Outdoor air pollution, subtypes and severity of ischemic stroke – a small-area level ecological study

Maheswaran, Ravi; Pearson, Tim; Beevers, Sean; Campbell, Mike; Wolfe, Charles D.A.

doi:10.1186/1476-072x-13-23

Cited by 25 publications

(32 citation statements)

References 28 publications

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“…The pollutants considered were nitric oxide (NO), nitrogen dioxide (NO 2 ), nitrogen oxides (NO x ), ozone (O 3 ), total oxidants (Ox−O 3 +NO 2 ), and PM. PM was subdivided into PM 2.5 and PM 10 , and the contribution of traffic exhaust and nonexhaust was examined.…”

Section: Air Pollutionmentioning

confidence: 99%

“…[21][22][23] The model provided annual mean concentrations for the pollutants at the geographical center of each postcode. Traffic exhaust and nontraffic exhaust sources were considered separately for PM 2.5 and PM 10 .…”

Section: Air Pollutionmentioning

confidence: 99%

“…Hemorrhagic strokes consisted of primary intracerebral hemorrhage and subarachnoid hemorrhage. Ischemic strokes were subdivided using the Oxford Community Stroke Project classification 10 as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), posterior circulation infarct (POCI), and lacunar infarct (LACI).…”

Section: Subjectsmentioning

confidence: 99%

“…4 Several associative studies suggest that the effects of outdoor air pollution may act as a potentially modifiable risk factor on survival rates after having a stroke. The onset of stroke has been linked to nitrogen dioxide, 9,10 and acute stroke mortality has been linked to ozone, 11 nitrogen dioxide, 11 sulfur dioxide, 11 and carbon monoxide. 11,12 Long-term poststroke mortality has been linked to nitrogen dioxide.…”

mentioning

confidence: 99%

“…13,14 Smaller PM below 2.5 µm in diameter (PM 2.5 ) may be especially hazardous to human health, 13 and PM levels <10 µm (PM 10 ) have also been implicated. Fewer studies have focused on the association between long-term PM exposures (ie, concentrations averaged over months or years) and adverse health conditions.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke

Desikan

Crichton

Hoang

et al. 2016

Stroke

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Background and Purpose-Outdoor air pollution represents a potentially modifiable risk factor for stroke. We examined the link between ambient pollution and mortality up to 5 years poststroke, especially for pollutants associated with vehicle exhaust. Methods-Data from the South London Stroke Register, a population-based register covering an urban, multiethnic population, were used. Hazard ratios (HR) for a 1 interquartile range increase in particulate matter <2.5 µm diameter (PM 2.5 ) and PM <10 µm (PM 10 ) were estimated poststroke using Cox regression, overall and broken down into exhaust and nonexhaust components.

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Section: Air Pollutionmentioning

confidence: 99%

Section: Air Pollutionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke

Desikan

Crichton

Hoang

et al. 2016

Stroke

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Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

Alper

Nguyen

et al. 2021

American J Industrial Med

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Background Few studies have examined the association between disaster‐related factors and stroke by subtype or number. We investigated the association between 9/11‐related posttraumatic stress disorder (PTSD), dust exposure, and stroke subtype as well as recurrent strokes. Methods The study included 29,012 individuals enrolled in the World Trade Center Health Registry. Stroke cases were obtained by matching Registry enrollees to the New York State Department of Health's discharge records for inpatient visits between 2000 and 2016. Cox proportional hazards regression models were performed to examine the association between 9/11‐related risk factors and stroke by subtype. Multinomial logistic regression models were conducted to assess the associations between the same risk factors and the number of stroke hospitalizations. Results Having PTSD significantly increased the risk of developing ischemic and hemorrhagic stroke, with adjusted hazards ratios (AHRs) of 1.64 (95% confidence interval [CI]: 1.28–2.10) and 1.73 (95% CI: 1.10–2.71), respectively. The point estimate for dust cloud exposure, although not significant statistically, suggested an increased risk of ischemic stroke (AHR = 1.20, 95% CI: 0.96–1.50). PTSD was significantly associated with recurrent strokes with an adjusted odds ratio of 1.79 (95% CI: 1.09–2.95). Conclusions PTSD is a risk factor for both ischemic and hemorrhagic stroke and is associated with recurrent strokes. Dust exposure on 9/11 is a possible risk factor for ischemic stroke but not for hemorrhagic stroke, and was not associated with recurrent strokes. Our findings warrant additional research on stroke‐morbidity and mortality associated with 9/11‐related PTSD and dust exposure.

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Association of outdoor air pollution with the medical expense of ischemic stroke: The case study of an industrial city in western China

Zeng

Luo

Fang

et al. 2021

Health Planning & Management

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Ischemic stroke, the most frequent cause of severe disability, imposes a significant mental and economic burden on patients and their families. There is increasing evidence to indicate that air pollution contributes to the risk of ischemic stroke. This study aimed to examine the correlation between air pollution and the expense imposed by an ischemic stroke. Data were obtained from hospitals and environmental monitoring stations in an industry city, Longspring, in western China. We used a generalized additive model to estimate the associations between the two factors, measured during 2015-2017. Counter-intuitively, the medical expenses arising from ischemia were negatively associated with the level of air pollution. The corresponding ER for per interquartile range increase of PM2.5, PM10, SO 2 , and NO 2 in lag10 was À 0.17% (95% confidence interval (95% CI À 0.31%, À 0.03%), À 0.11% (95% CI À 0.2%, À 0.02%), À 1.04% (95% CI À 1.92%, À 0.17%) and À 0.44% (95% CI À 0.66%, À 0.22%), respectively (p < 0.05). Subgroups based on gender, age, and season were considered in the analysis. The results indicated that pollutants had significant effects on ischaemia's medical expenses, which were stronger for older people, patients who survived, and warm seasons. This study is the first step in optimizing medical resources, which are essential for policymaking and service planning.

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Outdoor air pollution, subtypes and severity of ischemic stroke – a small-area level ecological study

Cited by 25 publications

References 28 publications

Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke

Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke

Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

Association of outdoor air pollution with the medical expense of ischemic stroke: The case study of an industrial city in western China

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