Long-term Traffic-related Air Pollutant Exposure and Amyotrophic Lateral Sclerosis Diagnosis in Denmark: A Bayesian Hierarchical Analysis

Epidemiology. 2022 Nov 1;33(6):757-766. doi: 10.1097/EDE.0000000000001536. Epub 2022 Jul 29.

Abstract

Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Limited evidence suggests ALS diagnosis may be associated with air pollution exposure and specifically traffic-related pollutants.

Methods: In this population-based case-control study, we used 3,937 ALS cases from the Danish National Patient Register diagnosed during 1989-2013 and matched on age, sex, year of birth, and vital status to 19,333 population-based controls free of ALS at index date. We used validated predictions of elemental carbon (EC), nitrogen oxides (NO x ), carbon monoxide (CO), and fine particles (PM 2.5 ) to assign 1-, 5-, and 10-year average exposures pre-ALS diagnosis at study participants' present and historical residential addresses. We used an adjusted Bayesian hierarchical conditional logistic model to estimate individual pollutant associations and joint and average associations for traffic-related pollutants (EC, NO x , CO).

Results: For a standard deviation (SD) increase in 5-year average concentrations, EC (SD = 0.42 µg/m 3 ) had a high probability of individual association with increased odds of ALS (11.5%; 95% credible interval [CrI] = -1.0%, 25.6%; 96.3% posterior probability of positive association), with negative associations for NO x (SD = 20 µg/m 3 ) (-4.6%; 95% CrI = 18.1%, 8.9%; 27.8% posterior probability of positive association), CO (SD = 106 µg/m 3 ) (-3.2%; 95% CrI = 14.4%, 10.0%; 26.7% posterior probability of positive association), and a null association for nonelemental carbon fine particles (non-EC PM 2.5 ) (SD = 2.37 µg/m 3 ) (0.7%; 95% CrI = 9.2%, 12.4%). We found no association between ALS and joint or average traffic pollution concentrations.

Conclusions: This study found high probability of a positive association between ALS diagnosis and EC concentration. Further work is needed to understand the role of traffic-related air pollution in ALS pathogenesis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Air Pollutants* / analysis
  • Air Pollutants* / toxicity
  • Air Pollution* / adverse effects
  • Air Pollution* / analysis
  • Amyotrophic Lateral Sclerosis* / diagnosis
  • Amyotrophic Lateral Sclerosis* / epidemiology
  • Amyotrophic Lateral Sclerosis* / etiology
  • Bayes Theorem
  • Carbon Monoxide / adverse effects
  • Case-Control Studies
  • Denmark / epidemiology
  • Environmental Exposure / adverse effects
  • Environmental Exposure / analysis
  • Humans
  • Neurodegenerative Diseases*
  • Nitrogen Oxides / analysis
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Vehicle Emissions / analysis
  • Vehicle Emissions / toxicity

Substances

  • Air Pollutants
  • Nitrogen Oxides
  • Particulate Matter
  • Vehicle Emissions
  • Carbon Monoxide