Abstract
Air pollution has been suggested as a potential environmental risk factor for Parkinson's disease (PD), but findings remain inconsistent, and sex-specific effects are understudied. This study examined associations between exposure to nitrogen dioxide (NO2) and particulate matter ≤ 10 µm (PM10) and incident PD, using data from the UK Biobank. Annual levels of NO2 (2005-2007) and PM10 (2007) were estimated based on residential addresses. Logistic regression models assessed the associations between air pollution exposure and PD onset, adjusting for age, sex, smoking status, and family history of PD. Competing risk models and inverse probability weighting were applied to address survivorship bias and missing data. Sex-stratified analyses explored potential differences by sex. Among 210,417 participants (mean follow-up = 9.17 years), 2592 developed PD. Higher exposure to both NO2 and PM10 was associated with increased PD risk. In sex-specific models, the associations remained significant in males but not in females. Competing risk models confirmed elevated PD risk with NO2 (HR = 1.05; 95 % CI: 1.01-1.09) and PM10 (HR = 1.08; 95 % CI: 1.03-1.13) in the overall cohort, with similar or stronger associations in males (NO2: HR = 1.07; 95 % CI: 1.02-1.13; PM10: HR = 1.07; 95 % CI: 1.02-1.14). In conclusion, long-term exposure to NO2 and PM10 was linked to increased PD risk, particularly in males. These findings highlight the importance of incorporating sex-specific analyses in environmental research on PD.</p>