Association between ambient air pollution and daily hospital admissions for ischemic stroke: A nationwide time-series analysis

Tian, Yaohua; Liu, Hui; Zhao, Zuolin; Xiao, Xiang; Li, Man; Juan, Juan; Song, Jing; Cao, Yaying; Wang, Xiaowen; Chen, Libo; Chen, Wei; Hu, Yonghua; Gao, Pei

doi:10.1371/journal.pmed.1002668

Cited by 205 publications

(151 citation statements)

References 52 publications

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“…For example, the most informative pollutant of traffic emissions NO 2 . The association were comparable to previously studies [6,11,12,16].…”

Section: Discussionsupporting

confidence: 91%

“…The identification of potentially vulnerable subpopulation has significant implications for public health [12], therefore we stratified the stroke cases into < 65 and ≥ 65 years groups. For ischemic stroke, we found that the effect estimates of SO 2 were higher for the < 65 than that in the ≥65 age group, which is the opposite of Tian et al [12]. This may be due to the varied activity patterns for different age groups in different cities.…”

Section: Discussionmentioning

confidence: 99%

“…However, in developing countries like China, the evidence is limited and very few studies [11] distinguished between ischemic and hemorrhagic stroke. Most studies only focused on ischemic stroke but the results have not been conclusive yet, with some finding evidence of a positive association [12] but not in other studies [13][14][15][16].…”

Section: Introductionmentioning

confidence: 98%

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Association of short-term exposure to sulfur dioxide and hospitalization for ischemic and hemorrhagic stroke in Guangzhou, China

Shen

Yuan

et al. 2020

BMC Public Health

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Background: In developing countries, ambient sulfur dioxide (SO 2 ) is a serious air pollutant concern, but there is no enough and consistent epidemiological evidence about its health effects on stroke hospitalization. Methods: We collected the daily air pollution data, meteorological data and number of daily hospital admissions for ischemic and hemorrhagic stroke, in Guangzhou from January 1st 2009 to December 31st 2014. Then we applied generalized additive model with a quasi-Poisson link to assess the relationship between short-term SO 2 exposure and the total number of hospital admissions for ischemic and hemorrhagic stroke. In addition, we evaluated the effect of ambient SO 2 by age (< 65 years and ≥ 65 years). Results: During the study period, a 24-h mean concentration of ambient SO 2 of 27.82 μg/m 3 , a total of 58,473 ischemic stroke and 9167 hemorrhagic stroke hospital admissions hospital were recorded. Ambient SO 2 was found to increase the risk for both ischemic and hemorrhagic stroke hospital admission in single pollutant model. The maximum value of percentage changes for ischemic and hemorrhagic stroke occurred in lag 0 day and lag 1 day, per 10 μg/m 3 increase in SO 2 concentrations was corresponded to a 1.27% (95% confidence interval (CI), 0.42-2.12%) and 1.55% (95%CI, 0.02-3.11%) increased risk, respectively. The association between SO 2 and ischemic stroke hospitalization was robust to two pollutant model, but for hemorrhagic stroke it's partially weakened after adjusting for co-pollutants. The effect of ambient SO 2 on ischemic stroke appeared to be greater for people < 65 years old, but null effect on hemorrhagic stroke was identified for both age groups. Conclusions: We found short-term exposure to ambient SO 2 may significantly increase the risks of hospitalization for ischemic stroke. The findings may contribute to a better understanding of the health effects of low-levels of SO 2 .

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“…For example, the most informative pollutant of traffic emissions NO 2 . The association were comparable to previously studies [6,11,12,16].…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Association of short-term exposure to sulfur dioxide and hospitalization for ischemic and hemorrhagic stroke in Guangzhou, China

Shen

Yuan

et al. 2020

BMC Public Health

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“…Apart from the respiratory system, it can likewise cause neurological disorders. SO 2 was uncovered being associated with stroke in which the risk of hospital admissions for ischemic stroke would raise 1.37% (1.05%-1.70%) with per 10 g/m 3 increase of SO 2 concentrations [64]. A recent study did not find significant effects on vascular dementia (OR = 0.95 for per 1 ppm SO 2 concentration increased) [42].…”

Section: Mechanisms Of the Association Between So 2 And Admentioning

confidence: 97%

Air Pollution and Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Yung

2020

JAD

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Background: Ambient air pollution has been associated with Alzheimer’s disease (AD) in the elderly. However, its effects on AD have not been meta-analyzed comprehensively. Objective: We conducted a systematic review and meta-analysis to assess the associations between air pollution and AD incidence. Methods: We searched PubMed and Web of Science for indexed publications up to March 2020. Odds risk (OR) and confidence intervals (CI) were estimated for particulate matter (PM)10 (PM10), PM2.5, ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO). The subgroup analysis was conducted based on the pollution levels. Results: Nine studies were included in the meta-analysis and review. The OR per 10μg/m3 increase of PM2.5 was 1.95 (95% CI: 0.88–4.30). The corresponding values per 10μg/m3 increment of other pollutants were 1.03 (95% CI: 0.68–1.57) for O3, 1.00 (95% CI: 0.89–1.13) for NO2, and 0.95 (95% CI: 0.91–0.99) for PM10 (only one study), respectively. Overall OR of the five air pollutants above with AD was 1.32 (95% CI: 1.09–1.61), suggesting a positive association between ambient air pollution and AD incidence. The sub-analysis indicated that the OR (2.20) in heavily polluted regions was notably higher than that in lightly polluted regions (1.06). Although AD risk rate data related to SO2 or CO exposure are still limited, the epidemiologic and toxicological evidence indicated that higher concentration of SO2 or CO exposure increased risks of dementia, implying that SO2 or CO might have a potential impact on AD. Conclusion: Air pollution exposure may exacerbate AD development.

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“…In China, several previous studies have shown that ambient CO has a statistically significant adverse effect on human health, could increase cause-specific mortality [2,3] and morbidity [4,5]. However, assessing the CO-related effect on human health with the mortality data, implicitly ignore the unequal weights to the deaths of young people and elderly.…”

mentioning

confidence: 99%

Ambient carbon monoxide and cause-specific years of life lost: a nationwide time-series analysis in China

Wang

et al. 2020

Preprint

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Background: Ambient carbon monoxide (CO) has been evaluated the effect on public health, mainly linked with mortality and morbidity. Little evidence is available regarding the relation between CO and years of life lost (YLL). Methods: Using data from 49 major cities in China from 2013 to 2017, we applied generalized additive models and random effects meta-analyses to explore the effects of CO on YLL from various diseases. In addition, stratified analyses were performed to estimate the effect modification of demographic factors. Results: A 1-mg/m³ increase of CO concentrations (lagged over 0–3 d), was associated with 24.1 (95% confidence interval [CI], 14.7, 33.5), 11.5 (6.4, 16.6), 0.9 (-0.5, 2.2), 3.4 (1.3, 5.5), 5.3 (2.5, 8.1), 0.8 (0.0, 1.6) increments in daily YLL from non-accidental causes, cardiovascular diseases, respiratory diseases, coronary heart disease, stroke and chronic obstructive pulmonary disease, respectively. These associations were robust to the adjustment of co-pollutants and varied substantially by geography and demographic characteristics. Associations were stronger in the elder people (≥75 years), males and those with low education attainment, than younger people, females and high educated populations. Conclusions: This nationwide analysis showed significant and positive associations between short-term ambient CO exposure and cause-specific YLL, and modified by geography and demographic characteristics. These findings may have significant public health implications for the reduction of CO-attributed disease burden in China.

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Association between ambient air pollution and daily hospital admissions for ischemic stroke: A nationwide time-series analysis

Cited by 205 publications

References 52 publications

Association of short-term exposure to sulfur dioxide and hospitalization for ischemic and hemorrhagic stroke in Guangzhou, China

Association of short-term exposure to sulfur dioxide and hospitalization for ischemic and hemorrhagic stroke in Guangzhou, China

Air Pollution and Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Ambient carbon monoxide and cause-specific years of life lost: a nationwide time-series analysis in China

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