Association of Ambient Particulate Matter Pollution of Different Sizes With In-Hospital Case Fatality Among Stroke Patients in China

Cai, Miao; Zhang, Shiyu; Lin, Xiaojun; Qian, Zhengmin; McMillin, Stephen Edward; Yang, Yin; Zhang, Zilong; Pan, Jay; Lin, Hualiang

doi:10.1212/wnl.0000000000200546

Cited by 42 publications

(21 citation statements)

References 47 publications

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“…Public holidays (PHs) and days of the week (DOW) were adjusted for as dummy variables in the models. Temporal trends, daily mean temperature, and relative humidity were controlled for as natural cubic splines ( 28 ). Degree of freedom (df) was selected by referring to Akaike Information Criterion (AIC), and we chose 5 df per year for temporal trends and 3 df for the daily mean temperature and relative humidity.…”

Section: Methodsmentioning

confidence: 99%

Daily diurnal temperature range associated with outpatient visits of acute lower respiratory infection in children: A time-series study in Guangzhou, China

Zhang

Xu²,

Chen³

et al. 2022

Front. Public Health

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BackgroundDiurnal temperature range (DTR) has been increasingly recognized as a risk factor for mortality and morbidity, but the association between DTR and acute lower respiratory infection (ALRI) outpatient visits has not been examined among children in China.MethodsA total of 79,416 ALRI outpatient visits among children were obtained from the Guangdong Second Provincial General Hospital between 2013 and 2019. DTR was calculated by taking the difference between the maximum and the minimum temperatures. Generalized additive models using a quasi-Poisson distribution were used to model the relationship between DTR and ALRI outpatient visits.ResultsDiurnal temperature range was significantly associated with elevated risks of ALRI outpatient visits: the excess risks (ERs) and 95% confidence intervals (CIs) were 2.31% (1.26, 3.36%) for ALRI, 3.19% (1.86, 4.54%) for pneumonia, and 1.79% (0.59, 3.01%) for bronchiolitis, respectively. Subgroup analyses suggested that the associations were significantly stronger during rainy seasons (ER for ALRI: 3.02%, 95% CI: 1.43, 4.64%) than those in dry seasons (ER for ALRI: 2.21%, 95% CI: 0.65, 3.81%), while no significant effect modifications were found in sex and age groups.ConclusionDiurnal temperature range may elevate the risk of ALRI outpatient visits among children in China, especially during rainy seasons. Public health policies are needed to mitigate the adverse health impacts of DTR on children.

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Section: Methodsmentioning

confidence: 99%

Daily diurnal temperature range associated with outpatient visits of acute lower respiratory infection in children: A time-series study in Guangzhou, China

Zhang

Xu²,

Chen³

et al. 2022

Front. Public Health

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“…Strong associations and negative effects between ambient gaseous pollution (e.g., NO2, SO2, and CO) and a variety of diseases has been demonstrated for people of all ages through multiregional and national cohort studies in China. These diseases include general mortality , cause-specific cardiovascular disease (Xu et al, 2022a), ischemic and hemorrhagic stroke (Xu et al, 2022b;Wu et al, 2022b;Cai et al, 2022;He et al, 2022), dementia mortality (Liu et al, 2022), blood pressure (Song et al, 2022;Wu et al, 2022a), renal function (Li et al, 2022a), neurodevelopmental delay (Su et al, 2022), serum liver enzymes , overweight and obesity , insomnia (Xu et al, 2021), subjective sleep quality (Wang et al, 2022), and visual impairment (Chen et al, 2022a). These studies attest well to the value of the CHAP dataset with some unique merits for the sake of public health, among others, now and in the future.…”

Section: Successful Applicationsmentioning

confidence: 99%

Ground-level gaseous pollutants across China: daily seamless mapping and long-term spatiotemporal variations

Wei

Wang

et al. 2022

Preprint

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Abstract. Gaseous pollutants at the ground level seriously threaten the urban air quality environment and public health. There are few estimates of gaseous pollutants that are spatially and temporally resolved and continuous over long periods in China. This study takes advantage of big data and artificial intelligence technologies to generate seamless daily maps of three major pollutant gases, i.e., NO2, SO2, and CO, across China from 2013 to 2020 at a uniform spatial resolution of 10 km. Cross-validation illustrated a high data quality on a daily basis for NO2, SO2, and CO, with mean out-of-bag coefficients of determination (root-mean-square errors) of 0.84 (7.99 μg/m3), 0.84 (10.7 μg/m3), and 0.80 (0.29 mg/m3), respectively. They have experienced significant declines and then recoveries during and after the COVID-19 lockdown associated with changes in anthropogenic emissions in eastern China, while surface CO recovered faster than SO2 and NO2. All gaseous pollutants decreased significantly by 0.23, 2.01, and 49 μg/m3 per year (p < 0.001) across China during 2013–2020, especially in three urban agglomerations. The declining rates were larger during 2013–2017 but slowed down in recent years. Both the areas and occurrence probabilities of days exceeding air quality standards also gradually shrank and weakened over time, especially for SO2 and CO, which almost disappeared during 2018–2020, suggesting significant improvements in air quality in China. This reconstructed dataset of surface gaseous pollutants, i.e., ChinaHighNO2, ChinaHighSO2, and ChinaHighCO, will benefit future (especially short-term) air pollution and environmental health-related studies.

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“…It has been well documented that air pollution is associated with morbidity and mortality of stroke and cardiovascular diseases [7][8][9][10] ; limited information exists about the effect of air pollution on the clinical trajectory of stroke. A retrospective cohort study of 96,582 adults from Kaiser Permanente Northern California reported significant associations between particle pollution and poststroke cardiovascular mortality among adults with a history of stroke.…”

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confidence: 99%

Air Pollution Associated With Incident Stroke, Poststroke Cardiovascular Events, and Death

Tian¹,

Cai²,

Li³

et al. 2022

Neurology

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Background:Ambient air pollution has been widely linked with morbidity and mortality of stroke. However, its effects on dynamic progression trajectory of stroke remain unknown.Objective:To investigate the effects of ambient air pollution on progression trajectory from healthy to incident stroke, post-stroke cardiovascular diseases, and subsequent death.Methods:We retrieved 318,752 participants from the UK Biobank. The annual concentrations of air pollution [particulate matter (PM2.5, PMcoarse, PM10 and PM2.5 absorbance), nitrogen dioxide (NO2), and nitrogen oxides (NOx)] were estimated through land-use regressions. A multi-state regression model was employed to investigate the effects of air pollution on each stage of the progression of stroke.Results:During 3,765,630 person-years of follow-up, we identified 5,967 incident stroke patients, 2,985 post-stroke cardiovascular patients, and 1,020 deaths afterward. Each 5 μg/m3 increase in PM2.5, NO2, and NOx was associated with the transition from healthy to incident stroke [Hazard Ratios (HRs) (95% confidence intervals (CI)) = 1.24 (1.10, 1.40); 1.02 (1.00, 1.03); 1.01 (1.00, 1.02)] and transitions from healthy to death directly [1.30 (1.21, 1.40); 1.03 (1.02, 1.04); 1.02 (1.01, 1.02)]. We also observed positive associations for post-stroke CVDs, especially for NO2 [1.04 (95% CI: 1.02, 1.06)], but these effects gradually declined for mortality outcome.Conclusion:This study provides the first evidence that ambient air pollution is one important factor associated with the progression of stroke, and the effects differed across different clinical stages. A better understanding of the differential effects of air pollutants on different stroke transition stages could provide valuable insight toward targets for health management and clinical prevention.

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Association of Ambient Particulate Matter Pollution of Different Sizes With In-Hospital Case Fatality Among Stroke Patients in China

Cited by 42 publications

References 47 publications

Daily diurnal temperature range associated with outpatient visits of acute lower respiratory infection in children: A time-series study in Guangzhou, China

Daily diurnal temperature range associated with outpatient visits of acute lower respiratory infection in children: A time-series study in Guangzhou, China

Ground-level gaseous pollutants across China: daily seamless mapping and long-term spatiotemporal variations

Air Pollution Associated With Incident Stroke, Poststroke Cardiovascular Events, and Death

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