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Long-term exposure to air pollution and mortality from dementia, psychiatric disorders, and suicide in a large pooled European cohort: ELAPSE study

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  • Zorana J. Andersen, University of Copenhagen
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  • Jiawei Zhang, University of Copenhagen
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  • Jeanette T. Jørgensen, University of Copenhagen
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  • Evangelia Samoli, University of Athens
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  • Shuo Liu, University of Copenhagen
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  • Jie Chen, Utrecht University
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  • Maciej Strak, Utrecht University, National Institute of Public Health and the Environment
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  • Kathrin Wolf, Helmholtz Zentrum München - German Research Center for Environmental Health
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  • Gudrun Weinmayr, Ulm University
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  • Sophia Rodopolou, University of Athens
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  • Elizabeth Remfry, Queen Mary University of London
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  • Kees de Hoogh, Swiss Tropical and Public Health Institute, University of Basel
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  • Tom Bellander, Karolinska Institutet, Region Stockholm
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  • Jørgen Brandt
  • Hans Concin, Agency for Preventive and Social Medicine, Bregenz, Austria.
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  • Emanuel Zitt, LKH Feldkirch, Agency for Preventive and Social Medicine, Bregenz, Austria.
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  • Daniela Fecht, MRC Centre for Environment and Health
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  • Francesco Forastiere, Department of Epidemiology Lazio Regional Health Service, King's College London
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  • John Gulliver, University of Leicester, Imperial College London
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  • Barbara Hoffmann, Heinrich Heine University Düsseldorf
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  • Ulla A. Hvidtfeldt, Danish Cancer Society
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  • W. M. Monique Verschuren, National Institute of Public Health and the Environment, Utrecht University
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  • Karl Heinz Jöckel, University of Duisburg-Essen
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  • Rina So, University of Copenhagen
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  • Tom Cole-Hunter, University of Copenhagen
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  • Amar J. Mehta, University of Copenhagen
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  • Laust H. Mortensen, University of Copenhagen, Denmark Statistics
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  • Matthias Ketzel
  • Anton Lager, Karolinska Institutet
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  • Karin Leander, Karolinska Institutet
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  • Petter Ljungman, Karolinska Institutet
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  • Gianluca Severi, Universite Paris-Saclay, University of Florence
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  • Marie Christine Boutron-Ruault, Universite Paris-Saclay
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  • Patrik K.E. Magnusson, Karolinska Institutet
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  • Gabriele Nagel, Ulm University
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  • Göran Pershagen, Karolinska Institutet, Region Stockholm
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  • Annette Peters, Helmholtz Zentrum München - German Research Center for Environmental Health, Ludwig Maximilian University of Munich
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  • Debora Rizzuto, Karolinska Institutet
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  • Yvonne T. van der Schouw, Utrecht University
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  • Sara Schramm, University of Duisburg-Essen
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  • Massimo Stafoggia, Karolinska Institutet, Department of Epidemiology Lazio Regional Health Service
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  • Klea Katsouyanni, University of Athens, King's College London
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  • Bert Brunekreef, Utrecht University
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  • Gerard Hoek, Utrecht University
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  • Youn Hee Lim, University of Copenhagen

Ambient air pollution is an established risk factor for premature mortality from chronic cardiovascular, respiratory and metabolic diseases, while evidence on neurodegenerative diseases and psychiatric disorders remains limited. We examined the association between long-term exposure to air pollution and mortality from dementia, psychiatric disorders, and suicide in seven European cohorts. Within the multicenter project ‘Effects of Low-Level Air Pollution: A Study in Europe’ (ELAPSE), we pooled data from seven European cohorts from six countries. Based on the residential addresses, annual mean levels of fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC), ozone (O3), and 8 PM2.5 components were estimated using Europe-wide hybrid land-use regression models. We applied stratified Cox proportional hazard models to investigate the associations between air pollution and mortality from dementia, psychiatric disorders, and suicide. Of 271,720 participants, 900 died from dementia, 241 from psychiatric disorders, and 164 from suicide, during a mean follow-up of 19.7 years. In fully adjusted models, we observed positive associations of NO2 (hazard ratio [HR] = 1.38; 95 % confidence interval [CI]: 1.13, 1.70 per 10 µg/m3), PM2.5 (HR = 1.29; 95 % CI: 0.98, 1.71 per 5 µg/m3), and BC (HR = 1.37; 95 % CI: 1.11, 1.69 per 0.5 × 10−5/m) with psychiatric disorders mortality, as well as with suicide (NO2: HR = 1.13 [95 % CI: 0.92, 1.38]; PM2.5: HR = 1.19 [95 % CI: 0.76, 1.87]; BC: HR = 1.08 [95 % CI: 0.87, 1.35]), and no association with dementia mortality. We did not detect any positive associations of O3 and 8 PM2.5 components with any of the three mortality outcomes. Long-term exposure to NO2, PM2.5, and BC may lead to premature mortality from psychiatric disorders and suicide.

Original languageEnglish
Article number107581
JournalEnvironment International
Volume170
ISSN0160-4120
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Publisher Copyright:
© 2022

    Research areas

  • Air pollution, Dementia, Long-term exposure, Mortality, Psychiatric disorders, Suicide

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