Zorana J. Andersen, Jiawei Zhang, Jeanette T. Jørgensen, Evangelia Samoli, Shuo Liu, Jie Chen, Maciej Strak, Kathrin Wolf, Gudrun Weinmayr, Sophia Rodopolou, Elizabeth Remfry, Kees de Hoogh, Tom Bellander, Jørgen Brandt, Hans Concin, Emanuel Zitt, Daniela Fecht, Francesco Forastiere, John Gulliver, Barbara Hoffmann, Ulla A. Hvidtfeldt, W.M. Monique Verschuren, Karl-Heinz Jöckel, Rina So, Tom Cole-Hunter, Amar J. Mehta, Laust H. Mortensen, Matthias Ketzel, Anton Lager, Karin Leander, Petter Ljungman, Gianluca Severi, Marie-Christine Boutron-Ruault, Patrik K.E. Magnusson, Gabriele Nagel, Göran Pershagen, Annette Peters, Debora Rizzuto, Yvonne T. van der Schouw, Sara Schramm, Massimo Stafoggia, Klea Katsouyanni, Bert Brunekreef, Gerard Hoek, Youn-Hee Lim, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, NNF17OC0027812, U.S. Environmental Protection Agency, EPA: R-82811201, Health Effects Institute, HEI: 4954-RFA14-3/16-5-3, Bundesministerium für Bildung und Forschung, BMBF, Karolinska Institutet, KI, Vetenskapsrådet, VR: 2017-00641, China Scholarship Council, CSC: 201806010406, Novo Nordisk Fonden, NNF, Deutsches Forschungszentrum für Gesundheit und Umwelt, Helmholtz Zentrum München, Supported by the Health Effects Institute (No. 4954-RFA14-3/16-5-3), the Novo Nordisk Foundation Challenge Programme (No. NNF17OC0027812), and scholarship from the China Scholarship Council (No. 201806010406). SALT and TwinGene are sub-studies of The Swedish Twin Registry (STR), which is managed by Karolinska Institutet and receives additional funding through the Swedish Research Council (No. 2017-00641). The KORA study was initiated and financed by the Helmholtz Zentrum München – German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The China Scholarship Council, China, the Novo Nordisk Foundation, Denmark, the Swedish Research Council, Sweden, the German Federal Ministry of Education and Research, and the State of Bavaria were not involved in the study design, data collection and analysis, decision to publish, or preparation of the manuscript., The research described in this article was conducted under contract to the Health Effects Institute (HEI), an organization jointly funded by the United States Environmental Protection Agency (EPA) (Assistance Award No. R-82811201) and certain motor vehicle and engine manufacturers. The contents of this article do not necessarily reflect the views of HEI, or its sponsors, nor do they necessarily reflect the views and policies of the EPA or motor vehicle and engine manufacturers. HEI has reviewed and approved the study design. HEI was not involved in data collection and analysis, decision to publish, or preparation of the manuscript. The authors would also like to thank all participants in the pooled cohort studies and the respective study teams of the ELAPSE project for their hard work and effort. We thank Marjan Tewis for the data management tasks in creating the pooled cohort database., and HAL UVSQ, Équipe
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.