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Original article Association between PM2.5 exposure and risk of Parkinson's disease in individuals with chronic obstructive pulmonary disease: a nested case-control study
Ci-Wen Luo1orcid , Yu-Hsiang Kuan2orcid , Wen-Ying Chen3orcid , Chun-Jung Chen4orcid , Frank Cheau-Feng Lin2orcid , Stella Chin-Shaw Tsai1orcid
Epidemiol Health 2023;e2023094
DOI: https://doi.org/10.4178/epih.e2023094 [Accepted]
Published online: October 17, 2023
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1Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, Taichung, Taiwan
2School of Medicine, Chung Shan Medical University, Taichung, Taiwan
3National Chung Hsing University, Taichung, Taiwan
4Taichung Veterans General Hospital, Taichung, Taiwan
5Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
Corresponding author:  Stella Chin-Shaw Tsai,
Email: t5722@ms3.sltung.com.tw
Received: 16 August 2023   • Revised: 15 September 2023   • Accepted: 25 September 2023
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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 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 and 548 patients were included in the case group and control group, respectively. Based on the 2,005 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, 1.180–14.188; P=0.0382).
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.

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