Air pollution and stroke hospitalization in the Beibu Gulf Region of China: A case-crossover analysis

Li, Meijun; Edgell, Randall C.; Wei, Jing; Li, Haopeng; Qian, Zhengmin; Feng, Jin; Tian, Fei; Wang, Xiaojie; Xin, Qinghua; Cai, Miao; Lin, Hualiang

doi:10.1016/j.ecoenv.2023.114814

Cited by 15 publications

(3 citation statements)

References 51 publications

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“…Additionally, negative associations between NO 2 exposure and hemorrhagic or ischemic stroke have been verified by several other studies. A time-stratified case-crossover study conducted in the Beibu Gulf Region of China reported that an elevated NO 2 exposure of 11.2 μg/m 3 was significantly linked to an increased risk for hospitalizations of total stroke [OR: 1.040, 95% CI: 1.027–1.053] and ischemic stroke [OR: 1.052, 95% CI: 1.033–1.071], but there was no significant association with hemorrhagic stroke [ 12 ]. A multicenter case-crossover study also suggested an evident relationship between hourly exposure to NO 2 and an increased risk of hospital admissions for total stroke and ischemic stroke, while no evident impact was found on hemorrhagic stroke [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Each 10 μg/m 3 increase in NO 2 concentration was associated with increments of 1.4% (95% CI: 0.9%, 1.9%) for total stroke mortality, specifically 2.4% (95% CI: 1.0%, 3.8%) for ischemic stroke and 2.4% (95% CI: 0.3%, 4.5%) for hemorrhagic stroke [ 11 ]. In contrast, a separate case-crossover study conducted in China discovered that NO 2 exposure was only linked to an increased risk of total stroke and ischemic stroke mortality, but not hemorrhagic stroke mortality [ 12 ]. Additionally, compared to ischemic and hemorrhagic stroke, there is a scarcity of research examining the association between NO 2 exposure and the sequelae of cerebrovascular disease.…”

Section: Introductionmentioning

confidence: 99%

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Residential Nitrogen Dioxide Exposure and Cause-Specific Cerebrovascular Mortality: An Individual-Level, Case-Crossover Study

Qian,

Cai,

et al. 2023

Toxics

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Background: Existing studies have already shown a connection between nitrogen dioxide (NO2) exposure and cerebrovascular mortality. However, the differential effects of NO2 on cerebrovascular disease and its subtypes remain unclear and require further exploration. Methods: Daily stroke mortality data between 2013 and 2021 in Shanghai, China were collected. Residential daily air pollution data for each decedent were predicted from a satellite model. An individual-level, time-stratified, case-crossover design was applied to examine the relationship between NO2 exposure and cerebrovascular mortality. A combination of conditional logistic regression and distributed lag models with a maximum lag of 7 days was used for data analysis. Results: A total of 219,147 cases of cerebrovascular mortality were recorded. Among them, the proportion of sequelae of cerebrovascular disease, hemorrhagic stroke and ischemic stroke was 50.7%, 17.1% and 27.5%, respectively. The monotonic increases in mortality risks of cerebrovascular diseases, sequelae of cerebrovascular disease and ischemic stroke were observed, without any discernible thresholds. Each 10 μg/m3 increase in NO2 concentration was associated with increments of 3.62% [95% confidence interval (CI): 2.56%, 4.69%] for total cerebrovascular mortality, 4.29% (95% CI: 2.81%, 5.80%) for sequelae of cerebrovascular disease mortality and 4.30% (95% CI: 2.30%, 6.33%) for ischemic stroke mortality. No positive associations between NO2 exposure and hemorrhagic stroke mortality were observed. A greater risk of NO2 was observed in the warm season, in patients with less than 9 years of education and in those with single marital status. The effects of NO2 were robust to mutual adjustment of co-pollutants. Conclusions: Short-term exposures to NO2 may increase the risk of cerebrovascular mortality, specifically for ischemic stroke and sequelae of cerebrovascular disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Residential Nitrogen Dioxide Exposure and Cause-Specific Cerebrovascular Mortality: An Individual-Level, Case-Crossover Study

Qian,

Cai,

et al. 2023

Toxics

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“…26 The bilinear interpolation algorithm to enhance the spatial resolution of environmental variable is presented in Figure S2. [27][28][29] Figure S2a shows the nearest four gridded raster data (typically retrieved from satellite remote sensing) for environmental variables at patient's residential address P. The environmental variables at location P (denoted as Y(P)) can be estimated as a weighted average of the concentrations of the nearest four grids surrounding P using the following formula: Where are the concentrations of environmental variables in the nearest four grids around location P, and are the associated weights (Figure S2a). The weights can be computed from the distance between the residential address (x P and y P ) to the grids of air pollutants (x 1 and y 1 , x 2 and y 2 , x 3 and y 3 , x 4 and y 4 ), and the grids closer to patient' s address P will be assigned larger weights.…”

Section: Exposure Measurementmentioning

confidence: 99%

Long term exposure to PM2.5 chemical components associated with prevalence of cardiovascular diseases in China

Cai,

Su,

et al. 2024

TIME

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<sec>IntroductionAmbient fine particulate matter pollution (PM2.5) has been widely associated with cardiovascular disease (CVD). However, less is known about the contribution of different chemical components of PM2.5 to CVD using a nationally representative sample in China. </sec><sec>MethodsA nationally representative sample of older adults was recruited from 31 provinces, municipalities, or autonomous regions of China by the fourth national Urban and Rural Elderly Population Survey in 2015. We estimated the annual average concentrations of PM2.5 and its five dust-free chemical components (black carbon [BC], organic matter [OM], sulphate [<inline-formula><tex-math id="M1">$ {\color[RGB]{39,137,177}{\robotoRefont\text{SO}_{\robotoRefont\text{4}}^{\robotoRefont\text{2-}} }}$</tex-math></inline-formula>], nitrate [<inline-formula><tex-math id="M2" color="#3e88b5">${\color[RGB]{19,134,178} {\robotoRefont\text{N}\robotoRefont\text{O}}_{\robotoRefont\text 3}^{\robotoRefont\text -} }$</tex-math></inline-formula>], and ammonium [<inline-formula><tex-math id="M3">$ {\color[RGB]{19,134,178} {\robotoRefont\text{N}\robotoRefont\text{H}}_{\robotoRefont\text 4}^{\robotoRefont\text +} }$</tex-math></inline-formula>]) at geocoded residential addresses with the spatial resolution of 10��10 km using bilinear interpolation. Logistic regression models were constructed to estimate the associations between PM2.5 chemical components and prevalence of self-reported CVD, and potential reducible fractions were further estimated using counterfactual analyses. </sec><sec>ResultsA total of 220,425 participants with a mean age of 69.73 years, 52.24% females, and 6.08% minor ethnicity were included in the study, of which 55,837 (25.3%) reported having CVD. An interquartile range (IQR) increment in annual PM2.5 chemical components was associated with significantly elevated risk of CVD prevalence. The odds ratios were 1.254 (95% CI: 1.235-1.275, IQR: 7.11 ?g/m3) for <inline-formula><tex-math id="M4">$ \color[RGB]{19,134,178}{\robotoRefont\text{N}\robotoRefont\text{O}}_{\robotoRefont\text3}^{\robotoRefont\text-} $</tex-math></inline-formula>, 1.197 (95% CI: 1.178-1.216, IQR: 4.35 ?g/m3) for <inline-formula><tex-math id="M5">$ \color[RGB]{19,134,178}{\robotoRefont\text{N}\robotoRefont\text{H}}_{\robotoRefont\text 4}^{\robotoRefont\text +} $</tex-math></inline-formula>, 1.187 (95% CI: 1.173-1.202, IQR: 5.34 ?g/m3) for OM, 1.122 (95% CI: 1.107-1.137, IQR: 0.97 ?g/m3) for BC, and 1.106 (95% CI: 1.089-1.123, IQR: 4.67 ?g/m3) for <inline-formula><tex-math id="M6">$\color[RGB]{19,134,178} {\robotoRefont\text{S}\robotoRefont\text{O}}_{\robotoRefont\text 4}^{\robotoRefont\text 2-} $</tex-math></inline-formula>. The associations were significantly stronger in those older than 70 years. </sec><sec>ConclusionsOur study suggests that long-term exposure to PM2.5 chemical components could increase the risk of CVD prevalence. Future air pollution guidelines target reducing specific PM2.5 chemical components may help alleviate the burden of CVD.</sec>

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Is short-term exposure to primary gaseous air pollutants associated with AIDS-related deaths? Evidence from a time-stratified case-crossover study

Sun,

Zhang,

Ruan

et al. 2024

Int J Biometeorol

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Air pollution and stroke hospitalization in the Beibu Gulf Region of China: A case-crossover analysis

Cited by 15 publications

References 51 publications

Residential Nitrogen Dioxide Exposure and Cause-Specific Cerebrovascular Mortality: An Individual-Level, Case-Crossover Study

Residential Nitrogen Dioxide Exposure and Cause-Specific Cerebrovascular Mortality: An Individual-Level, Case-Crossover Study

Long term exposure to PM<sub>2.5</sub> chemical components associated with prevalence of cardiovascular diseases in China

Is short-term exposure to primary gaseous air pollutants associated with AIDS-related deaths? Evidence from a time-stratified case-crossover study

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