TY - JOUR
T1 - Association of ambient PM1 with hospital admission and recurrence of stroke in China
AU - Liu, Tao
AU - Jiang, Yong
AU - Hu, Jianxiong
AU - Li, Zixiao
AU - Guo, Yuming
AU - Li, Xing
AU - Xiao, Jianpeng
AU - Yuan, Lixia
AU - He, Guanhao
AU - Zeng, Weilin
AU - Kan, Haidong
AU - Rong, Zuhua
AU - Chen, Gongbo
AU - Yang, Jun
AU - Wang, Yongjun
AU - Ma, Wenjun
N1 - Funding Information:
This work was supported by the National Key Research and Development Program of the Ministry of Science and Technology of China [grant numbers 2016YFC0901000, 2018YFA0606200]; National Natural Science Foundation of China [grant number 81874276, 42175181]; and Natural Science Foundation of Guangdong Province, China [grant number 2019A1515011264]. The authors thank the staff and participants of the CSCA (Chinese Stroke Center Alliance) study for their contribution.
Funding Information:
This work was supported by the National Key Research and Development Program of the Ministry of Science and Technology of China [grant numbers 2016YFC0901000 , 2018YFA0606200 ]; National Natural Science Foundation of China [grant number 81874276 , 42175181 ]; and Natural Science Foundation of Guangdong Province , China [grant number 2019A1515011264 ]. The authors thank the staff and participants of the CSCA (Chinese Stroke Center Alliance) study for their contribution.
Publisher Copyright:
© 2022
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Background: Particulate matter (PM) pollution is a well-known risk factor of stroke. However, little is known about the association between PM1 (aerodynamic diameter ≤ 1.0 μm) and stroke. We estimated the associations of short-term exposure to PM1 with hospital admission and recurrence of stoke in China. Methods: Stroke data were derived from the Chinese Stroke Center Alliance (CASA) program conducted in 1458 hospitals in 292 Chinese cities from 2015 to 2019. Daily air pollution and meteorological data were collected in the cities where studied hospitals were located. Daily PM1 concentration was estimated by a generalized additive model (GAM) using PM2.5 and meteorological variables. A time-stratified case-crossover design was applied to estimate the associations of short-term exposure to PM1 with hospital admission of stroke. A GAM model was used to estimate the association between average PM1 exposure during hospitalization and the recurrence of stroke. Results: A total of 989,591 stroke cases were included in the study. Each 10 μg/m3 increase in PM1 (lag06-day) was associated with a 0.53% (95%CI, 0.39%, 0.67%) increment in hospital admission for stroke. The adverse effects of PM1 on ischemic stroke was stronger than on intracerebral hemorrhage. We found the associations were significant in Northeast (0.94%, 95%CI, 0.51%, 1.38%), North (0.47%, 95%CI, 0.20%, 0.75%), Central (0.57%, 95%CI, 0.30%, 0.85%), and East China (0.63%, 95%CI, 0.27%, 0.99%). Of all stroke cases, 62,988 (6.4%) had recurrent stoke attack during their hospitalization. Each 10 μg/m3 increase in PM1 was associated with a 1.64% (95%CI, 1.28%, 2.01%) increment in recurrence of stroke during hospitalization. Conclusions: Short-term exposure to PM1 may increase the risk of incidence and recurrence of stroke in China, and the effects varied across different types of stroke and regions. Geographically targeted strategies and measures are needed to control air pollution for reducing the burden of stroke from PM1.
AB - Background: Particulate matter (PM) pollution is a well-known risk factor of stroke. However, little is known about the association between PM1 (aerodynamic diameter ≤ 1.0 μm) and stroke. We estimated the associations of short-term exposure to PM1 with hospital admission and recurrence of stoke in China. Methods: Stroke data were derived from the Chinese Stroke Center Alliance (CASA) program conducted in 1458 hospitals in 292 Chinese cities from 2015 to 2019. Daily air pollution and meteorological data were collected in the cities where studied hospitals were located. Daily PM1 concentration was estimated by a generalized additive model (GAM) using PM2.5 and meteorological variables. A time-stratified case-crossover design was applied to estimate the associations of short-term exposure to PM1 with hospital admission of stroke. A GAM model was used to estimate the association between average PM1 exposure during hospitalization and the recurrence of stroke. Results: A total of 989,591 stroke cases were included in the study. Each 10 μg/m3 increase in PM1 (lag06-day) was associated with a 0.53% (95%CI, 0.39%, 0.67%) increment in hospital admission for stroke. The adverse effects of PM1 on ischemic stroke was stronger than on intracerebral hemorrhage. We found the associations were significant in Northeast (0.94%, 95%CI, 0.51%, 1.38%), North (0.47%, 95%CI, 0.20%, 0.75%), Central (0.57%, 95%CI, 0.30%, 0.85%), and East China (0.63%, 95%CI, 0.27%, 0.99%). Of all stroke cases, 62,988 (6.4%) had recurrent stoke attack during their hospitalization. Each 10 μg/m3 increase in PM1 was associated with a 1.64% (95%CI, 1.28%, 2.01%) increment in recurrence of stroke during hospitalization. Conclusions: Short-term exposure to PM1 may increase the risk of incidence and recurrence of stroke in China, and the effects varied across different types of stroke and regions. Geographically targeted strategies and measures are needed to control air pollution for reducing the burden of stroke from PM1.
KW - China
KW - Hospital admission
KW - PM
KW - Recurrence
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85126537995&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2022.154131
DO - 10.1016/j.scitotenv.2022.154131
M3 - Article
C2 - 35219663
AN - SCOPUS:85126537995
VL - 828
JO - Science of the Total Environment
JF - Science of the Total Environment
SN - 0048-9697
M1 - 154131
ER -