Ambient Air Pollution and Risk for Ischemic Stroke: A Short-Term Exposure Assessment in South China

Abstract

Data on the association between air pollution and risk of ischemic stroke in China are still limited. This study aimed to investigate the association between short-term exposure to ambient air pollution and risk of ischemic strokes in Guangzhou, the most densely-populated city in south China, using a large-scale multicenter database of stroke hospital admissions. Daily counts of ischemic stroke admissions over the study years 2013-2015 were obtained from the Guangzhou Cardiovascular and Cerebrovascular Disease Event Surveillance System. Daily particulate matter <2.5 µm in diameter (PM 2.5 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), ozone (O 3 ), and meteorological data were collected. The associations between air pollutants and hospital admissions for stroke were examined using relative risks (RRs) and their corresponding 95% confidence intervals (CIs) based on time-series Poisson regression models, adjusting for temperature, public holiday, day of week, and temporal trends in stroke. Ischemic stroke admissions increased from 27,532 to 35,279 through 2013 to 2015, increasing by 28.14%. Parameter estimates for NO 2 exposure were robust regardless of the model used. The association between same-day NO 2 (RR = 1.0509, 95% CI: 1.0353-1.0668) exposure and stroke risk was significant when accounting for other air pollutants, day of the week, public holidays, temperature, and temporal trends in stroke events. Overall, we observed a borderline significant association between NO 2 exposure modeled as an averaged lag effect and ischemic stroke risk. This study provides data on air pollution exposures and stroke risk, and contributes to better planning of clinical services and emergency contingency response for stroke.

Association of short-term exposure to sulfur dioxide and hospitalization for ischemic and hemorrhagic stroke in Guangzhou, China

“…For example, the most informative pollutant of traffic emissions NO 2 . The association were comparable to previously studies [6,11,12,16].…”

“…However, in developing countries like China, the evidence is limited and very few studies [11] distinguished between ischemic and hemorrhagic stroke. Most studies only focused on ischemic stroke but the results have not been conclusive yet, with some finding evidence of a positive association [12] but not in other studies [13][14][15][16].…”

“…Guangzhou is one of the most densely populated cities in China. The industrial production and traffic burden make SO 2 one of the main atmospheric pollution sources in Guangzhou [16], which is severer than those in developed countries [17]. Moreover, the stroke mortality in Guangzhou was relatively higher compared to other cities of China [18].…”

Air Health Trend Indicator: Association between Short-Term Exposure to Ground Ozone and Circulatory Hospitalizations in Canada for 17 Years, 1996–2012

“…Based on this tracking tool, we examined the trend in national-level annual circulatory hospitalizations (in particular, IHD, OHD and CEV) known to be associated with short-term exposure to ozone [2,3,9,25,42]. For the warm season over the study time period of 1996–2012 there were overall gradual declines for OHD, and mixed trends of incline and decline for IHD and CEV in the annual risks for the base group of all ages, both sexes (fm1+).…”

Status of Air Quality with Potential Linkage to the Metrological Conditions in Three Major Cities of Pakistan

“…Urban air pollution is rapidly becoming an environmental problem of public concern worldwide. Urbanization and industrialization with an unsustainable use of resources aggravates the problem (Guo et al, 2017;Parekh et al, 2001). Anthropogenic particles are emitted directly into the atmosphere from combustion and industrial processes in the urban areas that contributes to the drastic rise in air pollution (Di et al, 2017a;2017b;Katsouyanni et al, 1993).…”