nitrogen-dioxide and Cerebral-Hemorrhage

The purpose of the present study was to determine whether seasonal and monthly variations in stroke incidence exist and whether they are related to meteorologic and air pollution parameters under similar weather and environmental conditions in selected areas of Seongdong district, Seoul, South Korea.. From January 1, 2004, to December 31, 2013, 3001 consecutive stroke events were registered in residents of selected areas of Seongdong district, Seoul, South Korea. The authors calculated the stroke attack rate per 100,000 people per month and the relative risk of stroke incidence associated with meteorologic and air pollution parameters. We also analyzed odds ratios with a 95% confidence interval for seasonal and monthly stroke incidence.. The incidence of stroke in September was significantly higher (odds ratio, 1.233; 95% confidence interval, 1.042-1.468) compared with January. The seasonal ischemic stroke incidence in summer (odds ratio, 1.183; 95% confidence interval, 1.056-1.345) was significantly higher than in winter, whereas the seasonal incidence of intracerebral hemorrhage relative to winter was not significant. The mean temperature was positively correlated with ischemic stroke (relative risk, 1.006; P=0.003), and nitrogen dioxide (relative risk, 1.262; P=0.001) showed a strong positive correlation with intracerebral hemorrhage incidence among the older age group.. We demonstrated distinct patterns of seasonal and monthly variation in the incidence of stroke and its subtypes through consideration of the meteorologic and air pollution parameters. We therefore expect that these findings may enhance our understanding of the relationships between stroke and weather and pollutants.

Topics: Adult; Age Factors; Aged; Air Pollution; Cerebral Hemorrhage; Female; Humans; Incidence; Male; Middle Aged; Nitrogen Dioxide; Registries; Risk Assessment; Seasons; Seoul; Stroke; Temperature; Weather

Years of exposure to tobacco smoke substantially increase the risk for stroke. Whether long-term exposure to outdoor air pollution can lead to stroke is not yet established. We examined the association between long-term exposure to traffic-related air pollution and incident and fatal stroke in a prospective cohort study.. We followed 57,053 participants of the Danish Diet, Cancer and Health cohort in the Hospital Discharge Register for the first-ever hospital admission for stroke (incident stroke) between baseline (1993-1997) and 2006 and defined fatal strokes as death within 30 days of admission. We associated the estimated mean levels of nitrogen dioxide at residential addresses since 1971 to incident and fatal stroke by Cox regression analyses and examined the effects by stroke subtypes: ischemic, hemorrhagic, and nonspecified stroke.. Over a mean follow-up of 9.8 years of 52,215 eligible subjects, there were 1984 (3.8%) first-ever (incident) hospital admissions for stroke of whom 142 (7.2%) died within 30 days. We detected borderline significant associations between mean nitrogen dioxide levels at residence since 1971 and incident stroke (hazard ratio, 1.05; 95% CI, 0.99-1.11, per interquartile range increase) and stroke hospitalization followed by death within 30 days (1.22; 1.00-1.50). The associations were strongest for nonspecified and ischemic strokes, whereas no association was detected with hemorrhagic stroke.. Long-term exposure to traffic-related air pollution may contribute to the development of ischemic but not hemorrhagic stroke, especially severe ischemic strokes leading to death within 30 days.

Topics: Aged; Air Pollution; Brain Ischemia; Cerebral Hemorrhage; Cohort Studies; Denmark; Diet; Dose-Response Relationship, Drug; Educational Status; Environmental Exposure; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Obesity; Oxidants, Photochemical; Proportional Hazards Models; Sex Factors; Smoking; Socioeconomic Factors; Stroke

Exposure to high levels of air pollution can increase the risk of cardiovascular events. However, there is no clear information in Japan on the effect of pollution on the incidence of stroke and acute myocardial infarction (AMI). Therefore, we investigated the effects of air pollution on the incidence of stroke and AMI in a setting where pollutant levels are rather low.. Data were obtained from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County in central Japan. We applied a time-stratified, bidirectional, case-crossover design to estimate the effects of air pollutants, which included suspended particulate matter (SPM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and photochemical oxidants (Ox). We used the distributed lag model to estimate the effect of pollutant exposure 0-3 days before the day of event onset and controlled for meteorological covariates in all of the models.. There were 2,038 first-ever strokes (1,083 men, 955 women) and 429 first-ever AMI cases (281 men, 148 women) during 1988-2004. The mean pollutant levels were as follows: SPM 26.9 μg/m(3); SO(2) 3.9 ppb; NO(2) 16.0 ppb, and Ox 28.4 ppb. In single-pollutant and two-pollutant models, SO(2) was associated with the risk of cerebral hemorrhage. Other stroke subtypes and AMI were not associated with air pollutant levels.. We observed an association between SO(2) and hemorrhagic stroke; however, we found inconclusive evidence for a short-term effect of air pollution on the incidence of other stroke types and AMI.

Topics: Aged; Aged, 80 and over; Air Pollution; Cerebral Hemorrhage; Environmental Exposure; Female; Humans; Incidence; Japan; Male; Middle Aged; Myocardial Infarction; Nitrogen Dioxide; Oxidants, Photochemical; Particulate Matter; Stroke; Sulfur Dioxide

Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low.. We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference.. There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988-2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 µg/m(3), SO(2) 3.9 ppb, NO(2) 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO(2) showed increased fatality risk. In multi-pollutant model, the highest quartile of NO(2) was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO(2). In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06-2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality.. We observed association between NO(2) levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities.

Topics: Acute Disease; Adult; Aged; Air Pollutants; Air Pollution; Cerebral Hemorrhage; Cerebral Infarction; Female; Humans; Japan; Male; Middle Aged; Models, Biological; Myocardial Infarction; Nitrogen Dioxide; Oxidants, Photochemical; Particulate Matter; Registries; Stroke; Subarachnoid Hemorrhage; Sulfur Dioxide; Vehicle Emissions

Evidence linking short-term exposure to outdoor air pollution with hemorrhagic stroke is inconsistent.. We evaluated the associations between outdoor air pollution and specific types of stroke in Tokyo, Japan, from April 2003 to December 2008. We obtained daily counts of stroke mortality (n = 41,440) and concentrations of nitrogen dioxide as well as particles less than 2.5 μm in diameter. Time-series analysis was employed.. Although same-day air pollutants were positively associated with ischemic stroke and intracerebral hemorrhage mortality, both air pollutants were more strongly associated with subarachnoid hemorrhage mortality: rate ratio was 1.041 (95% confidence interval: 1.011-1.072) for each 10 μg/m3 increase in the previous-day particles less than 2.5 μm.. This study suggests that short-term exposure to outdoor air pollution increases the risks of hemorrhagic stroke mortality as well as ischemic stroke mortality.

Topics: Air Pollutants; Air Pollution; Cerebral Hemorrhage; Environmental Exposure; Humans; Nitrogen Dioxide; Particulate Matter; Risk Factors; Stroke; Subarachnoid Hemorrhage; Tokyo

To explore the relationship between air pollution and acute onset of cerebral hemorrhage in Hangzhou.. Time-stratified case-crossover study was used to analyze the effect of aerosol optical depth (AOD), PM(10), SO(2) and NO(2) on the acute onset of cerebral hemorrhage. Conditional logistic regression was used to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) in relation to an increase of one unit of AOD and 10 microg/m(3) of air pollutants.. After adjusted temperature and relative humidity, the ORs of acute onset of cerebral hemorrhage by a unit increase in AOD at a 2 day-lag were 1.727 (95%CI: 1.103 - 2.703) in first half year and 2.412 (95%CI: 1.230 - 4.733) at a 2 day-lag in spring. For a 10 microg/m(3) increase in SO(2), the ORs were 1.119 (95%CI: 1.019 - 1.229), 1.230 (95%CI: 1.092 - 1.386), 1.254 (95%CI: 1.076 - 1.460) in the whole year (2 day-lag), in first half year (2 day-lag) and in spring (2 day-lag), respectively. NO(2) exposure in first half year (2 day-lag) was associated with cerebral hemorrhage, with OR as 0.841 (95%CI: 0.734 - 0.964). However, there were no statistical significances for AOD, SO(2), NO(2) in the rest time-periods (P > 0.05). Additionally, no association was found between PM(10) and the acute onset of cerebral hemorrhage in any time-periods (P > 0.05).. Our data showed that there was association between air pollution and the acute onset of cerebral hemorrhage, especially in spring and in the first half of the year.

Topics: Acute Disease; Aerosols; Air Pollutants; Air Pollution; Cerebral Hemorrhage; China; Confidence Intervals; Humans; Logistic Models; Nitrogen Dioxide; Odds Ratio; Particulate Matter; Sulfur Dioxide; Time Factors

Inconsistent results have been obtained from studies that have examined the relationship between air pollution and hospital visits for stroke. We undertook a time-stratified case-crossover study to evaluate associations between outdoor air pollution and emergency department visits for stroke among the elderly according to stroke type, season, and sex. Analyses are based on a total of 12,422 stroke visits among those 65 years of age and older in Edmonton, Canada between April 1, 1992 and March 31, 2002. Daily air pollution levels for SO(2), NO(2), PM(2.5), PM(10), CO and O(3) were estimated using data from fixed-site monitoring stations. Particulate matter data were only available from 1998 onwards. Conditional logistic regression was used to estimate the odds ratios (ORs) and their 95% confidence intervals in relation to an increase in the interquartile range (IQR) of each pollutant. ORs were adjusted for the effects of temperature and relative humidity. We found no association between outdoor measures of air pollution and all stroke visits. In contrast, elevated risks were observed between levels of air pollution and acute ischemic stroke between April and September. During this season, the ORs associated with an increase in the IQR of the 3-day average for CO and NO(2) were 1.32 (95% CI = 1.09-1.60) and 1.26 (95% CI = 1.09-1.46), respectively. CO exposures in the same season, lagged 1 day, were associated with an increased risk of hemorrhagic stroke with ORs was 1.20 (95% CI = 1.00-1.43). Our results suggest it is possible that vehicular traffic, which produces increased levels of NO(2) and CO, contributes to an increased incidence of emergency department visits for stroke.

Topics: Aged; Air Pollutants; Air Pollution; Canada; Carbon Monoxide; Cerebral Hemorrhage; Emergency Medical Services; Hospital Departments; Humans; Nitrogen Dioxide; Odds Ratio; Risk Factors; Seasons; Stroke; Vehicle Emissions

Air pollution is known to be associated with cardiovascular disease, but little is known about the occurrence of stroke in relation to air pollution. We investigated the association between acute stroke mortality and air pollution over a 7-year period (January 1991 through December 1997) in Seoul, Korea.. A generalized additive model was used to regress daily stroke death counts for each air pollutant, controlling for time trends, day of the week, and meteorological influences such as temperature, relative humidity, and atmospheric pressure. Ischemic and hemorrhagic stroke deaths were examined separately.. The effects of air pollutants on ischemic stroke mortality were statistically significant, whereas this was not the case for hemorrhagic stroke mortality. We observed estimated relative risks of 1.03 (95% CI, 1.00 to 1.06) and 1.04 (95% CI, 1.01 to 1.08) for ischemic stroke mortality for each interquartile range increase in total suspended particulates and sulfur dioxide concentrations on the same day. We also found significantly increased relative risks of 1.04 (95% CI, 1.01 to 1.07) for nitrogen dioxide with a 1-day lag, of 1.06 (95% CI, 1.02 to 1.09) for carbon monoxide with a 1-day lag, and of 1.06 (95% CI, 1.02 to 1.10) for ozone with a 3-day lag for each interquartile range increase.. These findings indicate that air pollutants are significantly associated with ischemic stroke mortality, which suggests an acute pathogenetic process in the cerebrovascular system induced by air pollution.

Topics: Air Pollution; Brain Ischemia; Carbon Monoxide; Cerebral Hemorrhage; Comorbidity; Environmental Monitoring; Epidemiological Monitoring; Humans; Korea; Nitrogen Dioxide; Ozone; Poisson Distribution; Regression Analysis; Risk; Smoke; Stroke; Sulfur Dioxide