Haisu Zhang, Liuhua Shi, Stefanie T Ebelt, Rohan R D'Souza, Joel D Schwartz, Noah Scovronick, Howard H Chang
{"title":"Short-term associations between ambient air pollution and emergency department visits for Alzheimer's disease and related dementias.","authors":"Haisu Zhang, Liuhua Shi, Stefanie T Ebelt, Rohan R D'Souza, Joel D Schwartz, Noah Scovronick, Howard H Chang","doi":"10.1097/EE9.0000000000000237","DOIUrl":null,"url":null,"abstract":"<p><p>Dementia is a seriously disabling illness with substantial economic and social burdens. Alzheimer's disease and its related dementias (AD/ADRD) constitute about two-thirds of dementias. AD/ADRD patients have a high prevalence of comorbid conditions that are known to be exacerbated by exposure to ambient air pollution. Existing studies mostly focused on the long-term association between air pollution and AD/ADRD morbidity, while very few have investigated short-term associations. This study aims to estimate short-term associations between AD/ADRD emergency department (ED) visits and three common air pollutants: fine particulate matter (PM<sub>2.5</sub>), nitrogen dioxide (NO<sub>2</sub>), and warm-season ozone.</p><p><strong>Methods: </strong>For the period 2005 to 2015, we analyzed over 7.5 million AD/ADRD ED visits in five US states (California, Missouri, North Carolina, New Jersey, and New York) using a time-stratified case-crossover design with conditional logistic regression. Daily estimated PM<sub>2.5</sub>, NO<sub>2,</sub> and warm-season ozone concentrations at 1 km spatial resolution were aggregated to the ZIP code level as exposure.</p><p><strong>Results: </strong>The most consistent positive association was found for NO<sub>2</sub>. Across five states, a 17.1 ppb increase in NO<sub>2</sub> concentration over a 4-day period was associated with a 0.61% (95% confidence interval = 0.27%, 0.95%) increase in AD/ADRD ED visits. For PM<sub>2.5</sub>, a positive association with AD/ADRD ED visits was found only in New York (0.64%, 95% confidence interval = 0.26%, 1.01% per 6.3 µg/m<sup>3</sup>). Associations with warm-season ozone levels were null.</p><p><strong>Conclusions: </strong>Our results suggest AD/ADRD patients are vulnerable to short-term health effects of ambient air pollution and strategies to lower exposure may reduce morbidity.</p>","PeriodicalId":11713,"journal":{"name":"Environmental Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915954/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Environmental Epidemiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/EE9.0000000000000237","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Dementia is a seriously disabling illness with substantial economic and social burdens. Alzheimer's disease and its related dementias (AD/ADRD) constitute about two-thirds of dementias. AD/ADRD patients have a high prevalence of comorbid conditions that are known to be exacerbated by exposure to ambient air pollution. Existing studies mostly focused on the long-term association between air pollution and AD/ADRD morbidity, while very few have investigated short-term associations. This study aims to estimate short-term associations between AD/ADRD emergency department (ED) visits and three common air pollutants: fine particulate matter (PM2.5), nitrogen dioxide (NO2), and warm-season ozone.
Methods: For the period 2005 to 2015, we analyzed over 7.5 million AD/ADRD ED visits in five US states (California, Missouri, North Carolina, New Jersey, and New York) using a time-stratified case-crossover design with conditional logistic regression. Daily estimated PM2.5, NO2, and warm-season ozone concentrations at 1 km spatial resolution were aggregated to the ZIP code level as exposure.
Results: The most consistent positive association was found for NO2. Across five states, a 17.1 ppb increase in NO2 concentration over a 4-day period was associated with a 0.61% (95% confidence interval = 0.27%, 0.95%) increase in AD/ADRD ED visits. For PM2.5, a positive association with AD/ADRD ED visits was found only in New York (0.64%, 95% confidence interval = 0.26%, 1.01% per 6.3 µg/m3). Associations with warm-season ozone levels were null.
Conclusions: Our results suggest AD/ADRD patients are vulnerable to short-term health effects of ambient air pollution and strategies to lower exposure may reduce morbidity.