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Particulate Air Pollution Exposure and Stroke among Adults in Israel

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Listed:
  • Britney Gaines

    (Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA)

  • Itai Kloog

    (Department of Geography and Environmental Development, Ben Gurion University, Beer Sheva 8410501, Israel)

  • Inbar Zucker

    (Ministry of Health, Jerusalem 9446724, Israel)

  • Gal Ifergane

    (Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
    Neurology Department, Soroka University Medical Center, Beer Sheva 8410101, Israel)

  • Victor Novack

    (Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
    Clinical Research Center, Soroka University Medical Center, Beer Sheva 8410101, Israel
    Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel)

  • Carmit Libruder

    (Ministry of Health, Jerusalem 9446724, Israel)

  • Yael Hershkovitz

    (Ministry of Health, Jerusalem 9446724, Israel)

  • Perry E. Sheffield

    (Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
    Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA)

  • Maayan Yitshak-Sade

    (Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA)

Abstract

Stroke is the second most common cause of death and disability in the world. Many studies have found fine particulate matter (PM 2.5 ) exposure to be associated with an increased risk of atherosclerotic cardiovascular disease, mostly focusing on ischemic heart disease and acute myocardial infarction. In a national analysis conducted in Israel—an area with unique climate conditions and high air pollution levels, we estimated the association between short-term PM 2.5 exposure and ischemic stroke, intracerebral hemorrhage (ICH), or transient ischemic attacks (TIA). Using the Israeli National Stroke Registry, we obtained information on all stroke cases across Israel in 2014–2018. We obtained daily PM 2.5 exposures from spatiotemporally resolved exposure models. We restricted the analytical data to days in which PM 2.5 levels did not exceed the Israeli 24 h standard (37.5 µg/m 3 ). We repeated the analysis with a stratification by sociodemographic characteristics and comorbidities. For all outcomes, the exposure–response curves were nonlinear. PM 2.5 exposure was associated with a higher ischemic stroke risk, with larger effect estimates at higher exposure levels. Although nonsignificant, the exposure–response curve for TIA was similar. The associations with ICH were nonsignificant throughout the PM 2.5 exposure distribution. The associations with ischemic stroke/TIA were larger among women, non-Jewish individuals, older adults, and individuals with diabetes, hypertension, and ischemic heart disease. In conclusion, short-term PM 2.5 exposure is associated with a higher risk for ischemic stroke and possibly TIA, even when PM 2.5 concentrations do not exceed the Israeli air quality guideline threshold. Vulnerability to the air pollution effects differed by age, sex, ethnicity, and comorbidities.

Suggested Citation

  • Britney Gaines & Itai Kloog & Inbar Zucker & Gal Ifergane & Victor Novack & Carmit Libruder & Yael Hershkovitz & Perry E. Sheffield & Maayan Yitshak-Sade, 2023. "Particulate Air Pollution Exposure and Stroke among Adults in Israel," IJERPH, MDPI, vol. 20(2), pages 1-11, January.
  • Handle: RePEc:gam:jijerp:v:20:y:2023:i:2:p:1482-:d:1034904
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    References listed on IDEAS

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    1. Helena Krasnov & Itai Kloog & Michael Friger & Itzhak Katra, 2016. "The Spatio-Temporal Distribution of Particulate Matter during Natural Dust Episodes at an Urban Scale," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-18, August.
    2. Yaohua Tian & Hui Liu & Zuolin Zhao & Xiao Xiang & Man Li & Juan Juan & Jing Song & Yaying Cao & Xiaowen Wang & Libo Chen & Chen Wei & Yonghua Hu & Pei Gao, 2018. "Association between ambient air pollution and daily hospital admissions for ischemic stroke: A nationwide time-series analysis," PLOS Medicine, Public Library of Science, vol. 15(10), pages 1-16, October.
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    Cited by:

    1. Michał Święczkowski & Sławomir Dobrzycki & Łukasz Kuźma, 2023. "Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study)," IJERPH, MDPI, vol. 20(8), pages 1-17, April.

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    Keywords

    air pollution; stroke; PM 2.5;
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