Short-term associations between ambient air pollution and stroke hospitalisations: time-series study in Shenzhen, China

Guo, Yanfang; Xie, X F; Lei, Lin; Zhou, Haibin; Deng, Shizhou; Xu, Ying; Liu, Zheng; Bao, Junzhe; Peng, Ji; Huang, Cunrui

doi:10.1136/bmjopen-2019-032974

Cited by 32 publications

(18 citation statements)

References 45 publications

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“…Consistent with existing studies (Wang et al, 2020), we have added evidence for a U-shaped nonlinear NO2cerebrovascular disease association, where morbidity leveled off at low exposure levels and increased sharply with higher exposure. Another recent time-series study estimated an increased risk of 1.054 (95% CI: 1.031, 1.077) in stroke morbidity per 10 μg/m 3 increase in NO2 across lag 0-3 days (Guo et al, 2020). It is difficult to directly compare the nonlinear and lag effects across cities due to the different study designs and model specifications.…”

Section: Discussionmentioning

confidence: 99%

Short-term effects of gaseous pollutants on cause-specific cerebrovascular disease among patients with type 2 diabetes: case-crossover evidence from Beijing, China

Liu¹,

Li²,

Guo³

et al. 2021

Preprint

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Background: The association between gaseous pollutants and cerebrovascular morbidity has been widely studied; however, the association in patients with type 2 diabetes has remained unknown in developing countries.Methods: A time-stratified case-crossover design combined with a distributed lag nonlinear model was adopted to estimate the short-term effects of gaseous pollutants (nitrogen dioxide [NO2], sulfur dioxide [SO2], ozone [O3], and carbon monoxide [CO]) on cerebrovascular cases among patients with type 2 diabetes in Beijing. In addition, our study explored the variability across sex and age groups.Results: A total of 223,216 (male 57.6% and elderly 61.7%) cerebrovascular cases were reported from 2014 to 2018. The cumulative exposure-response curves were U-shaped for NO2, J-shaped for SO2, and V-shaped for O3 and CO. Extreme low-O3, low-CO and high-CO increased the risk of cerebrovascular morbidity, with the maximum relative risk (RR) of 1.14 (95% CI: 1.01-1.28) (1st vs median), 1.02 (95% CI: 1.01-1.03) (1st vs median) and 1.25 (95% CI: 1.09-1.45) (99th vs median), respectively, appearing at lag0-13. Elderly individuals aged over 65 years were susceptible to extremely low-O3 (maximum RR: 1.27, 95% CI: 1.08-1.48). Men and elderly individuals were more susceptible to extremely high-CO, and the maximum RR was 10% [1.31 (1.11-1.54) vs. 1.19 (1.00, 1.41)] and 26% higher [1.41(1.17-1.69) vs. 1.12 (0.97, 1.30)] than women and adults, respectively. Conclusions: NO2, SO2, O3 and CO presented nonlinear and lagged effects on cerebrovascular disease among patients with type 2 diabetes, which may vary by sex and age. Our study added to the limited evidence for the risk of cerebrovascular disease due to gaseous pollutants among patients with comorbid type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Short-term effects of gaseous pollutants on cause-specific cerebrovascular disease among patients with type 2 diabetes: case-crossover evidence from Beijing, China

Liu¹,

Li²,

Guo³

et al. 2021

Preprint

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“…Three dominant air pollutants in the local city, the PM 2.5 , NO 2 , and O 3 , were entered as covariates, considering their impact on ICH onset. [15][16][17] Pollutant data were from the local Ecological and Environment Bureau (http:// sthj.chengdu.gov.cn/).…”

Section: Meteorological Data and Air Pollutantsmentioning

confidence: 99%

Optimal Antihypertensive Medication Adherence Reduces the Effect of Ambient Temperature on Intracerebral Hemorrhage Occurrence: A Case-Crossover Study

Wang¹,

Luo²,

Cheng³

et al. 2021

PPA

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“…Many factors have been confirmed to be related to IS, including smoking, lacking of physical exercise, hypertension, obesity, and atrial fibrillation ( 5 ). In addition, increasing epidemiological evidence has shown a striking relationship between air pollution exposure and IS ( 6 , 7 ). A study conducted in nine US counties demonstrated the short-term effects of PM 10 , CO, SO 2 , and NO 2 on hospitalizations for IS ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Ambient Air Pollution and Hospitalizations for Ischemic Stroke: A Time Series Analysis Using a Distributed Lag Nonlinear Model in Chongqing, China

Chen

Cheng

et al. 2022

Front. Public Health

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Short-term exposure to air pollution has been associated with ischemic stroke (IS) hospitalizations, but the evidence of its effects on IS in low- and middle-income countries is limited and inconsistent. We aimed to quantitatively estimate the association between air pollution and hospitalizations for IS in Chongqing, China. This time series study included 2,299 inpatients with IS from three hospitals in Chongqing from January 2015 to December 2016. Generalized linear regression models combined with a distributed lag nonlinear model (DLNM) were used to investigate the impact of air pollution on IS hospitalizations. Stratification analysis was further implemented by sex, age, and season. The maximum lag-specific and cumulative percentage changes of IS were 1.2% (95% CI: 0.4–2.1%, lag 3 day) and 3.6% (95% CI: 0.5–6.7%, lag 05 day) for each 10 μg/m3 increase in PM2.5; 1.0% (95% CI: 0.3–1.7%, lag 3 day) and 2.9% (95% CI: 0.6–5.2%, lag 05 day) for each 10 μg/m3 increase in PM10; 4.8% (95% CI: 0.1–9.7%, lag 4 day) for each 10 μg/m3 increase in SO2; 2.5% (95% CI: 0.3–4.7%, lag 3 day) and 8.2% (95% CI: 0.9–16.0%, lag 05 day) for each 10 μg/m3 increase in NO2; 0.7% (95% CI: 0.0–1.5%, lag 6 day) for each 10 μg/m3 increase in O3. No effect modifications were detected for sex, age, and season. Our findings suggest that short-term exposure to PM2.5, PM10, SO2, NO2, and O3 contributes to more IS hospitalizations, which warrant the government to take effective actions in addressing air pollution issues.

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Short-term associations between ambient air pollution and stroke hospitalisations: time-series study in Shenzhen, China

Cited by 32 publications

References 45 publications

Short-term effects of gaseous pollutants on cause-specific cerebrovascular disease among patients with type 2 diabetes: case-crossover evidence from Beijing, China

Short-term effects of gaseous pollutants on cause-specific cerebrovascular disease among patients with type 2 diabetes: case-crossover evidence from Beijing, China

Optimal Antihypertensive Medication Adherence Reduces the Effect of Ambient Temperature on Intracerebral Hemorrhage Occurrence: A Case-Crossover Study

Ambient Air Pollution and Hospitalizations for Ischemic Stroke: A Time Series Analysis Using a Distributed Lag Nonlinear Model in Chongqing, China

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