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Influence of PM 2.5 Exposure Level on the Association between Alzheimer’s Disease and Allergic Rhinitis: A National Population-Based Cohort Study

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  • Ruo-Ling Li

    (Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Medical Management, Division of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan)

  • Yung-Chyuan Ho

    (School of Medical Applied Chemistry, Chung Shan Medical University, Taichung 40201, Taiwan)

  • Ci-Wen Luo

    (Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan)

  • Shiuan-Shinn Lee

    (Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan)

  • Yu-Hsiang Kuan

    (Department of Pharmacology, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
    Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan)

Abstract

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease that leads to dementia, health impairment, and high economic cost. Allergic rhinitis (AR) is a chronic inflammatory and allergic disease of the respiratory system that leads to health problems and has major effects on the daily lives of patients and their caregivers. Particulate matter (PM) refers to air pollutants 2.5 μm or less in diameter that are a source of concern because of their role in numerous diseases, including AR and other neurodegenerative diseases. To date, no study has demonstrated how PM 2.5 exacerbates AR and results in AD. We conducted a national population-based cohort study by obtaining patient data from the National Health Insurance Research Database of Taiwan for the 2008–2013 period. PM 2.5 concentration data were obtained from the ambient air quality monitoring network established by the Environmental Protection Administration of Taiwan. Monthly PM 2.5 exposure levels were categorized into quartiles from Q1–Q4. The Cox proportional hazards analysis, after adjusting for age, sex, low income, and urbanization level, revealed that patients with AR had an elevated risk of developing AD (hazard ratio (HR): 2.008). In addition, the cumulative incidence of AD in the AR group was significantly higher than in the comparison group. The PM 2.5 levels at Q2–Q4 (crude HR: 1.663–8.315; adjusted HR: 1.812–8.981) were stratified on the basis of the PM 2.5 exposure group and revealed that AR patients exposed to PM 2.5 are significantly prone to develop AD. In addition, the logistic regression analyses, after adjustment, demonstrated that an increase in the PM 2.5 exposure level at Q2–Q4 (adjusted odds ratio (OR): 2.656–5.604) increased the risk of AR in AD patients. In conclusion, an increased PM 2.5 exposure level could be correlated with AR, which could in turn cause AD. AR increased the risk of AD, in which exposure to PM 2.5 increases the higher probability of AD.

Suggested Citation

  • Ruo-Ling Li & Yung-Chyuan Ho & Ci-Wen Luo & Shiuan-Shinn Lee & Yu-Hsiang Kuan, 2019. "Influence of PM 2.5 Exposure Level on the Association between Alzheimer’s Disease and Allergic Rhinitis: A National Population-Based Cohort Study," IJERPH, MDPI, vol. 16(18), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3357-:d:266272
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    References listed on IDEAS

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    1. Bo Teng & Xuelei Zhang & Chunhui Yi & Yan Zhang & Shufeng Ye & Yafang Wang & Daniel Q. Tong & Binfeng Lu, 2017. "The Association between Ambient Air Pollution and Allergic Rhinitis: Further Epidemiological Evidence from Changchun, Northeastern China," IJERPH, MDPI, vol. 14(3), pages 1-18, February.
    2. Lin, Yen-Ju & Tian, Wei-Hua & Chen, Chun-Chih, 2011. "Urbanization and the utilization of outpatient services under National Health Insurance in Taiwan," Health Policy, Elsevier, vol. 103(2), pages 236-243.
    3. Anders Bjerg & Linda Ekerljung & Roelinde Middelveld & Sven-Erik Dahlén & Bertil Forsberg & Karl Franklin & Kjell Larsson & Jan Lötvall & Inga Sif Ólafsdóttir & Kjell Torén & Bo Lundbäck & Christer Ja, 2011. "Increased Prevalence of Symptoms of Rhinitis but Not of Asthma between 1990 and 2008 in Swedish Adults: Comparisons of the ECRHS and GA2LEN Surveys," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-10, February.
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    2. Ming Zeng & Jiang Du & Weike Zhang, 2019. "Spatial-Temporal Effects of PM 2.5 on Health Burden: Evidence from China," IJERPH, MDPI, vol. 16(23), pages 1-23, November.
    3. Yingjie Liu & Chan Lu & Yuguo Li & Dan Norbäck & Qihong Deng, 2022. "Outdoor Air Pollution and Indoor Window Condensation Associated with Childhood Symptoms of Allergic Rhinitis to Pollen," IJERPH, MDPI, vol. 19(13), pages 1-12, June.
    4. Ci-Wen Luo & Yun-Wei Chiang & Han-Yin Sun & Kun-Lin Yeh & Min-Wei Lee & Wen-Jun Wu & Yu-Hsiang Kuan, 2022. "Fine Particulate Matter Exposure Levels in Patients with Normal-Tension Glaucoma and Primary Open-Angle Glaucoma: A Population-Based Study from Taiwan," IJERPH, MDPI, vol. 19(7), pages 1-12, April.

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