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Frank Cheau-Feng Lin 1 Article
Association between PM2.5 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
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 (PM<sub>2.5</sub>) 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/m<sup>3</sup>×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 PM<sub>2.5</sub> concentrations were significantly correlated with an increased risk of PD among patients with COPD. Furthermore, exposure to high PM<sub>2.5</sub> 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.

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