TY - JOUR
T1 - Long-term ozone exposure and mortality from neurological diseases in Canada
AU - Zhao, Naizhuo
AU - Pinault, Lauren
AU - Toyib, Olaniyan
AU - Vanos, Jennifer
AU - Tjepkema, Michael
AU - Cakmak, Sabit
N1 - Funding Information:
This work was funded under Government of Canada's the Addressing Air Pollution Horizontal Initiative (AAPHI). The authors would like to thank Statistics Canada for help accessing census and socioeconomic data.The authors would like to thank to Dr. Rick Burnett for the SCHIF analysis in this paper.
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Background: There is increasing interest in the health effects of air pollution. However, the relationships between ozone exposure and mortality attributable to neurological diseases remain unclear. Objectives: To assess associations of long-term exposure to ozone with death from Parkinson's disease, dementia, stroke, and multiple sclerosis. Methods: Our analyses were based on the 2001 Canadian Census Health and Environment Cohort. Census participants were linked with vital statistics records through 2016, resulting in a cohort of 3.5 million adults/51,045,700 person-years, with 8,500/51,300/43,300/1,300 deaths from Parkinson's/dementia/stroke/multiple sclerosis, respectively. Ten-year average ozone concentrations estimated by chemical transport models and adjusted by ground measurements were assigned to subjects based on postal codes. Cox proportional hazards models were used to calculate hazard ratios (HRs) for deaths from the four neurological diseases, adjusting for eight common demographic and socioeconomic factors, seven environmental indexes, and six contextual covariates. Results: The fully adjusted HRs for Parkinson's, dementia, stroke, and multiple sclerosis mortalities related to one interquartile range increase in ozone (10.1 ppb), were 1.09 (95% confidence interval 1.04–1.14), 1.08 (1.06–1.10), 1.06 (1.04–1.09), and 1.35 (1.20–1.51), respectively. The covariates did not influence significance of the ozone-mortality associations, except airshed (i.e., broad region of Canada). During the period of 2001–2016, 5.66%/5.01%/ 3.77%/19.11% of deaths from Parkinson's/dementia/stroke/multiple sclerosis, respectively, were attributable to ozone exposure. Conclusions: We found positive associations between ozone exposure and mortality due to Parkinson's, dementia, stroke, and multiple sclerosis.
AB - Background: There is increasing interest in the health effects of air pollution. However, the relationships between ozone exposure and mortality attributable to neurological diseases remain unclear. Objectives: To assess associations of long-term exposure to ozone with death from Parkinson's disease, dementia, stroke, and multiple sclerosis. Methods: Our analyses were based on the 2001 Canadian Census Health and Environment Cohort. Census participants were linked with vital statistics records through 2016, resulting in a cohort of 3.5 million adults/51,045,700 person-years, with 8,500/51,300/43,300/1,300 deaths from Parkinson's/dementia/stroke/multiple sclerosis, respectively. Ten-year average ozone concentrations estimated by chemical transport models and adjusted by ground measurements were assigned to subjects based on postal codes. Cox proportional hazards models were used to calculate hazard ratios (HRs) for deaths from the four neurological diseases, adjusting for eight common demographic and socioeconomic factors, seven environmental indexes, and six contextual covariates. Results: The fully adjusted HRs for Parkinson's, dementia, stroke, and multiple sclerosis mortalities related to one interquartile range increase in ozone (10.1 ppb), were 1.09 (95% confidence interval 1.04–1.14), 1.08 (1.06–1.10), 1.06 (1.04–1.09), and 1.35 (1.20–1.51), respectively. The covariates did not influence significance of the ozone-mortality associations, except airshed (i.e., broad region of Canada). During the period of 2001–2016, 5.66%/5.01%/ 3.77%/19.11% of deaths from Parkinson's/dementia/stroke/multiple sclerosis, respectively, were attributable to ozone exposure. Conclusions: We found positive associations between ozone exposure and mortality due to Parkinson's, dementia, stroke, and multiple sclerosis.
KW - Dementia
KW - Mortality
KW - Multiple sclerosis
KW - Ozone exposure
KW - Parkinson's
KW - Stroke
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U2 - 10.1016/j.envint.2021.106817
DO - 10.1016/j.envint.2021.106817
M3 - Article
C2 - 34385046
AN - SCOPUS:85111983390
SN - 0160-4120
VL - 157
JO - Environment international
JF - Environment international
M1 - 106817
ER -