University of Groningen
Pre-symptomatic blood metal levels and the risk of ALS
Peters, S; Broberg, K; van den Berg, L; Gallo, V; Vineis, P; Vermeulen, R
Published in:
Environmental Epidemiology
DOI:
10.1097/01.ee9.0000609388.05310.d9
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Publication date:
2019
Link to publication in University of Groningen/UMCG research database
Citation for published version (APA):
Peters, S., Broberg, K., van den Berg, L., Gallo, V., Vineis, P., & Vermeulen, R. (2019). Pre-symptomatic
blood metal levels and the risk of ALS. Environmental Epidemiology, 3, 311-311.
https://doi.org/10.1097/01.ee9.0000609388.05310.d9
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Abstracts • Environmental Epidemiology (XXX) XXX www.environmentalepidemiology.com
311 examined across studies. Moreover, evidence regarding the association between UFP and cardiovascular disease at a sub-daily timescale is lacking.
Objective: To investigate the relationship between different particle metrics, including particle number (PNC), length (PLC), and surface area (PSC) concentrations, and myocardial infarction (MI) at an hourly timescale.
Methods: We collected hourly air pollution and meteorological data from fixed urban background monitoring sites and hourly nonfatal MI cases from the MONICA/KORA MI registry in Augsburg, Germany during 2005-2015. We conducted a time-stratified case-crossover anal-ysis with conditional logistic regression to estimate the association between hourly particle metrics and MI cases, adjusted for air tempera-ture and relative humidity. We also examined the independent effects of a certain particle metric in two-pollutant models by adjusting for co-pollutants, including particulate matter with an aerodynamic diam-eter ≤10 µm or 2.5 µm (PM10, PM2.5), nitrogen dioxide, ozone, and black carbon.
Results: Overall, a total of 5,898 cases of nonfatal MI cases were recorded. Interquartile range increases in PNC within the size range of 10-100 nm (UFP), PLC, and PSC were associated with an increase of MI six hours later by 3.27% (95% confidence interval [CI]: 0.27%, 6.37%), 5.71% (95% CI: 1.79%, 9.77%), and 5.56% (95% CI: 1.11%, 10.20%), respectively. No association was observed for PNC within the size range of 100-500 nm. The effect estimates for PLC and PSC remained similar after adjustment for PM and gaseous pollutants. The associations were not modified by individual characteristics, co-pollut-ants, or air temperature.
Conclusions: Transient exposure to particle length and surface area concentrations may trigger the onset of myocardial infraction.
Pre-symptomatic blood metal levels and the risk of ALS: a prospective cohort study
on behalf of the EPIC consortium, Peters S1,2, Broberg K3, van den
Berg L2, Gallo V4, Vineis P5, Vermeulen R1,6
1Institute for Risk Assessment Sciences, Utrecht University, 2Department
of Neurology, University Medical Center Utrecht, 3Institute of
Environmental Medicine, Karolinska Institutet, 4Centre for Primary
Care and Public Health, Queen Mary University of London, 5School
of Public Health, Imperial College London, 6Julius Center for Health
Sciences and Primary Care, University Medical Center Utrecht
OPS 40: Metals: neurological effects, Room 412, Floor 4, August 28, 2019, 10:30 AM - 12:00 PM
Background: Metals have been suggested as risk factor for amyo-trophic lateral sclerosis (ALS), but only retrospective studies on this pos-sible association are available to date. We aimed to compare metal levels in prospectively collected blood samples from ALS patients and matched controls, to explore whether metals are associated with ALS risk.
Methods: A nested case-control study for ALS was conducted within a large prospective European cohort. ALS cases were defined as those subjects for whom “motor neuron disease” was reported as an immedi-ate, antecedent or underlying cause of death. We analysed erythrocytes metal levels in stored blood samples that were obtained at recruitment, as a biomarker for metal exposure from any source. Lead, mercury, manganese, selenium, copper, zinc, cadmium and arsenic concentra-tions were measured by sensitive and high-throughput methods, based on inductively coupled plasma-mass spectrometry. To estimate the risk of ALS in relation to pre-symptomatic blood metal levels, we applied conditional logistic regression models, adjusted for educational level, physical activity and smoking.
Results: The study population comprised 107 cases (65% male) and 319 matched controls. The median age at recruitment was 60 and the median time between blood collection at recruitment and ALS death
was 8 years (ranging from 1 to 15 years). Cadmium and lead levels were associated with increased ALS risk, but ORs attenuate after adjustment. Zinc levels were significantly associated with decreased ALS risk, but non-significant when adjusted.
Conclusion: The metal concentrations in pre-symptomatic blood from ALS patients and controls indicated that cadmium and lead may be associated with an increased risk of ALS. This is the first study to compare metal levels before the disease onset, and hence avoiding any reverse causation, and our findings support previous suggestions that these metals play a role in the aetiology of ALS.
Identify Research Gaps for Future Research on Environment, Climate Change and Health
Peters A1, Huss A2, Vermeulen R2
1Helmholtz Zentrum München, 2Utrecht University
.S08: Setting the European Environment and Health Research Agenda, 2020-2030: the HERA project, Room 217, Floor 2, August 26, 2019, 1:30 PM - 3:00 PM
The research gaps existing within the area of environment, climate change and health are identified using three different complementary approaches. First, a classical exposure assessment paradigm is used to assess the research needs according to the urban environment including air pollution, noise, green; biological agents interfacing bacterial, plant and animal origins of exposures; chemicals including endocrine disrup-tors and pesticides; water contamination considering sea, surface and underground water; and ionizing and non-ionizing radiation. Second, a sector- or problem-based approach is used assessing the research needs according to urbanization (including healthy cities); transport and mobil-ity; sustainable food production (including agriculture); energy transition (including fracking); waste, contaminated industrial sites and circular economy; and industrial and occupational changes. Third, research gaps are assessed in holistic approaches to environment and health employing a one health, planetary health perspective and focusing on ecosystems under pressure and ecosystem services; animal and human interactions and health: the role of wild fauna, domestic animals and farming practices in pathogen transmission and evolution; and socioeconomic factors and the environment, environmental injustice. We will present first results of an online expert survey and a face-to-face workshop. We will invite the audience to provide further insights into research gaps and discuss the approaches for prioritization of the research needs.
When Air Pollution Strikes Out of the Blue
Peters A1
1Helmholtz Zentrum München
.S18: Landmarks of Air Pollution Epidemiology: Legacy of Douglas Dockery, Beatrix Theater, August 27, 2019, 1:30 PM - 3:00 PM
Studies assessing the triggering of cardiac events have shown that the impact of ambient air pollution can be life threatening in vulnerable pop-ulations. These studies indicated novel pathophysiological responses to ambient air pollution at the time. The presentation will review the evidence collected as part of studies focusing on vulnerable patient groups. First, it will focus on the role of air pollution to elicit arrhythmia in patients with implanted cardioverter defibrillators. Second, it will review the evidence for ambient air pollution as a trigger of acute myocardial infractions. Thirdly, it will highlight the interplay between panel studies, controlled human exposure studies and studies employing patient records in understand-ing the underlyunderstand-ing mechanisms. This research exemplifies the relevance of considering the timing of exposure response relationships. The exam-ples demonstrate the need to employ different designs and approaches for assessing the acute and severe impact of ambient air pollution and in particular of fine particulate matter. Last but not least, the paper will high-light the role of Douglas Dockery in assembling consistent and coherent evidence for the impact of fine particulate matter on the heart.
