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Association of short-term exposure to ambient air pollution with mortality from ischemic and hemorrhagic stroke

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单位: [1]Sun Yat Sen Univ, Sch Publ Hlth, Dept Epidemiol, 74 Zhongshan Second Rd, Guangzhou 510080, Guangdong, Peoples R China [2]Jiangsu Prov Ctr Dis Control & Prevent, Dept Environm & Hlth, 172 Jiangsu Rd, Nanjing 210009, Jiangsu, Peoples R China [3]Univ Maryland, Dept Atmospher & Ocean Sci, Earth Syst Sci Interdisciplinary Ctr, College Pk, MD 20742 USA [4]Guangzhou Med Univ, State Key Lab Resp Dis, Affiliated Hosp 1, Guangzhou, Peoples R China [5]Guangzhou Med Univ, Sch Publ Hlth, Dept Prevent Med, Guangzhou, Guangdong, Peoples R China [6]Luohu Dist Chron Dis Hosp, Shenzhen, Peoples R China [7]Natl Meteorol Informat Ctr, Meteorol Data Lab, Beijing, Peoples R China [8]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Neurol,Wuhan,Peoples R China [9]Sun Yat Sen Univ, Sch Publ Hlth, Dept Occupat & Environm Hlth, Guangzhou, Peoples R China [10]Hubei Prov Ctr Dis Control & Prevent, Inst Chron Noncommunicable Dis Control & Prevent, Wuhan, Peoples R China
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关键词: air pollution case-crossover study hemorrhagic stroke ischemic stroke mortality

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Background Short-term exposure to ambient air pollution has been linked to increased risk of stroke mortality, but its adverse effects on mortality from specific types of stroke including ischemic stroke and hemorrhagic stroke remain poorly understood. Methods Using the China National Mortality Surveillance System, we conducted a time-stratified case-crossover study among 412,567 stroke deaths in Jiangsu province, China during 2015-2019. Residential daily PM2.5, PM10, SO2, NO2, CO, and O-3 exposure concentrations were extracted from the ChinaHighAirPollutants dataset for each subject. Conditional logistic regression models were performed to conduct exposure-response analyses. Results Each 10 mu g/m(3) increase of PM2.5, PM10, SO2, NO2, CO, and O-3 was respectively associated with a 1.44%, 0.93%, 5.55%, 2.90%, 0.148%, and 0.54% increase in odds of mortality from ischemic stroke, which was significantly stronger than that from hemorrhagic stroke (percent change in odds: 0.74%, 0.51%, 3.11%, 1.15%, 0.090%, and 0.10%). The excess fraction of ischemic stroke mortality associated with PM2.5, PM10, SO2, NO2, CO, and O-3 exposure was 6.90%, 6.48%, 8.21%, 8.61%, 9.67%, and 4.76%, respectively, which was also significantly higher than that of hemorrhagic stroke mortality (excess fraction: 3.49%, 3.48%, 4.69%, 3.48%, 5.86%, and 0.88%). These differences in adverse effects generally remained across sex, age, and season. Conclusions Short-term exposure to ambient air pollution was significantly associated with increased risk of both ischemic and hemorrhagic stroke mortality and posed considerable excess mortality. Our results suggest that air pollution exposure may lead to substantially greater adverse effects on mortality from ischemic stroke than that from hemorrhagic stroke.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 神经科学
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大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 神经科学
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Q1 NEUROSCIENCES Q1 CLINICAL NEUROLOGY
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Q1 CLINICAL NEUROLOGY Q1 NEUROSCIENCES

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第一作者单位: [1]Sun Yat Sen Univ, Sch Publ Hlth, Dept Epidemiol, 74 Zhongshan Second Rd, Guangzhou 510080, Guangdong, Peoples R China
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