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Publications

Journal Article Epublish 6 citations

PubMed: 39448632 DOI: 10.1038/s41531-024-00815-x

The effect of air pollution on hospitalizations with Parkinson's disease among medicare beneficiaries nationwide.

NPJ Parkinsons Dis 10(1):196

Authors: Veronica A Wang, Scott Delaney, Lauren E Flynn, Brad A Racette, Gary W Miller, Danielle Braun, Antonella Zanobetti, Daniel Mork

Affiliations

  • Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA.
  • Barrow Neurological Institute, Phoenix, AZ, USA.
  • Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
  • Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Department of Data Science, Dana Farber Cancer Institute, Boston, MA, USA.

Abstract

We examined the effect of annual exposure to fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O), on the rate of first hospitalization with a PD-related diagnosis (hospitalization with PD) among Medicare Fee-for-Service beneficiaries (2001-2016). Machine learning-derived annual air pollution concentrations were linked to residential ZIP codes. For each exposure, we fitted four models: 1) traditional outcome stratification, 2) marginal structural, 3) doubly robust, and 4) generalized propensity score matching Poisson regression models, adjusted for sociodemographic and meteorological confounders and long-term trends. Among 49,121,026 beneficiaries, incidence rate ratios of 1.08 (95% CI: 1.07, 1.10), 1.07 (95% CI: 1.05, 1.08), and 1.03 (95% CI: 1.02, 1.05) for an interquartile range increase in PM (3.72 µg/m), NO (13.84 ppb), and O (10.09 ppb), respectively, were estimated from doubly robust models. Results were similar across modeling approaches. In this nationwide study, higher air pollution exposure increased the rate of hospitalizations with PD.

MeSH

Hospitalization, Incidence, Parkinson Disease, Air Pollution, Medicare, Air, Environmental Pollution