Epidemiology and Health

Original Articles

Association between PM_2.5 exposure and risk of Parkinson’s disease in individuals with chronic obstructive pulmonary disease in Taiwan: a nested case-control study: Ci-Wen Luo, Yu-Hsiang Kuan, Wen-Ying Chen, Chun-Jung Chen, Frank Cheau-Feng Lin, Stella Chin-Shaw Tsai; Epidemiol Health. 2023;45:e2023094. Published online October 17, 2023; DOI: https://doi.org/10.4178/epih.e2023094

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Abstract Summary PDF: Abstract
OBJECTIVES
This cohort study investigated the correlation between Parkinson’s disease (PD) risk and chronic obstructive pulmonary disease (COPD) risk under particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) exposure.
METHODS
Data from the National Health Research Institutes of Taiwan were used in this study. The Environmental Protection Administration of Taiwan established an air quality monitoring network for monitoring Taiwan’s general air quality. COPD was indicated by at least 3 outpatient records and 1 hospitalization for COPD. After the implementation of age, sex, and endpoint matching at a 1:4 ratio, 137 patients and 548 patients were included in the case group and control group, respectively. Based on the 2005 World Health Organization (WHO) standards, monthly air particle concentration data were classified into the following 4 groups in analyses of exposure–response relationships: normal level, and 1.0, 1.5, and 2.0 times the WHO level ([concentration ≥2]×25 μg/m3×number of exposure months).
RESULTS
A multivariate logistic regression revealed that the 1.0 and 1.5 WHO level groups did not significantly differ from the normal level group, but the 2.0 WHO level did (odds ratio, 4.091; 95% confidence interval, 1.180 to 14.188; p=0.038).
CONCLUSIONS
Elevated PM2.5 concentrations were significantly correlated with an increased risk of PD among patients with COPD. Furthermore, exposure to high PM2.5 levels can further increase the risk of PD.; Summary

Key Message
This nested case-control study, utilizing data from Taiwan's National Health Research Institutes and after meticulous matching, found that higher exposure to PM2.5 was associated with an increased risk of developing Parkinson's disease among individuals with chronic obstructive pulmonary disease, with those exposed to PM2.5 levels at 2 times the WHO standards having a 4 times higher odds of Parkinson's disease compared to those exposed to normal levels, indicating that air pollution may exacerbate neurological disease risk in those with existing respiratory conditions.

Chronic obstructive pulmonary disease mortality trends in Spain, 1980-2020: Lucia Cayuela, José Luis López-Campos, Anna Michela Gaeta, Rocio Reinoso-Arija, Aurelio Cayuela; Epidemiol Health. 2023;45:e2023036. Published online March 18, 2023; DOI: https://doi.org/10.4178/epih.e2023036

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Abstract Summary PDF: Abstract
OBJECTIVES
In Spain, there has been a recent increase in the mortality rate for chronic obstructive pulmonary disease (COPD) in younger women. This study aimed to analyze trends in the COPD mortality rate in Spain from 1980 to 2020, evaluating any differences between genders and age groups.
METHODS
Death certificates and mid-year population data were obtained from the Spanish National Institute of Statistics. For both genders, age group-specific and standardized (overall and truncated) rates were calculated by the direct method using the world standard population. The data were analyzed using the joinpoint regression method.
RESULTS
In both men and women, the number of COPD deaths increased from 1980 to 1999 (average annual increase of 7% in men and 4% in women), while from 1999 onwards, deaths decreased by -1.0% per year in both genders. In women, there was a significant final period of increase in the 55-59 to 70-74 age groups and a slowing of the decline in the over 75 age group. Additionally, an increase in mortality for the truncated rates was observed for women between 2006 and 2020. In men under 70 years of age, there was an initial period in which death rates remained stable or significantly increased, followed by a period in which they decreased significantly.
CONCLUSIONS
Our study shows age and gender differences in COPD mortality trends in Spain. Although the data show a downward trend, we have identified a worrying increase in the truncated rates in women for the last few years.; Summary

Key Message
Currently, mortality trends for COPD in Spain shows age and gender differences. Although the data show an overall downward trend, we have identified a worrying increase in the truncated rates in women for the last few years. This could be representing the beginning of an epidemic increase in mortality from COPD in women. Consequently, strategies should be strengthened and promoted to prevent smoking in all its forms in the general population, as well as encourage proper cessation treatments.

Cohort Profile

The Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA), India: Padukudru Anand Mahesh, Komarla Sundararaja Lokesh, Purnima Madhivanan, Sindaghatta Krishnarao Chaya, Biligere Siddaiah Jayaraj, Koustav Ganguly, Murali Krishna; Epidemiol Health. 2018;40:e2018027. Published online June 23, 2018; DOI: https://doi.org/10.4178/epih.e2018027

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13 Web of Science
13 Crossref

Abstract PDF

Abstract

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.

Summary

Citations

Citations to this article as recorded by

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