of Four Different Cigarette Types of One Popular Brand: Influence of Tobacco Strength and Additives
The inhalation of particulate matter (PM) in second-hand smoke (SHS) is hazardous to health of smokers and non-smokers. Tobacco strength (amount of tar, nicotine, and carbon monoxide) and different additives might have an effect on the amount of PM. This study aimed to investigate the influence of tobacco strength or additives on PM. Four cigarette types of the brand Marlboro with different strengths and with or without additives were analyzed in comparison to the 3R4F reference cigarette. SHS was generated by an automatic environmental tobacco smoke emitter (AETSE) in an enclosed space with a volume of 2.88 m³. PM concentrations (PM10, PM2.5, PM₁) were measured with a laser aerosol spectrometer followed by statistical analysis. The two strongest Marlboro brands (Red and Red without additives) showed the highest PM concentrations of all tested cigarettes. The measured mean concentrations Cmean of PM10 increased up to 1458 µg/m³ for the Marlboro Red without additives (PM2.5: 1452 µg/m³, PM₁: 1263 µg/m³). The similarly strong Marlboro Red showed very similar PM values. The second strongest type Marlboro Gold showed 36% (PM10, PM2.5) and 32% (PM₁) lower values, respectively. The "lightest" type Marlboro Silver Blue showed 54% (PM10, PM2.5) or 50% (PM₁) lower PM values. The results indicate that the lower the tar, nicotine, and carbon monoxide amounts, as well as the longer the cigarette filter, the lower are the PM levels. An influence of additives could not be determined.
Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
Air pollution and diabetes-related biomarkers in non-diabetic adults: A pathway to impaired glucose metabolism?
While prior studies have linked air pollution (AP) to diabetes prevalence and incidence, few have investigated whether AP exposure is also associated with alterations in diabetes-related biomarkers in metabolically healthy adults.
To evaluate the associations between short-, medium-, and long-term AP and diabetes-related biomarkers (adiponectin, interleukin-1 receptor antagonist [IL-1RA], high sensitivity C-reactive protein [hsCRP], fibrinogen) in persons without diabetes.
Adiponectin, IL-1RA, hsCRP, and fibrinogen were measured in blood samples collected at the baseline (t0; 2000-2003) and first follow-up (t1; 2006-2008) examinations of the prospective Heinz Nixdorf Recall (HNR) cohort study in Germany. Participants' residential mean exposures to PM10, PM2.5, NO2, and accumulation mode particle number concentration (PNAM) were estimated for several time windows (1- to 365-day) prior to examination using a dispersion and chemistry transport model. We fitted covariate-adjusted linear mixed effects models using a random participant intercept and investigated effect modification by obesity status.
We analyzed 6727 observations (nt0 = 3626, nt1 = 3101) from 4052 participants of the HNR study (52% women; ages 45-76 years at t0). For all air pollutants, medium-term exposures (60- to 120-day) were negatively associated with adiponectin (e.g., 91-day PNAM: -2.51% change [-3.40%, -1.53%] per interquartile [IQR] increase). Several short-, medium-, and long-term AP exposures were positively associated with IL-1RA (e.g., 365-day PM10: 2.64% change [1.25%, 4.22%] per IQR increase). Long-term exposures were positively associated with hsCRP level while no consistent patterns were observed for fibrinogen. Stronger associations for adiponectin were observed among non-obese participants.
In persons without diabetes, we observed differing patterns of association between AP and diabetes-related biomarkers across a range of exposure windows, supporting the hypothesis that AP may play a role in the development of diabetes.
Neuroimmunology Unit, Medical School, University of Tampere, Tampere University Hospital, Finland
Adipsin Is Associated with Multiple Sclerosis: A Follow-Up Study of Adipokines
..In MS group, a correlation was found between the level of adipsin and EDSS score at baseline..
National School of Public Health, Carlos III Institute of Health. Madrid, Spain; Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain
Impact of air pollution on low birth weight in Spain: An approach to a National Level Study.
According to the WHO, low birth weight (<2500 gr) is a primary maternal health indicator as the cause of multiple morbi-mortality in the short and long-term. It is known that air pollution from road traffic (PM10, NO2) and O3 have an important impact on low birth weight (LBW), but there are few studies of this topic in Spain. The objective of this study is to determine the possible exposure windows in the gestational period in which there is greater susceptibility to urban air pollution and to quantify the relative risks (RR) and population attributable risks (PAR) of low birth weight associated with pollutant concentrations in Spain.
We calculated the weekly average births with low birth weight (ICD-10: P07.0-P07.1) for each Spanish province for the period 2001-2009, using the average weekly concentrations of PM10, NO2 and O3, measured in the capital cities of the provinces. The estimation of RR and PAR were carried out using generalized linear models with link Poisson, controlling for the trend, seasonality and auto-regressive character of the series and for the influence of temperature during periods of heat waves and/or cold. Finally, a meta-analysis was used to estimate the global RR and PAR based on the RR obtained for each of the provinces.
The RR for the whole of Spain is 1.104 (CI95%: 1.072, 1.138) for the association between LBW and PM10, and 1.091 (CI95%: 1.059, 1.124) for the association between NO2 and LBW. Our results suggest that 5% of low birth weight births in the case of PM10 and 8% in the case of NO2 could have been avoided with a reduction of 10 μg/m3 in the concentrations of these pollutants.
The impact of the results obtained- with 6105 cases attributable to PM10 and up to 9385 cases attributable to NO2 in a period of 9 study years- suggest the need to design structural and awareness public health measures to reduce air pollution in Spain.
If it's not a cheeky question - Roughly your weight at birth? Thank you
Petr75 - Birth - Underweight
Dx - 94kg
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
Individual and area-level determinants associated with C-reactive protein as a marker of cardiometabolic risk among adults: Results from the German National Health Interview and Examination Survey 2008-2011.
No statistically significant association of PM10 exposure with hsCRP was observed. However, adults residing in municipalities with high compared to those with low social deprivation showed significantly elevated hsCRP levels (change in geometric mean 13.5%, 95%CI 3.2%-24.7%) after adjusting for age and sex. The observed relationship was independent of individual-level educational status. Further adjustment for smoking, sports activity, and abdominal obesity appeared to markedly reduce the association between area-level social deprivation and hsCRP, whereas all individual-level variables contributed significantly to the model.
Area-level social deprivation is associated with higher systemic inflammation and the potentially mediating role of modifiable risk factors needs further elucidation. Identifying and assessing the source-specific harmful components of ambient air pollution in population-based studies remains challenging.
Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
An in vitro method to evaluate hemolysis of human red blood cells (RBCs) treated by airborne particulate matter (PM10).
Air pollutants are capable to enter bloodstream through the nose, mouth, skin and the digestive tract. Hemolysis is the premature destruction of red blood cells (RBCs) membranes. This can affect metabolism of RBCs and reduce cell life. Each of these adverse effects could lead to anemia, jaundice and other pathological conditions. Hemolysis can induce by the mineral components adsorbed on the particles. The aim of this study was to evaluate hemolysis of RBCs treated by airborne PM10 (PM with aerodynamic diameter ≤ 10 μm) in vitro. Study had two main stages including sampling and preparation of PM10 suspension, and hemolysis test. Particle samples were collected by means of a high-volume sampler on fiberglass filters. The PM10 was extracted through dry ultrasonic method. Blood sample was incubated by PM10 at concentrations 50-300 μg/mL for 3 h. Hemolysis percent was assessed through measurement of Hemoglobin concentration in test samples and total blood hemoglobin (TBH) sample by the cyanmethemoglobin method. Analysis of variance (ANOVA) and Tukey post-hoc test were applied to compare mean values of hemolysis percent between different PM concentrations. Method used in current study is suggested for investigation of toxic effects of airborne particle matter (PM1, PM2.5 and PM10) on human RBCs.
Department of Bio-Medical Sciences, Biomedical Technology, Cape Peninsula University of Technology, Bellville, Cape Town, South Africa
Red blood cell membrane fluidity in the etiology of multiple sclerosis.
Organisms adjust the order, or fluidity, of their cellular membranes in response to changes in their physiochemical environment by adjusting the lipid composition of their membranes. We investigated membrane fluidity using the phospholipid, fatty acid and cholesterol content of red blood cells (RBCs) from multiple sclerosis (MS) patients and correlated this with C-reactive protein (CRP) as well as with the severity of neurological outcome as measured by the Kurtzke Expanded Disability Status Scale (EDSS) and its Functional System Scores. The study group consisted of 31 patients with MS and 30 healthy control subjects. Phospholipids were determined using a colorimetric assay, fatty acids by gas chromatography, cholesterol by an enzymatic assay and CRP by a Beckman nephelometer. Cell membrane fluidity was calculated according to previously established formulae. RBC membrane fluidity as measured by the saturated to polyunsaturated fatty acid ratio was higher in patients than in controls (P = 0.04). The phosphatidylethanolamine saturated to polyunsaturated fatty acid ratio showed highly significant positive correlations with the EDSS and CRP < 5 microg/ml. CRP showed significant inverse correlations with the saturated nature but positive correlations with the ordered-crystalline-phase to liquid-crystalline-phase lipid ratio. In this study we show that membrane fluidity as measured by the relationship between membrane fatty acids, phospholipids and cholesterol is closely interrelated with inflammation and disease outcome in patients with MS. In conclusion, our findings suggest that the membrane lipid composition of patients with MS and, consequently, membrane fluidity are altered, which seems to be influenced by the inflammatory status.
From the Department of Global Health, School of Health Sciences, Wuhan University, China
Long-Term Exposure to Air Pollution and Survival After Ischemic Stroke.
Background and Purpose- China bears a heavy burden of stroke because of its large population of elderly people and the propensity for stroke. Previous studies have examined the association between air pollution and stroke mortality or hospital admission. However, the global evidence for adverse effects of air pollution on survival after stroke is scarce. Methods- We used the first national hospital-based prospective registry cohort of stroke in China, which included 12 291 ischemic stroke patients who visited hospitals during 2007 to 2008. All patients were followed for 1-year poststroke. Deaths during the follow-up period were recorded. Participants' 3-year prestroke exposures to ambient PM1, PM2.5, PM10 (particulate matter with aerodynamic diameters ≤1, ≤2.5, and ≤10 μm, respectively) and NO2 (nitrogen dioxide) were estimated by machine learning algorithms with satellite remote sensing, land use information, and meteorological data. Cox proportional hazards models were used to examine the association between air pollution and survival after ischemic stroke. Results- In total, 1649 deaths were identified during the 1-year follow-up period. After controlling for potential confounders, significant associations were observed between exposure to PM1 and PM2.5 and incident fatal ischemic stroke. The corresponding hazard ratios and 95% CIs associated with 10 µg/m3 increase in PM1 and PM2.5 were 1.05 (1.02-1.09) and 1.03 (1.00-1.06), respectively. No significant association was observed for PM10 or NO2 (hazard ratios and 95% CIs, 1.01 [1.00-1.03] and 1.03 [0.99-1.06], respectively). Higher hazard ratios (and 95% CIs) were observed for male, elderly and obese individuals. Conclusions- Prestroke exposure to PM1 and PM2.5 was associated with increased incident fatal ischemic stroke in the year following an ischemic stroke in China. Improved air quality may be beneficial for people to recover from stroke.
School of Public Health, Tianjin Medical University, China
Smog and risk of overall and type-specific cardiovascular diseases: A pooled analysis of 53 cohort studies with 21.09 million participants.
The reported associations of smog with the risk of cardiovascular disease (CVD) and CVD subtypes were inconsistent. We systematically searched the Pubmed (Medline) and Embase databases (from the inception to April 25, 2018) to identify the cohort studies investigating the association between smog and CVD and specific types of CVD. We conducted a meta-analysis for different types of air pollutants (PM2.5, PM10, NO2, and O3) in smog with the risk of specific types of CVD separately. We summarized the study-specific effect estimates using both the fixed effect model and the random effect model. The meta-analysis included 35 publications with 53 cohort studies. Overall, the associations between per 10 μg/m3 increase in PM2.5 exposure and risk of CVD events, stroke events, ischemic heart disease(IHD) events were significant, with relative risks (RRs) of 1.11 (95% confidence interval: 1.07-1.15), 1.12 (95% CI: 1.08-1.16) and 1.14(95% CI: 1.08-1.21), respectively. PM2.5, PM10, NO2, and O3 exposure were associated with an increased risk of CVD mortality, with RRs of 1.11 (95% CI: 1.07-1.15), 1.09 (95% CI: 1.02-1.16), 1.23 (95% CI: 1.15-1.31) and 1.03 (95% CI: 1.02-1.05), respectively. Compared with PM10, NO2, and O3 exposure, PM2.5 exposure had a greater risk of stroke incidence and IHD incidence (RR 1.12, 95% CI 1.05-1.19 for stroke incidence; 1.19, 1.09-1.30 for IHD). However, no clear evidence for the associations of PM10 exposure with risk of CVD incidence, stroke incidence, and IHD incidence was observed. This meta-analysis confirms the evidence that PM2.5 exposure was significantly associated with increased risk of CVD, stroke, and IHD. PM2.5, PM10, NO2, and O3 exposure were separately associated with an increased risk of CVD mortality. There was a stronger association between PM2.5 exposure and the risk of stroke and IHD incidence. It urgently needs well-designed studies to further to elaborate the biological and epidemiological mechanisms that link smog with CVD. MAIN FINDINGS: Compared with PM10, NO2, and O3 exposures, PM2.5 exposure was positively associated with increased risk of stroke and IHD incidence. For air pollutants and CVD events, the association of NO2 with the risk CVD mortality is more significant.
Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
Particulate Air Pollution Exposure and Plasma Vitamin D Levels in Pregnant Women: A Longitudinal Cohort Study
No studies have assessed the associations between air pollution exposure and vitamin D status in pregnant women.
To examine the association between particulate air pollution exposure and circulating 25-hydroxyvitamin [25(OH)D] levels in pregnant women.
A longitudinal cohort study.
A total of 3285 pregnant women were recruited at a Maternal and Child Health Hospital.
MAIN OUTCOME MEASURES:
Serum 25(OH)D levels.
We observed trimester-specific associations between particulate air pollution exposure and circulating 25(OH)D levels. The associations were most pronounced for the periods of third trimester and the entire pregnancy. A 10 μg/m3 increase in PM2.5 and PM10 exposure during the entire pregnancy was associated with a 4.62% (95% CI, -6.31% to -2.93%) and 5.06% (95% CI, -6.50% to -3.62%) decrease in 25(OH)D levels, respectively. Particulate air pollution exposure was also associated with elevated odds of maternal vitamin D deficiency. A 10 μg/m3 increase in PM2.5 and PM10 exposure during the entire pregnancy was associated with a 45% (OR=1.45, 95% CI, 1.29 to 1.63) and 48% (OR=1.48, 95% CI, 1.33 to 1.64) increase in the odds of maternal vitamin D deficiency. Mediation analysis estimated that decreased solar UVB radiation mediated 69.5% and 66.4% of the inverse association between PM2.5 and PM10 exposure and circulating 25(OH)D levels.
Our results suggest that prenatal exposure to particulate air pollution may play an independent role in maternal vitamin D deficiency. The role of air pollution should be incorporated into future guidelines for the prevention of maternal vitamin D deficiency.
King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
Association of Air Pollution Exposure With Psychotic Experiences During Adolescence
Urbanicity is a well-established risk factor for clinical (eg, schizophrenia) and subclinical (eg, hearing voices and paranoia) expressions of psychosis. To our knowledge, no studies have examined the association of air pollution with adolescent psychotic experiences, despite air pollution being a major environmental problem in cities.
To examine the association between exposure to air pollution and adolescent psychotic experiences and test whether exposure mediates the association between urban residency and adolescent psychotic experiences.
Design, Setting, and Participants:
The Environmental-Risk Longitudinal Twin Study is a population-based cohort study of 2232 children born during the period from January 1, 1994, through December 4, 1995, in England and Wales and followed up from birth through 18 years of age. The cohort represents the geographic and socioeconomic composition of UK households. Of the original cohort, 2066 (92.6%) participated in assessments at 18 years of age, of whom 2063 (99.9%) provided data on psychotic experiences. Generation of the pollution data was completed on October 4, 2017, and data were analyzed from May 4 to November 21, 2018.
High-resolution annualized estimates of exposure to 4 air pollutants-nitrogen dioxide (NO2), nitrogen oxides (NOx), and particulate matter with aerodynamic diameters of less than 2.5 (PM2.5) and less than 10 μm (PM10)-were modeled for 2012 and linked to the home addresses of the sample plus 2 commonly visited locations when the participants were 18 years old.
Main Outcomes and Measures:
At 18 years of age, participants were privately interviewed regarding adolescent psychotic experiences. Urbanicity was estimated using 2011 census data.
Among the 2063 participants who provided data on psychotic experiences, sex was evenly distributed (52.5% female). Six hundred twenty-three participants (30.2%) had at least 1 psychotic experience from 12 to 18 years of age. Psychotic experiences were significantly more common among adolescents with the highest (top quartile) level of annual exposure to NO2 (odds ratio [OR], 1.71; 95% CI, 1.28-2.28), NOx (OR, 1.72; 95% CI, 1.30-2.29), and PM2.5 (OR, 1.45; 95% CI, 1.11-1.90). Together NO2 and NOx statistically explained 60% of the association between urbanicity and adolescent psychotic experiences. No evidence of confounding by family socioeconomic status, family psychiatric history, maternal psychosis, childhood psychotic symptoms, adolescent smoking and substance dependence, or neighborhood socioeconomic status, crime, and social conditions occurred.
Conclusions and Relevance:
In this study, air pollution exposure-particularly NO2 and NOx-was associated with increased odds of adolescent psychotic experiences, which partly explained the association between urban residency and adolescent psychotic experiences. Biological (eg, neuroinflammation) and psychosocial (eg, stress) mechanisms are plausible.