Proximity to Water Pollutant Facilities and Risk of Incident Progressive Supranuclear Palsy

OBJECTIVES: Progressive supranuclear palsy (PSP) is a tauopathy of unknown etiology. Environmental toxin exposure is implicated as a risk factor. The aim of our study was to evaluate whether residential proximity to water pollutant-emitting industrial facilities is associated with incident PSP diagnosis. METHODS: Within the prospective, population-based UK Biobank cohort, we compared incident PSP cases and age- and sex-matched controls by baseline residential proximity to facilities in the European Pollutant Release and Transfer Register (PRTR). RESULTS: Among 221 incident PSP cases (mean [SD] age, 63.0 [5.5] years; 91 women [41.2%]) and 2,249 controls, increased PSP risk was associated with proximity to facilities emitting heavy metals (odds ratio [OR] 1.38; 95% CI 1.03-1.85), pesticides (OR 1.66; 95% CI 1.12-2.46), other organic pollutants (OR 1.52; 95% CI 1.13-2.04), and other inorganic pollutants (OR 1.60; 95% CI 1.19-2.15), after false discovery rate correction. Risk decreased linearly with greater distance (5-10 km), and that residence exceeding 40 years conferred increased risk for heavy metals and organic and inorganic pollutants, unlike shorter residence windows. DISCUSSION: Residential proximity to water pollutant-emitting facilities was associated with incident PSP, with possible evidence of distance-dependent and duration-dependent relationships, supporting a potential role for environmental water pollutants in PSP pathogenesis. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that baseline residential proximity to water pollutant-emitting facilities reported in the 2007 PRTR is associated with a higher risk of subsequent diagnosis of PSP in the UK Biobank.