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Neuroepidemiology in Resource-Limited Areas

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Front. Neurol. | doi: 10.3389/fneur.2018.00827

Acute Effects of Particulate Air Pollution on Ischemic Stroke and Hemorrhage Stroke Mortality

 Runhua Zhang1, 2, 3, 4, Gaifen Liu1, 2, 3, 4,  Yong Jiang1, 2, 3, 4, Gang Li5, Yuesong Pan1, 2, 3, 4, Zaihua Wei5, Jing Wang5 and  Yongjun Wang1, 2, 3, 4*
  • 1Beijing Tiantan Hospital, Capital Medical University, China
  • 2China National Clinical Research Center of Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, China
  • 3Center of Stroke, Beijing Institute for Brain Disorders, China
  • 4Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
  • 5Chinese Center For Disease Control and Prevention, China

Background and Purpose Most of studies reported the association of particulate matter (PM) with stroke are originated from high-income countries. Few studies have examined the association between PM and stroke in middle- and low-income countries and considered the subtypes of stroke. In this study, we examined the short-term effects of particulate matter < 2.5 μm in diameter (PM2.5) and particulate matter < 10 μm in diameter (PM10) on ischemic stroke mortality and hemorrhage stroke mortality in Beijing, China.
Methods We used quasi-Poisson generalized additive models to evaluate the association of PM2.5 and PM10 and cerebrovascular diseases mortality, as well as ischemic stroke mortality and hemorrhage stroke mortality. In the model, we controlled long-term and season trends, temperature, and relative humidity, day of week and air pollution. For cerebrovascular diseases mortality, we examined the effects stratified by sex and age with different lag days.
Results A total of 48,122 deaths for cerebrovascular disease (32,799 deaths for ischemic stroke and 12,909 deaths for hemorrhage stroke) were included in the study. PM2.5 was associated with stroke mortality. The increase of 0.27% (95% CI, 0.12%-0.43%), 0.23% (95% CI, 0.04%-0.42%) and 0.39% (95% CI, 0.09%-0.70%) were estimated for cerebrovascular diseases, ischemic stroke and hemorrhage stroke mortality with 10 μg/m3 increase of PM2.5, respectively. For PM10, the associations were also detected for cerebrovascular diseases and ischemic stroke, whereas no association was observed with hemorrhage stroke. Stratified analysis suggested age and gender did not modify the effects significantly.
Conclusions Our study suggested that short-term exposure to ambient PM may increase the risk of stroke.

Keywords: Particulate Matter, risk, Stroke, Ischemic, Hemorrhage

Received: 09 Jun 2018; Accepted: 13 Sep 2018.

Edited by:

Wenzhi Wang, Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, China

Reviewed by:

Giridhara R Babu, Public Health Foundation of India, India
Jiming Fang, Institute for Clinical Evaluative Sciences, Canada
David Wang, OSF HealthCare, United States  

Copyright: © 2018 Zhang, Liu, Jiang, Li, Pan, Wei, Wang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Yongjun Wang, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, yongjunwang@ncrcnd.org.cn