Fine particulate air pollution and occurrence of spontaneous intracerebral hemorrhage in an area of low air pollution

Nzwalo, Hipólito; Guilherme, Patrı́cia; Nogueira, Jerina; Félix, Catarina; André, Ana; Teles, Joana; Mouzinho, Maria Manuel; Ferreira, Fátima; Marreiros, Ana; Logallo, Nicola; Bentes, Carla

doi:10.1016/j.clineuro.2018.11.022

Cited by 17 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only a small number of studies have investigated haemorrhagic stroke, separate from all-cause stroke. 18,19,20,21,25,[30][31][32][33]38,39,61 Even fewer studies have focused specifically on intracerebral haemorrhage. 11,30,49,62,63 One Taiwanese study reported a 12% risk increase in intracerebral haemorrhage admis sions per 17•46 µg/m³ (IQR) increased PM 2•5 levels on the day of stroke compared to other days.…”

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

“…18,19,20,21,25,[30][31][32][33]38,39,61 Even fewer studies have focused specifically on intracerebral haemorrhage. 11,30,49,62,63 One Taiwanese study reported a 12% risk increase in intracerebral haemorrhage admis sions per 17•46 µg/m³ (IQR) increased PM 2•5 levels on the day of stroke compared to other days. 63 A 2019 study of just under 400 patients showed a 5•7% (95% CI 1•02-1•10; p=0•002) increased risk of spontaneous intracerebral haemorrhage per 10 µg/m³ increase of PM 2•5 concentration.…”

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

“…The same study reported a higher risk of non-lobar intracerebral haemorrhage versus lobar intracerebral haemorrhage. 30 Non-lobar intracerebral haemorrhage usually results from chronic damage to the basal ganglia, thalamus, internal or external capsule, brainstem, and cerebellum due to several vascular risk factors, including hypertension (small vessel disease). Lobar intracerebral haemorrhage is often caused by cerebral amyloid angiopathy, but hypertension is also an important risk factor.…”

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

“…[18][19][20] This finding might suggest that air pollutants exclusively increase intracerebral haemor rhage risk and not subarachnoid haemorrhage. 19,30,63 The long-term exposure to air pollution and risk of haemorrhagic stroke All long-term exposure studies have used haemorrhagic stroke, and not intracerebral haemorrhage, as an outcome. 4,[46][47][48][49] Two recent European studies did not find any association between PM 2•5 exposure and incident haemorrhagic stroke during a mean follow-up of over 15 years.…”

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

See 3 more Smart Citations

Ambient air pollution and the risk of ischaemic and haemorrhagic stroke

Verhoeven

Allach

Vaartjes

et al. 2021

The Lancet Planetary Health

111

View full text Add to dashboard Cite

Stroke is a leading cause of disability and the second most common cause of death worldwide. Increasing evidence suggests that air pollution is an emerging risk factor for stroke. Over the past decades, air pollution levels have continuously increased and are now estimated to be responsible for 14% of all stroke-associated deaths. Interpretation of previous literature is difficult because stroke was usually not distinguished as ischaemic or haemorrhagic, nor by cause. This Review summarises the evidence on the association between air pollution and the different causes of ischaemic stroke and haemorrhagic stroke, to clarify which people are most at risk. The risk for ischaemic stroke is increased after short-term or long-term exposure to air pollution. This effect is most pronounced in people with cardiovascular burden and stroke due to large artery disease or small vessel disease. Short-term exposure to air pollution increases the risk of intracerebral haemorrhage, a subtype of haemorrhagic stroke, whereas the effects of long-term exposure are less clear. Limitations of the current evidence are that studies are prone to misclassification of exposure, often rely on administrative data, and have insufficient clinical detail. In this Review, we provide an outlook on new research opportunities, such as those provided by the decreased levels of air pollution due to the current COVID-19 pandemic.

show abstract

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 99%

See 2 more Smart Citations

Ambient air pollution and the risk of ischaemic and haemorrhagic stroke

Verhoeven

Allach

Vaartjes

et al. 2021

The Lancet Planetary Health

111

View full text Add to dashboard Cite

show abstract

“…In one study of 368 cases of small-vessel attributed ICH, short term exposure to increased PM2.5 was greater on the three days preceding the hemorrhage compared to a control period 15-17 days prior to the index event. 106 A second study of 517 patients did not identify any association between PM2.5, black carbon, or nitrogen dioxide, and ICH, and used a similar design comparing exposures 1-7 days prior to the hemorrhage to a referent set of days in the same month. 107 PM2.5 and PM10 were not shown to associate with hemorrhagic stroke in a large Chinese study involving 69,399 subjects.…”

Section: Resultsmentioning

confidence: 99%

Neurology in a Changing Climate: A Scoping Review

Louis

Carlson

Suresh

et al. 2021

Preprint

View full text Add to dashboard Cite

ImportanceAlthough the international community collectively seeks to reduce global temperature rise to less than 1.5ºC, there are already irreversible environmental changes that have occurred, and currently available evidence suggests these changes will continue to occur. As we begin to witness the effects of a warming planet on human health, it is imperative that as neurologists we anticipate the ways in which the epidemiology and incidence of neurologic disease may be affected.ObjectiveIn this review, we organize our analysis around three key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuro-infectious diseases, and pollutant impacts. Across each of these key themes, we appraise and review recent literature relevant to neurological disease and the practice of neurology.Evidence ReviewStudies were identified using a set of relevant search terms relating to climate change and neurologic diseases in the PubMed repository for publications between 1990 and 2021. Studies were included if they pertained to human incidence or prevalence of disease, were in the English language, and were relevant to neurologic disease.FindingsWe identified a total of 136 articles, grouped into the three key themes of our study; extreme weather events and temperature fluctuations (23 studies), emerging neuro-infectious diseases (42 studies), and pollutant impacts (71 studies). Broadly, the studies included highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity.Conclusions and RelevanceOur work highlights three key priorities for further work; namely, neuro-infectious disease risk mitigation, an understanding of the pathophysiology of airborne pollutants on the nervous system, and research into how to improve delivery of neurologic care in the face of climate-related disruptions.Key PointsQuestionHow does climate change impact neurological disease?Findings136 articles were identified relating neurologic disease to climate change. Articles were grouped into three key themes, highlighting evidence linking neurologic disease exacerbation to temperature fluctuation, tick-borne infections with climate change, and airborne pollutants to cerebrovascular disease.MeaningA substantial body of literature suggests that neurologic disease incidence, morbidity, and mortality is directly impacted by climate change and its sequelae, but much remains to be uncovered.

show abstract