{"doi":"10.1289/ehp7425","title":"Fine Particle Exposure and Clinical Aggravation in Neurodegenerative Diseases in New York State","abstract":"BACKGROUND: Adult-onset neurodegenerative diseases affect millions and negatively impact health care systems worldwide. Evidence suggests that air pollution may contribute to aggravation of neurodegeneration, but studies have been limited. OBJECTIVE: We examined the potential association between long-term exposure to particulate matter 2:5 lm in aerodynamic diameter [fine particulate matter (PM 2:5 )] and disease aggravation in Alzheimer's (AD) and Parkinson's (PD) diseases and amyotrophic lateral sclerosis (ALS), using first hospitalization as a surrogate of clinical aggravation. METHODS: We used data from the New York Department of Health Statewide Planning and Research Cooperative System (SPARCS 2000(SPARCS -2014) ) to construct annual county counts of first hospitalizations with a diagnosis of AD, PD, or ALS (total, urbanicity-, sex-, and age-stratified). We used annual PM 2:5 concentrations estimated by a prediction model at a 1-km 2 resolution, which we aggregated to population-weighted county averages to assign exposure to cases based on county of residence. We used outcome-specific mixed quasi-Poisson models with county-specific random intercepts to estimate rate ratios (RRs) for a 1-y PM 2:5 exposure. We allowed for nonlinear exposure-outcome relationships using penalized splines and accounted for potential confounders. RESULTS: We found a positive nonlinear PM 2:5 -PD association that plateaued above 11 lg=m 3 (RR = 1:09, 95% CI: 1.04, 1.14 for a PM 2:5 increase from 8.1 to 10:4 lg=m 3 ). We also found a linear PM 2:5 -ALS positive association (RR = 1:05, 95% CI: 1.01, 1.09 per 1-lg=m 3 PM 2:5 increase), and suggestive evidence of an association with AD. We found effect modification by age for PD and ALS with a stronger positive association in patients <70 years of age but found insufficient evidence of effect modification by sex or urbanization level for any of the outcomes. CONCLUSION: Our findings suggest that annual increase in county-level PM 2:5 concentrations may contribute to clinical aggravation of PD and ALS. Importantly, the average annual PM 2:5 concentration in our study was 8:1 lg=m 3 , below the current American national standards, suggesting the standards may not adequately protect the aging population.","journal":"Environmental Health Perspectives","year":2021,"id":161925,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":53,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9613,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":266057,"name":"Amelia K. Boehme","orcid":"0000-0001-7408-1075","position":1,"is_corresponding":false},{"id":68462,"name":"Marc G. Weisskopf","orcid":null,"position":2,"is_corresponding":false},{"id":347861,"name":"Diane B. Ré","orcid":"0000-0002-6842-6759","position":3,"is_corresponding":false},{"id":288772,"name":"Ana Navas‐Acién","orcid":"0000-0001-9824-7797","position":4,"is_corresponding":false},{"id":22876,"name":"Aaron van Donkelaar","orcid":"0000-0002-2998-8521","position":5,"is_corresponding":false},{"id":22649,"name":"Randall V. Martin","orcid":"0000-0003-2632-8402","position":6,"is_corresponding":false},{"id":283194,"name":"Marianthi‐Anna Kioumourtzoglou","orcid":"0000-0001-5710-4992","position":7,"is_corresponding":false},{"id":677916,"name":"Yanelli Nunez","orcid":"0000-0003-0950-8639","position":0,"is_corresponding":true}],"reference_count":58,"raw_metadata":null,"created_at":"2026-07-18T23:45:00.600065Z","pmid":"33555200","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}