Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, Canada

Villeneuve, Paul J.; Chen, Li; Stieb, Dave; Rowe, Brian H.

doi:10.1007/s10654-006-9050-9

Cited by 151 publications

(130 citation statements)

References 45 publications

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“…This may be because of over classification with the use of both primary and secondary discharge codes. However, an increase in cardiovascular and respiratory hospitalizations is consistent with the literature [8,16,24,50,66], though some literature has shown no increase in cardiovascular hospitalizations [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] or mortality [67]. Figure 4 displays the percent increase in hospital admissions for the haze period compared to the non-haze period in the affected region for all specific diagnoses of interest with single and distributed lag models.…”

Section: Resultssupporting

confidence: 76%

“…While it is clear that local populations are affected by wildfire events, a growing concern is the potential health impact on geographically distant populations, specifically in susceptible groups such as the elderly. Epidemiologic research has identified the elderly, who are more likely to have pre-existing lung and heart diseases, as a population vulnerable to the effects of short-term exposures to air pollution including fine particles [24,[40][41][42][43][44][45][46][47][48][49][50].…”

Section: Introductionmentioning

confidence: 99%

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Canadian Forest Fires and the Effects of Long-Range Transboundary Air Pollution on Hospitalizations among the Elderly

Breysse

McDermott

et al. 2014

IJGI

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In July 2002, lightning strikes ignited over 250 fires in Quebec, Canada, destroying over one million hectares of forest. The smoke plume generated from the fires had a major impact on air quality across the east coast of the U.S. Using data from the Medicare National Claims History File and the U.S. Environmental Protection Agency (EPA) National air pollution monitoring network, we evaluated the health impact of smoke exposure on 5.9 million elderly people (ages 65+) in the Medicare population in 81 counties in 11 northeastern and Mid-Atlantic States of the US. We estimated differences OPEN ACCESS ISPRS Int. J. Geo-Inf. 2014, 3 714 in the exposure to ambient PM 2.5 -airborne particulate matter with aerodynamic diameter of ≤2.5 µm-concentrations and hospitalizations for cardiovascular, pulmonary and injury outcomes, before and during the smoke episode. We found that there was an associated 49.6% (95% confidence interval (CI), 29.8, 72.3) and 64.9% (95% CI, 44.3-88.5) increase rate of hospitalization for respiratory and cardiovascular diagnoses, respectively, when the smoke plume was present compared to before the smoke plume had arrived. Our study suggests that rapid increases in PM 2.5 concentrations resulting from wildfire smoke can impact the health of elderly populations thousands of kilometers removed from the fires.

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Section: Resultssupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Canadian Forest Fires and the Effects of Long-Range Transboundary Air Pollution on Hospitalizations among the Elderly

Breysse

McDermott

et al. 2014

IJGI

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“…We fitted air pollutants using lag 0-2 (mean of the concurrent day and 2 previous days) based on evidence from published Canadian studies. [32][33][34] We chose daily mean air temperature as our primary exposure, because it represents the exposure throughout the entire day and night. 13 Cold and heat were separately analyzed.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the effect of cold and hot temperatures on mortality in Ontario, Canada: a population-based study

Chen

Wang

et al. 2016

CMAJ Open

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Background: Ambient high temperature is associated with death; however, heat-related risk of death has not been quantified systematically in Ontario, the most populous province in Canada. Less is known about cold-related risk in this population. Our objective was to quantify the health impact from cold and hot temperatures in Ontario. Methods:The study population consisted of all residents of Ontario who died between Jan. 1, 1996, and Dec. 31, 2010, from any nonaccidental cause. A case-crossover analysis was applied to assess the relation between daily temperature fluctuation and deaths from nonaccidental and selected causes in cold (December-February) and warm (June-August) seasons, respectively, adjusting for various potential confounders. Risk estimates were obtained for each census division, then pooled across Ontario. We examined potential effect modification for selected comorbidities and sociodemographic characteristics. Results:In warm seasons, each 5°C increase in daily mean temperature was associated with a 2.5% increase in nonaccidental deaths (95% confidence interval [CI] = 1.3% to 3.8%) on the day of exposure (lag 0). In cold seasons, each 5°C decrease in daily temperature was associated with a 3.0% (95% CI 1.8% to 4.2%) increase in nonaccidental deaths, which persisted over 7 days (lag 0-6). The cold-related effects (lag 0-6) were stronger for cardiovascular-related deaths (any cardiovascular death: 4.1%, 95% CI 2.3% to 5.9%; ischemic heart disease: 5.8%, 95% CI 3.6% to 8.1%), especially among people less than 65 years of age (8.0%, 95% CI 3.0% to 13.0%). Conversely, heat most strongly increased respiratory-related deaths during admission to hospital (26.0%, 95% CI 0% to 61.4%). Across Ontario, each 5°C change in daily temperature was estimated to induce 7 excess deaths per day in cold seasons and 4 excess deaths in warm seasons.Interpretation: Heat contributed to excess deaths in Ontario, although the effect of cold weather appeared to be greater. Further work is required to better define high-risk subgroups, which might include the homeless and people with inadequately heated housing. Abstract Research CMAJ OPENCMAJ OPEN, 4(1) E49

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“…There was, however, an 11% (95% CI, 1-22%) increase in stroke risk in exposed patients with diabetes [88]. A large case-crossover study found an association between other components of air pollution (NO2 and CO) and cerebrovascular disease, but no correlation was noted with changing PM levels [89]. Similarly, a large registry of first-ever strokes found no association with PM 10 for ischemic or hemorrhagic stroke [90].…”

Section: Pm and Cerebrovascular Health Effectsmentioning

confidence: 98%

Clearing the Air: A Review of the Effects of Particulate Matter Air Pollution on Human Health

2011

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The World Health Organization estimates that particulate matter (PM) air pollution contributes to approximately 800,000 premature deaths each year, ranking it the 13th leading cause of mortality worldwide. However, many studies show that the relationship is deeper and far more complicated than originally thought. PM is a portion of air pollution that is made up of extremely small particles and liquid droplets containing acids, organic chemicals, metals, and soil or dust particles. PM is categorized by size and continues to be the fraction of air pollution that is most reliably associated with human disease. PM is thought to contribute to cardiovascular and cerebrovascular disease by the mechanisms of systemic inflammation, direct and indirect coagulation activation, and direct translocation into systemic circulation. The data demonstrating PM's effect on the cardiovascular system are strong. Populations subjected to long-term exposure to PM have a significantly higher cardiovascular incident and mortality rate. Short-term acute exposures subtly increase the rate of cardiovascular events within days of a pollution spike. The data are not as strong for PM's effects on cerebrovascular disease, though some data and similar mechanisms suggest a lesser result with smaller amplitude. Respiratory diseases are also exacerbated by exposure to PM. PM causes respiratory morbidity and mortality by creating oxidative stress and inflammation that leads to pulmonary anatomic and physiologic remodeling. The literature shows PM causes worsening respiratory symptoms, more frequent medication use, decreased lung function, recurrent health care utilization, and increased mortality. PM exposure has been shown to have a small but significant adverse effect on cardiovascular, respiratory, and to a lesser extent, cerebrovascular disease. These consistent results are shown by multiple studies with varying populations, protocols, and regions. The data demonstrate a dose-dependent relationship between PM and human disease, and that removal from a PM-rich environment decreases the prevalence of these diseases. While further study is needed to elucidate the effects of composition, chemistry, and the PM effect on susceptible populations, the preponderance of data shows that PM exposure causes a small but significant increase in human morbidity and mortality. Most sources agree on certain "common sense" recommendations, although there are lonely limited data to support them. Indoor PM exposure can be reduced by the usage of air conditioning and particulate filters, decreasing indoor combustion for heating and cooking, and smoking cessation. Susceptible populations, such as the elderly or asthmatics, may benefit from limiting their outdoor activity during peak traffic periods or poor air quality days. These simple changes may benefit individual patients in both short-term symptomatic control and long-term cardiovascular and respiratory complications.

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Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, Canada

Cited by 151 publications

References 45 publications

Canadian Forest Fires and the Effects of Long-Range Transboundary Air Pollution on Hospitalizations among the Elderly

Canadian Forest Fires and the Effects of Long-Range Transboundary Air Pollution on Hospitalizations among the Elderly

Assessment of the effect of cold and hot temperatures on mortality in Ontario, Canada: a population-based study

Clearing the Air: A Review of the Effects of Particulate Matter Air Pollution on Human Health

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