Relationship Between Hemorrhagic Stroke Hospitalization and Exposure to Fine Particulate Air Pollution in Taipei, Taiwan

Abstract

This study was undertaken to determine whether there was a correlation between fine particle (PM2.5) levels and hospital admissions for hemorrhagic stroke (HS) in Taipei, Taiwan. Hospital admissions for HS and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased HS admissions were significantly associated with PM2.5 levels both on warm days (>23°C) and cool days (<23°C), with an interquartile range rise associated with a 12% (95% CI = 7-18%) and 4% (95% CI = 0-8%) elevation in admissions for HS, respectively. In the two-pollutant models, PM2.5 remained significantly high after inclusion of SO2 or O3 on both warm and cool days. This study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for HS.

Clinical effects of air pollution on the central nervous system; a review

“…PM 2.5 is associated with increased hemorrhagic stroke admissions on both warm (>23 C) and cold (< 23 C) days. [56] Further, PM 2.5 increases the relative risk of hospital admissions caused by ischemic stroke by 11% on warm days (>23 C) and by 4% on cold days (<23 C) in Taiwan. [57] Warm temperature (>13.5 C) was associated with increased hospital admissions for ischemic and hemorrhagic stroke during short-term exposure to PM 2.5 , PM2.5–10 and PM 10 individually.…”

Role of astrocyte activation in fine particulate matter-enhancement of existing ischemic stroke in Sprague-Dawley male rats

“…The relationship between PM 2.5 exposure and stroke hospitalization was reported in several epidemiological investigations Chiu et al, 2014;Wang et al, 2014). Motor, cognitive, and behavioral changes were also noted in humans and animals after airborne PM exposure (Lucchini et al, 2007;Win-Shwe et al, 2008).…”

“…Epidemiological investigations demonstrated that exposure to PM 2.5 increased the risk of developing respiratory diseases and lung cancer (Cui et al, 2015;Pope et al, 2011;Tsai et al, 2014b), as well as enhanced mortality and hospitalization rates for cardiovascular diseases (Chang et al, 2013, Chiu et al, 2014Lipsett et al, 2011;Thurston et al, 2015). Yang et al (2014) and Chiu et al (2014) showed that PM 2.5 exposure was associated with a higher frequency of stroke hospitalizations and mortality in humans. However, the mechanisms underlying PM 2.5 -mediated development of ischemic stroke (IS) are not fully understood.…”

“…The risk factors for stroke include hypertension, smoking, and obesity, among which the environment plays an important role, in particular air pollution (Costa et al, 2014, Tsai et al, 2014aChang et al, 2015;Thurston et al, 2015). Particulate air pollutants are correlated with a marked rise in hospital admissions and stroke mortality (Chiu et al, 2014;Wang et al, 2014;Yang et al, 2014). Thus, animal models of ischemic stroke (IS) were developed to elucidate molecular mechanisms and pathophysiology underlying development of IS.…”

Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London Stroke Register: a case–cross-over analysis

“…Haemorrhagic stroke is less common than ischaemic stroke leading to lower statistical power and fewer studies considering it as a separate outcome. However, two recently published studies in Taiwan provided evidence of positive associations between hospital admission for haemorrhagic stroke and exposure to PM 2.5 (particularly on warm days), 4 and between emergency room visits for haemorrhagic stroke and the same day exposure to the PM 2.5 components nitrate and elemental carbon. 5 Further studies with sufficient information to distinguish between stroke subtypes (eg, ischaemic and haemorrhagic) are therefore required.…”