Air pollution positively correlates with daily stroke admission and in hospital mortality: a study in the urban area of Como, Italy

Vidale, Simone; Bonanomi, Andrea; Guidotti, Mario; Arnaboldi, Marco; Sterzi, Roberto

doi:10.1007/s10072-009-0206-8

Cited by 41 publications

(33 citation statements)

References 12 publications

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“…An interesting area for investigation will be the relationship of variations in life-style-related and demo-topographic factors and acute cardiovascular fatality in relation to air pollution. Over the last decade, the epidemiological studies have demonstrated potential deleterious effects of ambient air pollution on health and its relation to heart disease and stroke, including increased risk for triggering of acute cardiovascular events [36,37,38,39,40,41,42], hospital admission for acute exacerbation of patients with congestive heart failure [43], or ventricular arrhythmias [44]. Although the mechanisms have not been fully elucidated, current evidence suggests that alterations in hemodynamics [36,45], hemostatic factors [46,47], vasoconstriction [48], and autonomic function [49] may underlie the cardiovascular effects of air pollution.…”

Section: Discussionmentioning

confidence: 99%

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Turin

Kita²,

Rumana³

et al. 2012

Cerebrovasc Dis

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Background: Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low. Methods: We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference. Results: There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988–2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 µg/m³, SO₂ 3.9 ppb, NO₂ 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO₂ showed increased fatality risk. In multi-pollutant model, the highest quartile of NO₂ was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO₂. In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06–2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality. Conclusion: We observed association between NO₂ levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities.

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Section: Discussionmentioning

confidence: 99%

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Turin

Kita²,

Rumana³

et al. 2012

Cerebrovasc Dis

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“…We have identified 18 studies, which fulfilled these criteria (Table 4). [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] ACUTE EFFECTS OF PARTICULATE MATTER EXPOSURE Although most studies on PM and cardiovascular diseases have been conducted in developed western countries, first impulses for epidemiologic research on IS came from South Korea and Taiwan. 15,22,25 An increase in PM by an interquartile range in Seoul was associated with a 3% higher IS mortality.…”

Section: Particulate Matter and Human Health Particulate Matter Is A mentioning

confidence: 99%

“…20,27,28 Only three results reached the level of significance. 14,16,25 This reveals limitations of comparing air pollution and its influence on health outcomes globally. The composition of PM varies dramatically dependent on pollution sources like car traffic or industry.…”

Section: Particulate Matter and Human Health Particulate Matter Is A mentioning

confidence: 99%

Impact of Particulate Matter Exposition on the Risk of Ischemic Stroke: Epidemiologic Evidence and Putative Mechanisms

Bornstädt

Kunz

Endres

2013

J Cereb Blood Flow Metab

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Ambient particulate matter (PM) pollution is estimated to be responsible for 3.2 million deaths annually worldwide. Although many studies have demonstrated PM as a serious risk factor for cardiovascular diseases, less is known on its association with cerebrovascular events. Over the last decade, however, an increasing number of studies have provided data showing a relationship between PM exposure and ischemic stroke (IS). In this article, we will report on existing epidemiologic findings for an association between PM exposure and IS based on a systemic literature search. Thus, despite inconsistencies in the results, currently available data suggest that PM exposure is a risk factor for IS, especially in patients with preexisting illnesses. With regards to the mechanisms leading to PM-dependent vascular damage, in particular proinflammatory, prooxidative, as well as proatherogenic pathways have been suggested to be involved. Notably, to date there is only one study published, which demonstrates the influence of PM exposure on cerebrovascular function. We will discuss reasonable approaches for future neurovascular research in this field.

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“…PM 2.5 , NO 2 , particulate matter with aerodynamic diameter r10 mm (PM 10 ), carbon monoxide (CO) and ozone are the most commonly observed pollutants associated with ischemic stroke admissions. [8][9][10][11][12][13] Our previous study found that increased levels of NO 2 and CO contributed to an increased incidence of ED visits for acute ischemic stroke among the elderly aged 65 years and older in the warm season. 12 The purpose of the present analysis is to examine 1) the validity of the AQHI in predicting morbidity risk for acute ischemic stroke; 2) the three pollutants (O 3 , PM 2.5 , NO 2 ) used for AQHI calculation, of which individual pollutants are most consistent with observed associations with the AQHI; and 3) whether observed associations are more pronounced in the elderly.…”

Section: Introductionmentioning

confidence: 98%

The Air Quality Health Index as a predictor of emergency department visits for ischemic stroke in Edmonton, Canada

Chen

Villeneuve

Rowe

et al. 2013

J Expo Sci Environ Epidemiol

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The Air Quality Health Index (AQHI) is an aggregate measure of outdoor air quality. We investigated associations between the AQHI and emergency department (ED) visits for acute ischemic stroke to validate the AQHI as a predictor of risk of morbidity from stroke. ED visits in Edmonton, Canada between 1998 and 2002 were linked to hourly AQHI values and concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), ozone, particulate matter with aerodynamic diameter less than 2.5 and 10 μm, and sulfur dioxide. A time-stratified case-crossover analysis was employed, and measures of association were adjusted for temperature and relative humidity. The AQHI, NO2 and CO were positively associated with the number of ED visits for ischemic stroke during April-September, and associations were strongest for persons 75 years of age and older. In this age range, the odds ratios (95% confidence intervals) for an interquartile range increase of AQHI in 1-24 h, 25-48 h, and 1-72 h lag periods were 1.23 (1.08-1.40), 1.15 (1.01-1.31), and 1.30 (1.10-1.54), respectively. Significant positive associations were also observed for NO2 and CO. Our finding that ED visits for stroke were significantly associated with the AQHI suggests that the AQHI may be a valid communication tool for air pollution morbidity effects related to stroke.

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Air pollution positively correlates with daily stroke admission and in hospital mortality: a study in the urban area of Como, Italy

Cited by 41 publications

References 12 publications

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Impact of Particulate Matter Exposition on the Risk of Ischemic Stroke: Epidemiologic Evidence and Putative Mechanisms

The Air Quality Health Index as a predictor of emergency department visits for ischemic stroke in Edmonton, Canada

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