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

Author

Listed:
  • Pi Guo

    (Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
    These authors contributed equally in this work and they are co‐first authors.)

  • Yulin Wang

    (Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
    These authors contributed equally in this work and they are co‐first authors.)

  • Wenru Feng

    (Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China)

  • Jiagang Wu

    (Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China)

  • Chuanxi Fu

    (Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China)

  • Hai Deng

    (Department of Cardiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China)

  • Jun Huang

    (Department of Cardiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China)

  • Li Wang

    (Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China)

  • Murui Zheng

    (Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China)

  • Huazhang Liu

    (Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, 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.

Suggested Citation

  • Pi Guo & Yulin Wang & Wenru Feng & Jiagang Wu & Chuanxi Fu & Hai Deng & Jun Huang & Li Wang & Murui Zheng & Huazhang Liu, 2017. "Ambient Air Pollution and Risk for Ischemic Stroke: A Short-Term Exposure Assessment in South China," IJERPH, MDPI, vol. 14(9), pages 1-11, September.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:9:p:1091-:d:112566
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    References listed on IDEAS

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    1. Itai Kloog & Brent A Coull & Antonella Zanobetti & Petros Koutrakis & Joel D Schwartz, 2012. "Acute and Chronic Effects of Particles on Hospital Admissions in New-England," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-8, April.
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    Cited by:

    1. Dongyang Nie & Mindong Chen & Yun Wu & Xinlei Ge & Jianlin Hu & Kai Zhang & Pengxiang Ge, 2018. "Characterization of Fine Particulate Matter and Associated Health Burden in Nanjing," IJERPH, MDPI, vol. 15(4), pages 1-12, March.
    2. Yongquan Yu & Huibin Dong & Shen Yao & Minghui Ji & Xingjuan Yao & Zhan Zhang, 2017. "Protective Effects of Ambient Ozone on Incidence and Outcomes of Ischemic Stroke in Changzhou, China: A Time-Series Study," IJERPH, MDPI, vol. 14(12), pages 1-10, December.
    3. Mingrui Cui & Changqing Zhan & Wenjuan Wu & Dandan Guo & Yijun Song, 2022. "Acute Gaseous Air Pollution Exposure and Hospitalizations for Acute Ischemic Stroke: A Time-Series Analysis in Tianjin, China," IJERPH, MDPI, vol. 19(20), pages 1-8, October.
    4. Zesheng Chen & Bin Wang & Yanlin Hu & Lan Dai & Yangming Liu & Jing Wang & Xueqin Cao & Yiming Wu & Ting Zhou & Xiuqing Cui & Tingming Shi, 2022. "Short-Term Effects of Low-Level Ambient Air NO 2 on the Risk of Incident Stroke in Enshi City, China," IJERPH, MDPI, vol. 19(11), pages 1-13, May.
    5. Hwashin Hyun Shin & Wesley S. Burr & Dave Stieb & Lani Haque & Harun Kalayci & Branka Jovic & Marc Smith-Doiron, 2018. "Air Health Trend Indicator: Association between Short-Term Exposure to Ground Ozone and Circulatory Hospitalizations in Canada for 17 Years, 1996–2012," IJERPH, MDPI, vol. 15(8), pages 1-19, July.

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