nitrogen-dioxide and Stroke

Despite recent advances in treatment and prevention, stroke remains a leading cause of morbidity and mortality. There is a critical need to identify novel modifiable risk factors for disease, including environmental agents. A body of evidence has accumulated suggesting that elevated levels of ambient air pollutants may not only trigger cerebrovascular events in susceptible people (short-term exposures) but also increase the risk of future events (long-term average exposures). This review assesses the updated evidence for both short and long-term exposure to ambient air pollution as a risk factor for stroke incidence and outcomes. It discusses the potential pathophysiologic mechanisms and makes recommendations to mitigate exposure on a personal and community level. The evidence indicates that reduction in air pollutant concentrations represent a significant population-level opportunity to reduce risk of cerebrovascular disease.

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

The complex interplay of multiple environmental factors and cardiovascular has scarcely been studied. Within the EXPANSE project, we evaluated the association between long-term exposure to multiple environmental indices and stroke incidence across Europe.. In over 15 million participants, increased levels of NO. We observed increased HRs for stroke with exposure to PM

Topics: Adult; Air Pollution; Built Environment; Europe; Humans; Incidence; Nitrogen Dioxide; Stroke; Temperature

Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has established a connection between extended exposure to air pollutants and ischemic stroke. However, the link between short-term exposure to air pollutants and stroke remains less definitive.. A comprehensive search was conducted on MEDLINE, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Sciences databases up until February 2023, without any language restrictions. The inclusion criteria encompassed observational or interventional studies that examined the correlation between short-term exposure to air pollutants (carbon monoxide [CO], sulfur dioxide [SO. A total of 18,035,408 cases of ischemic stroke were included in the analysis, derived from 110 observational studies. Asia accounted for most included studies, representing 58.8% of the total. By contrast, Europe and the Americas contributed 24.6% and 16.7% of the studies, respectively. Notably, none of the included studies were conducted in Africa. Stroke incidence was significantly associated with an increase in the concentration of NO. There is a strong and significant correlation between gaseous and particulate air pollutants and the occurrence and mortality rates of stroke. This close temporal association underscores the importance of implementing global initiatives to develop policies aimed at reducing air pollution. By doing so, alleviate the burden of ischemic stroke and its consequences.

Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Ischemic Stroke; Nitrogen Dioxide; Particulate Matter; Stroke

Middle East Respiratory Syndrome (MERS) is a novel respiratory illness firstly reported in Saudi Arabia in 2012. It is caused by a new corona virus, called MERS corona virus (MERS-CoV). Most people who have MERS-CoV infection developed severe acute respiratory illness.. This work is done to determine the clinical characteristics and the outcome of intensive care unit (ICU) admitted patients with confirmed MERS-CoV infection.. This study included 32 laboratory confirmed MERS corona virus infected patients who were admitted into ICU. It included 20 (62.50%) males and 12 (37.50%) females. The mean age was 43.99 ± 13.03 years. Diagnosis was done by real-time reverse transcription polymerase chain reaction (rRT-PCR) test for corona virus on throat swab, sputum, tracheal aspirate, or bronchoalveolar lavage specimens. Clinical characteristics, co-morbidities and outcome were reported for all subjects.. Most MERS corona patients present with fever, cough, dyspnea, sore throat, runny nose and sputum. The presence of abdominal symptoms may indicate bad prognosis. Prolonged duration of symptoms before patients' hospitalization, prolonged duration of mechanical ventilation and hospital stay, bilateral radiological pulmonary infiltrates, and hypoxemic respiratory failure were found to be strong predictors of mortality in such patients. Also, old age, current smoking, smoking severity, presence of associated co-morbidities like obesity, diabetes mellitus, chronic heart diseases, COPD, malignancy, renal failure, renal transplantation and liver cirrhosis are associated with a poor outcome of ICU admitted MERS corona virus infected patients.. Plasma HO-1, ferritin, p21, and NQO1 were all elevated at baseline in CKD participants. Plasma HO-1 and urine NQO1 levels each inversely correlated with eGFR (. SnPP can be safely administered and, after its injection, the resulting changes in plasma HO-1, NQO1, ferritin, and p21 concentrations can provide information as to antioxidant gene responsiveness/reserves in subjects with and without kidney disease.. A Study with RBT-1, in Healthy Volunteers and Subjects with Stage 3-4 Chronic Kidney Disease, NCT0363002 and NCT03893799.. HFNC did not significantly modify work of breathing in healthy subjects. However, a significant reduction in the minute volume was achieved, capillary [Formula: see text] remaining constant, which suggests a reduction in dead-space ventilation with flows > 20 L/min. (ClinicalTrials.gov registration NCT02495675).. 3 组患者手术时间、术中显性失血量及术后 1 周血红蛋白下降量比较差异均无统计学意义（. 对于肥胖和超重的膝关节单间室骨关节炎患者，采用 UKA 术后可获满意短中期疗效，远期疗效尚需进一步随访观察。.. Decreased muscle strength was identified at both time points in patients with hEDS/HSD. The evolution of most muscle strength parameters over time did not significantly differ between groups. Future studies should focus on the effectiveness of different types of muscle training strategies in hEDS/HSD patients.. These findings support previous adverse findings of e-cigarette exposure on neurodevelopment in a mouse model and provide substantial evidence of persistent adverse behavioral and neuroimmunological consequences to adult offspring following maternal e-cigarette exposure during pregnancy. https://doi.org/10.1289/EHP6067.. This RCT directly compares a neoadjuvant chemotherapy regimen with a standard CROSS regimen in terms of overall survival for patients with locally advanced ESCC. The results of this RCT will provide an answer for the controversy regarding the survival benefits between the two treatment strategies.. NCT04138212, date of registration: October 24, 2019.. Results of current investigation indicated that milk type and post fermentation cooling patterns had a pronounced effect on antioxidant characteristics, fatty acid profile, lipid oxidation and textural characteristics of yoghurt. Buffalo milk based yoghurt had more fat, protein, higher antioxidant capacity and vitamin content. Antioxidant and sensory characteristics of T. If milk is exposed to excessive amounts of light, Vitamins B. The two concentration of ZnO nanoparticles in the ambient air produced two different outcomes. The lower concentration resulted in significant increases in Zn content of the liver while the higher concentration significantly increased Zn in the lungs (p < 0.05). Additionally, at the lower concentration, Zn content was found to be lower in brain tissue (p < 0.05). Using TEM/EDX we detected ZnO nanoparticles inside the cells in the lungs, kidney and liver. Inhaling ZnO NP at the higher concentration increased the levels of mRNA of the following genes in the lungs: Mt2 (2.56 fold), Slc30a1 (1.52 fold) and Slc30a5 (2.34 fold). At the lower ZnO nanoparticle concentration, only Slc30a7 mRNA levels in the lungs were up (1.74 fold). Thus the two air concentrations of ZnO nanoparticles produced distinct effects on the expression of the Zn-homeostasis related genes.. Until adverse health effects of ZnO nanoparticles deposited in organs such as lungs are further investigated and/or ruled out, the exposure to ZnO nanoparticles in aerosols should be avoided or minimised.

Topics: A549 Cells; Acetylmuramyl-Alanyl-Isoglutamine; Acinetobacter baumannii; Acute Lung Injury; Adaptor Proteins, Signal Transducing; Adenine; Adenocarcinoma; Adipogenesis; Administration, Cutaneous; Administration, Ophthalmic; Adolescent; Adsorption; Adult; Aeromonas hydrophila; Aerosols; Aged; Aged, 80 and over; Aging; Agriculture; Air Pollutants; Air Pollution; Airway Remodeling; Alanine Transaminase; Albuminuria; Aldehyde Dehydrogenase 1 Family; Algorithms; AlkB Homolog 2, Alpha-Ketoglutarate-Dependent Dioxygenase; Alzheimer Disease; Amino Acid Sequence; Ammonia; Ammonium Compounds; Anaerobiosis; Anesthetics, Dissociative; Anesthetics, Inhalation; Animals; Anti-Bacterial Agents; Anti-HIV Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Antibiotics, Antineoplastic; Antibodies, Antineutrophil Cytoplasmic; Antibodies, Monoclonal, Humanized; Antifungal Agents; Antigens, Bacterial; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Antioxidants; Antitubercular Agents; Antiviral Agents; Apolipoproteins E; Apoptosis; Arabidopsis; Arabidopsis Proteins; Arsenic; Arthritis, Rheumatoid; Asthma; Atherosclerosis; ATP-Dependent Proteases; Attitude of Health Personnel; Australia; Austria; Autophagy; Axitinib; Bacteria; Bacterial Outer Membrane Proteins; Bacterial Proteins; Bacterial Toxins; Bacterial Typing Techniques; Bariatric Surgery; Base Composition; Bayes Theorem; Benzoxazoles; Benzylamines; beta Catenin; Betacoronavirus; Betula; Binding Sites; Biological Availability; Biological Oxygen Demand Analysis; Biomarkers; Biomarkers, Tumor; Biopsy; Bioreactors; Biosensing Techniques; Birth Weight; Blindness; Blood Chemical Analysis; Blood Gas Analysis; Blood Glucose; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Blood-Brain Barrier; Blotting, Western; Body Mass Index; Body Weight; Bone and Bones; Bone Density; Bone Resorption; Borates; Brain; Brain Infarction; Brain Injuries, Traumatic; Brain Neoplasms; Breakfast; Breast Milk Expression; Breast Neoplasms; Bronchi; Bronchoalveolar Lavage Fluid; Buffaloes; Cadherins; Calcification, Physiologic; Calcium Compounds; Calcium, Dietary; Cannula; Caprolactam; Carbon; Carbon Dioxide; Carboplatin; Carcinogenesis; Carcinoma, Ductal; Carcinoma, Ehrlich Tumor; Carcinoma, Hepatocellular; Carcinoma, Non-Small-Cell Lung; Carcinoma, Pancreatic Ductal; Carcinoma, Renal Cell; Cardiovascular Diseases; Carps; Carrageenan; Case-Control Studies; Catalysis; Catalytic Domain; Cattle; CD8-Positive T-Lymphocytes; Cell Adhesion; Cell Cycle Proteins; Cell Death; Cell Differentiation; Cell Line; Cell Line, Tumor; Cell Movement; Cell Nucleus; Cell Phone Use; Cell Proliferation; Cell Survival; Cell Transformation, Neoplastic; Cell Transformation, Viral; Cells, Cultured; Cellulose; Chemical Phenomena; Chemoradiotherapy; Child; Child Development; Child, Preschool; China; Chitosan; Chlorocebus aethiops; Cholecalciferol; Chromatography, Liquid; Circadian Clocks; Circadian Rhythm; Circular Dichroism; Cisplatin; Citric Acid; Clinical Competence; Clinical Laboratory Techniques; Clinical Trials, Phase I as Topic; Clinical Trials, Phase II as Topic; Clostridioides difficile; Clostridium Infections; Coculture Techniques; Cohort Studies; Cold Temperature; Colitis; Collagen Type I; Collagen Type I, alpha 1 Chain; Collagen Type XI; Color; Connective Tissue Diseases; Copper; Coronary Angiography; Coronavirus 3C Proteases; Coronavirus Infections; Cost of Illness; Counselors; COVID-19; COVID-19 Testing; Creatine Kinase; Creatinine; Cross-Over Studies; Cross-Sectional Studies; Cryoelectron Microscopy; Cryosurgery; Crystallography, X-Ray; Cues; Cultural Competency; Cultural Diversity; Curriculum; Cyclic AMP Response Element-Binding Protein; Cyclin-Dependent Kinase Inhibitor p21; Cycloparaffins; Cysteine Endopeptidases; Cytokines; Cytoplasm; Cytoprotection; Databases, Factual; Denitrification; Deoxycytidine; Diabetes Complications; Diabetes Mellitus; Diabetes Mellitus, Experimental; 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Forced Expiratory Volume; Forests; Fractures, Bone; Fruit and Vegetable Juices; Fusobacteria; G1 Phase Cell Cycle Checkpoints; G2 Phase Cell Cycle Checkpoints; Gamma Rays; Gastrectomy; Gastrointestinal Microbiome; Gastrointestinal Stromal Tumors; Gefitinib; Gels; Gemcitabine; Gene Amplification; Gene Expression; Gene Expression Regulation; Gene Expression Regulation, Bacterial; Gene Expression Regulation, Neoplastic; Gene Expression Regulation, Plant; Gene Knockdown Techniques; Gene-Environment Interaction; Genotype; Germany; Glioma; Glomerular Filtration Rate; Glucagon; Glucocorticoids; Glycemic Control; Glycerol; Glycogen Synthase Kinase 3 beta; Glycolipids; Glycolysis; Goblet Cells; Gram-Negative Bacterial Infections; Granulocyte Colony-Stimulating Factor; Graphite; Greenhouse Effect; Guanidines; Haemophilus influenzae; HCT116 Cells; Health Knowledge, Attitudes, Practice; Health Personnel; Health Services Accessibility; Health Services Needs and Demand; Health Status Disparities; Healthy Volunteers; 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Oocytes; Open Reading Frames; Osteoclasts; Osteogenesis; Osteoporosis; Osteoporosis, Postmenopausal; Outpatients; Ovarian Neoplasms; Ovariectomy; Overweight; Oxazines; Oxidants; Oxidation-Reduction; Oxidative Stress; Oxides; Oxidoreductases; Oxygen; Oxygen Inhalation Therapy; Oxygenators, Membrane; Ozone; Paclitaxel; Paenibacillus; Pain Measurement; Palliative Care; Pancreatic Neoplasms; Pandemics; Parasympathetic Nervous System; Particulate Matter; Pasteurization; Patient Preference; Patient Satisfaction; Pediatric Obesity; Permeability; Peroxiredoxins; Peroxynitrous Acid; Pharmaceutical Services; Pharmacists; Pharmacy; Phaseolus; Phenotype; Phoeniceae; Phosphates; Phosphatidylinositol 3-Kinases; Phospholipid Transfer Proteins; Phospholipids; Phosphorus; Phosphorylation; Photoperiod; Photosynthesis; Phylogeny; Physical Endurance; Physicians; Pilot Projects; Piperidines; Pituitary Adenylate Cyclase-Activating Polypeptide; Plant Extracts; Plant Leaves; Plant Proteins; Plant Roots; Plaque, Atherosclerotic; Pneumonia; Pneumonia, Viral; Point-of-Care Testing; Polyethylene Glycols; Polymers; Polysorbates; Pore Forming Cytotoxic Proteins; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Postprandial Period; Poverty; Pre-Exposure Prophylaxis; Prediabetic State; Predictive Value of Tests; Pregnancy; Pregnancy Trimester, First; Pregnancy, High-Risk; Prenatal Exposure Delayed Effects; Pressure; Prevalence; Primary Graft Dysfunction; Primary Health Care; Professional Role; Professionalism; Prognosis; Progression-Free Survival; Prolactin; Promoter Regions, Genetic; Proof of Concept Study; Proportional Hazards Models; Propylene Glycol; Prospective Studies; Prostate; Protein Binding; Protein Biosynthesis; Protein Isoforms; Protein Kinase Inhibitors; Protein Phosphatase 2; Protein Processing, Post-Translational; Protein Serine-Threonine Kinases; Protein Structure, Tertiary; Protein Transport; Proteoglycans; Proteome; Proto-Oncogene Proteins c-akt; Proto-Oncogene Proteins c-myc; Proto-Oncogene Proteins c-ret; Proto-Oncogene Proteins p21(ras); Proton Pumps; Protons; Protoporphyrins; Pseudomonas aeruginosa; Pseudomonas fluorescens; Pulmonary Artery; Pulmonary Disease, Chronic Obstructive; Pulmonary Gas Exchange; Pulmonary Veins; Pyrazoles; Pyridines; Pyrimidines; Qualitative Research; Quinoxalines; Rabbits; Random Allocation; Rats; Rats, Sprague-Dawley; Rats, Wistar; Receptors, Histamine H3; Receptors, Immunologic; Receptors, Transferrin; Recombinant Proteins; Recurrence; Reference Values; Referral and Consultation; Regional Blood Flow; Registries; Regulon; Renal Insufficiency, Chronic; Reperfusion Injury; Repressor Proteins; Reproducibility of Results; Republic of Korea; Research Design; Resistance Training; Respiration, Artificial; Respiratory Distress Syndrome; Respiratory Insufficiency; Resuscitation; Retinal Dehydrogenase; Retreatment; Retrospective Studies; Reverse Transcriptase Inhibitors; Rhinitis, Allergic; Ribosomal Proteins; Ribosomes; Risk Assessment; Risk Factors; Ritonavir; Rivers; RNA Interference; RNA-Seq; RNA, Messenger; RNA, Ribosomal, 16S; RNA, Small Interfering; Rosuvastatin Calcium; Rural Population; Saccharomyces cerevisiae; Saccharomyces cerevisiae Proteins; Salivary Ducts; Salivary Gland Neoplasms; San Francisco; SARS-CoV-2; Satiation; Satiety Response; Schools; Schools, Pharmacy; Seasons; Seawater; Selection, Genetic; Sequence Analysis, DNA; Serine-Threonine Kinase 3; Sewage; Sheep; Sheep, Domestic; Shock, Hemorrhagic; Signal Transduction; Silver; Silymarin; Single Photon Emission Computed Tomography Computed Tomography; Sirolimus; Sirtuin 1; Skin; Skin Neoplasms; Skin Physiological Phenomena; Sleep Initiation and Maintenance Disorders; Social Class; Social Participation; Social Support; Soil; Soil Microbiology; Solutions; Somatomedins; Soot; Specimen Handling; Spectrophotometry, Ultraviolet; Spectroscopy, Fourier Transform Infrared; Spectrum Analysis; Spinal Fractures; Spirometry; Staphylococcus aureus; STAT1 Transcription Factor; STAT3 Transcription Factor; Streptomyces coelicolor; Stress, Psychological; Stroke; Stroke Volume; Structure-Activity Relationship; Students, Medical; Students, Pharmacy; Substance Abuse Treatment Centers; Sulfur Dioxide; Surface Properties; Surface-Active Agents; Surveys and Questionnaires; Survival Analysis; Survival Rate; Survivin; Sweden; Swine; Swine, Miniature; Sympathetic Nervous System; T-Lymphocytes, Regulatory; Talaromyces; Tandem Mass Spectrometry; tau Proteins; Telemedicine; Telomerase; Telomere; Telomere Homeostasis; Temperature; Terminally Ill; Th1 Cells; Thiamethoxam; Thiazoles; Thiophenes; Thioredoxin Reductase 1; Thrombosis; Thulium; Thyroid Cancer, Papillary; Thyroid Carcinoma, Anaplastic; Thyroid Neoplasms; Time Factors; Titanium; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; TOR Serine-Threonine Kinases; Transcription Factor AP-1; Transcription Factors; Transcription, Genetic; Transcriptional Activation; Transcriptome; Transforming Growth Factor beta1; 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YAP-Signaling Proteins; Yogurt; Young Adult; Zebrafish; Zebrafish Proteins; Ziziphus

Middle East Respiratory Syndrome (MERS) is a novel respiratory illness firstly reported in Saudi Arabia in 2012. It is caused by a new corona virus, called MERS corona virus (MERS-CoV). Most people who have MERS-CoV infection developed severe acute respiratory illness.. This work is done to determine the clinical characteristics and the outcome of intensive care unit (ICU) admitted patients with confirmed MERS-CoV infection.. This study included 32 laboratory confirmed MERS corona virus infected patients who were admitted into ICU. It included 20 (62.50%) males and 12 (37.50%) females. The mean age was 43.99 ± 13.03 years. Diagnosis was done by real-time reverse transcription polymerase chain reaction (rRT-PCR) test for corona virus on throat swab, sputum, tracheal aspirate, or bronchoalveolar lavage specimens. Clinical characteristics, co-morbidities and outcome were reported for all subjects.. Most MERS corona patients present with fever, cough, dyspnea, sore throat, runny nose and sputum. The presence of abdominal symptoms may indicate bad prognosis. Prolonged duration of symptoms before patients' hospitalization, prolonged duration of mechanical ventilation and hospital stay, bilateral radiological pulmonary infiltrates, and hypoxemic respiratory failure were found to be strong predictors of mortality in such patients. Also, old age, current smoking, smoking severity, presence of associated co-morbidities like obesity, diabetes mellitus, chronic heart diseases, COPD, malignancy, renal failure, renal transplantation and liver cirrhosis are associated with a poor outcome of ICU admitted MERS corona virus infected patients.. Plasma HO-1, ferritin, p21, and NQO1 were all elevated at baseline in CKD participants. Plasma HO-1 and urine NQO1 levels each inversely correlated with eGFR (. SnPP can be safely administered and, after its injection, the resulting changes in plasma HO-1, NQO1, ferritin, and p21 concentrations can provide information as to antioxidant gene responsiveness/reserves in subjects with and without kidney disease.. A Study with RBT-1, in Healthy Volunteers and Subjects with Stage 3-4 Chronic Kidney Disease, NCT0363002 and NCT03893799.. HFNC did not significantly modify work of breathing in healthy subjects. However, a significant reduction in the minute volume was achieved, capillary [Formula: see text] remaining constant, which suggests a reduction in dead-space ventilation with flows > 20 L/min. (ClinicalTrials.gov registration NCT02495675).. 3 组患者手术时间、术中显性失血量及术后 1 周血红蛋白下降量比较差异均无统计学意义（. 对于肥胖和超重的膝关节单间室骨关节炎患者，采用 UKA 术后可获满意短中期疗效，远期疗效尚需进一步随访观察。.. Decreased muscle strength was identified at both time points in patients with hEDS/HSD. The evolution of most muscle strength parameters over time did not significantly differ between groups. Future studies should focus on the effectiveness of different types of muscle training strategies in hEDS/HSD patients.. These findings support previous adverse findings of e-cigarette exposure on neurodevelopment in a mouse model and provide substantial evidence of persistent adverse behavioral and neuroimmunological consequences to adult offspring following maternal e-cigarette exposure during pregnancy. https://doi.org/10.1289/EHP6067.. This RCT directly compares a neoadjuvant chemotherapy regimen with a standard CROSS regimen in terms of overall survival for patients with locally advanced ESCC. The results of this RCT will provide an answer for the controversy regarding the survival benefits between the two treatment strategies.. NCT04138212, date of registration: October 24, 2019.. Results of current investigation indicated that milk type and post fermentation cooling patterns had a pronounced effect on antioxidant characteristics, fatty acid profile, lipid oxidation and textural characteristics of yoghurt. Buffalo milk based yoghurt had more fat, protein, higher antioxidant capacity and vitamin content. Antioxidant and sensory characteristics of T. If milk is exposed to excessive amounts of light, Vitamins B. The two concentration of ZnO nanoparticles in the ambient air produced two different outcomes. The lower concentration resulted in significant increases in Zn content of the liver while the higher concentration significantly increased Zn in the lungs (p < 0.05). Additionally, at the lower concentration, Zn content was found to be lower in brain tissue (p < 0.05). Using TEM/EDX we detected ZnO nanoparticles inside the cells in the lungs, kidney and liver. Inhaling ZnO NP at the higher concentration increased the levels of mRNA of the following genes in the lungs: Mt2 (2.56 fold), Slc30a1 (1.52 fold) and Slc30a5 (2.34 fold). At the lower ZnO nanoparticle concentration, only Slc30a7 mRNA levels in the lungs were up (1.74 fold). Thus the two air concentrations of ZnO nanoparticles produced distinct effects on the expression of the Zn-homeostasis related genes.. Until adverse health effects of ZnO nanoparticles deposited in organs such as lungs are further investigated and/or ruled out, the exposure to ZnO nanoparticles in aerosols should be avoided or minimised.

Topics: A549 Cells; Acetylmuramyl-Alanyl-Isoglutamine; Acinetobacter baumannii; Acute Lung Injury; Adaptor Proteins, Signal Transducing; Adenine; Adenocarcinoma; Adipogenesis; Administration, Cutaneous; Administration, Ophthalmic; Adolescent; Adsorption; Adult; Aeromonas hydrophila; Aerosols; Aged; Aged, 80 and over; Aging; Agriculture; Air Pollutants; Air Pollution; Airway Remodeling; Alanine Transaminase; Albuminuria; Aldehyde Dehydrogenase 1 Family; Algorithms; AlkB Homolog 2, Alpha-Ketoglutarate-Dependent Dioxygenase; Alzheimer Disease; Amino Acid Sequence; Ammonia; Ammonium Compounds; Anaerobiosis; Anesthetics, Dissociative; Anesthetics, Inhalation; Animals; Anti-Bacterial Agents; Anti-HIV Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Antibiotics, Antineoplastic; Antibodies, Antineutrophil Cytoplasmic; Antibodies, Monoclonal, Humanized; Antifungal Agents; Antigens, Bacterial; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Antimetabolites, Antineoplastic; Antineoplastic Agents; 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Long-term exposure to air pollutants is associated with increased stroke incidence, morbidity, and mortality; however, research on the association of pollutant exposure with poststroke hospital readmissions is lacking.. We assessed associations between average annual carbon monoxide (CO), nitrogen dioxide (NO. Of 448 148 patients with stroke, 12.5% were readmitted within 30 days. Except for tropospheric NO. Long-term air pollutant exposure below national limits was associated with increased 30-day readmissions after stroke, regardless of hospital performance category. Whether air quality improvements lead to reductions in poststroke readmissions requires further research.

Topics: Aged; Air Pollutants; Air Pollution; Environmental Exposure; Humans; Medicare; Nitrogen Dioxide; Particulate Matter; Patient Readmission; Stroke; United States

Ambient particulate matter (PM) air pollution is a leading cause of global disability and accounts for an annual 2.9 million deaths globally. PM is established as an important risk factor for cardiovascular disease, however the evidence supporting a link specifically between long-term exposure to ambient PM and incident stroke is less clear. We sought to evaluate the association of long-term exposure to different size fractions of ambient PM with incident stroke (overall and by etiologic subtypes) and cerebrovascular deaths within the Women's Health Initiative, a large prospective study of older women in the US.. During a median follow-up time of 15 years, participants experienced 4,556 cerebrovascular events. The hazard ratio for all cerebrovascular events was 2.14 (95% CI: 1.87, 2.44) comparing the top versus bottom quartiles of PM. Long-term exposure to fine (PM

Topics: Aged; Air Pollutants; Air Pollution; Environmental Exposure; Female; Humans; Nitrogen Dioxide; Particulate Matter; Prospective Studies; Stroke; Women's Health

Long-term air pollution is a risk factor for stroke. Which types and sources of air pollution contribute most to stroke in populations is unknown. We investigated whether risk of stroke differed by type and source of air pollution.. We selected all persons aged >50 years and living in Denmark in the period 2005-17. We estimated running 5-year mean residential air-pollution concentrations of particulate matter <2.5 µm (PM2.5), ultrafine particles (UFP), elemental carbon (EC) and nitrogen dioxide (NO2). Pollutants were modelled as total air pollution from all emission sources, as well as apportioned into contributions from non-traffic and traffic sources. Hazard ratios (HRs) and CIs were estimated by using Cox proportional hazards models, adjusting for area-level and personal demographic and socio-economic covariates. We identified all primary strokes from hospital and mortality registers.. The cohort numbered 2 million people and 94 256 cases of stroke. Interquartile ranges (IQR) of air pollution were associated with risk of stroke with HRs of 1.077 (95% CI: 1.061-1.094, IQR: 1.85 µg/m3) for PM2.5, 1.039 (1.026-1.052, IQR: 4248 particles/cm3) for UFP, 1.009 (1.001-1.018, IQR: 0.28 µg/m3) for EC and 1.028 (1.017-1.040, IQR: 7.15 µg/m3) for NO2. Traffic sources contributed little to the total exposure. HRs associated with air pollution from traffic were close to the null, whereas non-traffic sources tended to be associated with HRs higher than those for total air pollution, e.g. for non-traffic PM2.5, the HR was 1.091 (1.074-1.108).. Air pollution, including UFP, was associated with risk of stroke. The risk appeared attributable mainly to air pollution from non-traffic sources.

Topics: Air Pollutants; Air Pollution; Carbon; Denmark; Environmental Exposure; Humans; Nitrogen Dioxide; Particulate Matter; Stroke

Higher neighbourhood greenness is associated with beneficial health outcomes, and short-term exposure to air pollution is associated with an elevated risk of stroke onset. However, little is known about their interactions.. Daily data on stroke first onset were collected from 20 counties in Shangdong Province, China, from 2013 to 2019. The enhanced vegetation index (EVI) and concentrations of fine particulate matter (PM. Residence in areas with higher greenness was related to weaker associations between air pollution and stroke risk, suggesting that effectively planning green spaces can improve public health.

Topics: Air Pollutants; Air Pollution; China; Cross-Over Studies; Environmental Exposure; Humans; Nitrogen Dioxide; Particulate Matter; Stroke

Air pollutant concentrations in South Korea vary greatly by region and time. To assess temporal and spatial associations of stroke subtypes with long-term air pollution effects on stroke mortality, we studied ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH).. This was an observational study conducted in South Korea from 2001-2018. Concentrations of carbon monoxide (CO), nitrogen dioxide (NO. The concentrations of air pollutants gradually decreased from 2001-2018, along with decreases in IS and ICH mortality rates. However, mortality rates associated with SAH remained constant. From 2001-2006, NO. Considering temporal and spatial trends, high concentrations of air pollutants were most likely to be associated with IS mortality. Our results strengthen the existing evidence of the deleterious effects of air pollution on IS mortality.

Topics: Air Pollutants; Air Pollution; Humans; Nitrogen Dioxide; Republic of Korea; Stroke

Daily exposure to ambient air pollution is associated with stroke morbidity and mortality; however, the association between hourly exposure to air pollutants and risk of emergency hospital admissions for stroke and its subtypes remains relatively unexplored.. We obtained hourly concentrations of fine particulate matter (PM. Hourly exposure to PM. Our findings suggest that exposure to PM

Topics: Aged; Air Pollutants; Air Pollution; China; Cross-Over Studies; Environmental Exposure; Hospitals; Humans; Ischemic Stroke; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Stroke; Sulfur Dioxide

We used a large national cohort in Canada to assess the incidence of acute myocardial infarction (AMI) and stroke hospitalizations in association with long-term exposure to fine particulate matter (PM

Topics: Air Pollutants; Air Pollution; Canada; Cohort Studies; Environmental Exposure; Humans; Myocardial Infarction; Nitrogen Dioxide; Ozone; Particulate Matter; Stroke

Recent studies suggest potential interactions of air pollutants with dietary factors and genetic susceptibility on mortality risk; however, evidence from prospective studies is still lacking. We aimed to assess the association between air pollution and mortality, and investigate the modification effects of a healthy diet and genetic susceptibility.. A total of 386 937 participants were enrolled from 2006 to 2010 and followed up to 2018 in the UK Biobank study. The annual average air pollutant concentrations of particulate matter (PM) with diameters ≤2.5 (PM2.5), ≤10 (PM10) and between 2.5 and 10 µm (PM2.5-10) and nitrogen oxides (NO2 and NOx) were calculated and linked to participants' residential addresses. Healthy dietary patterns were evaluated by a healthy diet score (HDS) based on intakes of vegetables, fruit, fish, unprocessed red meat and processed meat. We also calculated genetic risk score (GRS) of the lifespan. We examined potential interactions by setting variable cross-product terms of air pollutants with diets or GRS in the models.. We identified 11 881 deaths [2426 from cardiovascular diseases (CVD), 1211 from coronary heart disease (CHD) and 466 from stroke] during a median follow-up of 8.9 years. We found that PM2.5 [hazard ratio (HR), 1.27; 95% CI, 1.05-1.55], PM10 (HR, 1.18; 95% CI, 1.04-1.34), NO2 (HR, 1.05; 95% CI, 1.01-1.08), and NOx (HR, 1.02; 95% CI, 1.01-1.03) were associated with all-cause mortality. PM2.5 was also associated with increased risks of CVD mortality (HR, 1.68; 95% CI, 1.10-2.56) and CHD mortality (HR, 2.08; 95% CI, 1.16-3.75). In addition, we found that adherence to healthy dietary patterns modified associations of PM2.5, NO2 and NOx with all-cause mortality (P-interaction = 0.006, 0.006 and 0.02, respectively). Among the individual dietary components, vegetable intakes showed interactions with PM2.5, NO2 and NOx (P-interaction = 0.007, 0.004 and 0.02, respectively). The associations between air pollutants and increased risks of all-cause mortality were attenuated among participants with higher vegetable intakes. We did not observe interactions between air pollutants and HDS on CVD, CHD or stroke mortality (P-interaction > 0.05). Besides, we did not find interactions between air pollutants and genetic risk for lifespan on mortality risk.. This study provides evidence linking long-term exposure to various air pollutants to the risk of all-cause, CVD and CHD mortality, and the potential attenuation of a healthy diet, especially high vegetable intakes, on such relations. Our findings highlight the importance of adherence to a healthy diet in lowering ambient air-pollution-related mortality risk.

Topics: Air Pollutants; Air Pollution; Biological Specimen Banks; Cardiovascular Diseases; Diet, Healthy; Environmental Exposure; Genetic Predisposition to Disease; Humans; Nitrogen Dioxide; Particulate Matter; Prospective Studies; Stroke; United Kingdom; Vegetables

Short-term exposure to ambient air pollution has been linked to increased risk of stroke mortality, but its adverse effects on mortality from specific types of stroke including ischemic stroke and hemorrhagic stroke remain poorly understood.. Using the China National Mortality Surveillance System, we conducted a time-stratified case-crossover study among 412,567 stroke deaths in Jiangsu province, China during 2015-2019. Residential daily PM. Each 10 μg/m. Short-term exposure to ambient air pollution was significantly associated with increased risk of both ischemic and hemorrhagic stroke mortality and posed considerable excess mortality. Our results suggest that air pollution exposure may lead to substantially greater adverse effects on mortality from ischemic stroke than that from hemorrhagic stroke.

Topics: Air Pollutants; Air Pollution; China; Cross-Over Studies; Environmental Exposure; Hemorrhagic Stroke; Humans; Ischemia; Ischemic Stroke; Nitrogen Dioxide; Particulate Matter; Stroke

Previous studies found that exposure to ambient nitrogen dioxide (NO

Topics: Aged; Air Pollutants; Air Pollution; China; Humans; Ischemic Stroke; Male; Nitrogen Dioxide; Particulate Matter; Stroke

Ambient air pollution has been widely linked with morbidity and mortality of stroke. However, its effects on dynamic progression trajectory of stroke remain unknown.We investigated the effects of ambient air pollution on progression trajectory from healthy status to incident stroke, poststroke cardiovascular diseases, and subsequent death.. We retrieved 318,752 participants from the UK Biobank. The annual concentrations of air pollution [particulate matter (PM. During 3,765,630 person-years of follow-up, we identified 5,967 incident stroke patients, 2,985 poststroke cardiovascular patients, and 1,020 deaths afterward. Each 5 μg/m. This study provides the first evidence that ambient air pollution is one important factor associated with the progression of stroke, and the effects differed across different clinical stages. A better understanding of the differential effects of air pollutants on different stroke transition stages could provide valuable insight toward targets for health management and clinical prevention.

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Humans; Incidence; Nitrogen Dioxide; Particulate Matter; Prospective Studies; Stroke

Many epidemiological studies have observed the association of air pollutant exposure with the onset, progression, and mortality of stroke. The aim of this study was to investigate the associations of air pollutants, including SO. Data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 were obtained. The 21,240 patients who were admitted for or died due to stroke were 1:4 matched for age, sex, income, and region of residence with 84,960 control participants. The meteorological factors of mean, highest, and lowest temperatures; relative humidity; ambient atmospheric pressure; and air pollutant concentrations (SO. The odds ratio associated with seven days of exposure to CO was 1.16 (95% CI = 1.04-1.31) in stroke patients. For 30 days of exposure, the odds ratio associated with CO was 1.16 (95% CI = 1.02-1.32) in stroke patients. Seven and 30 days of NO. Both short- and long-term exposure to CO were related to stroke.

Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Nitrogen Dioxide; Particulate Matter; Stroke

To investigate the association between ambient air pollution and stroke morbidity in different subgroups and seasons.. We performed a time-series analysis based on generalised linear models to study the short-term exposure-response relationships between air pollution and stroke hospitalisations, and conducted subgroup analyses to identify possible sensitive populations.. For every 10 µg/m. Our study indicates that short-term exposure to PM

Topics: Adult; Aged; Air Pollution; China; Environmental Exposure; Female; Hospitalization; Humans; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Stroke

Ambient air pollution has been linked to stroke, but few studies have examined in detail stroke subtypes and confounding by road traffic noise, which was recently associated with stroke. Here we examined the association between long-term exposure to air pollution and incidence of stroke (overall, ischemic, hemorrhagic), adjusting for road traffic noise. In a nationwide Danish Nurse Cohort consisting of 23,423 nurses, recruited in 1993 or 1999, we identified 1,078 incident cases of stroke (944 ischemic and 134 hemorrhagic) up to December 31, 2014, defined as first-ever hospital contact. The full residential address histories since 1970 were obtained for each participant and the annual means of air pollutants (particulate matter with diameter < 2.5 µm and < 10 µm (PM

Topics: Air Pollutants; Air Pollution; Cohort Studies; Denmark; Environmental Exposure; Humans; Incidence; Nitrogen Dioxide; Particulate Matter; Stroke

Although growing evidence links air pollution to stroke incidence, less is known about the effect of air pollution on atrial fibrillation (AF), an important risk factor for stroke.. We assessed the associations between air pollution and incidence of AF and stroke. We also sought to characterize the shape of pollutant-disease relationships.. The population-based cohort comprised 5,071,956 Ontario residents, age 35–85 y and without the diagnoses of both outcomes on 1 April 2001 and was followed up until 31 March 2015. AF and stroke cases were ascertained using health administrative databases with validated algorithms. Based on annual residential postal codes, we assigned 5-y running average concentrations of fine particulate matter ([Formula: see text]), nitrogen dioxide ([Formula: see text]), and ozone ([Formula: see text]) from satellite-derived data, a land-use regression model, and a fusion-based method, respectively, as well as redox-weighted averages of [Formula: see text] and [Formula: see text] ([Formula: see text]) for each year. Using Cox proportional hazards models, we estimated the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of AF and stroke with each of these pollutants, adjusting for individual- and neighborhood-level variables. We used newly developed nonlinear risk models to characterize the shape of pollutant–disease relationships.. Between 2001 and 2015, we identified 313,157 incident cases of AF and 122,545 cases of stroke. Interquartile range increments of [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] were associated with increases in the incidence of AF [HRs (95% CIs): 1.03 (1.01, 1.04), 1.02 (1.01, 1.03), 1.01 (1.00, 1.02), and 1.01 (1.01, 1.02), respectively] and the incidence of stroke [HRs (95% CIs): 1.05 (1.03, 1.07), 1.04 (1.01, 1.06), 1.05 (1.03, 1.06), and 1.05 (1.04, 1.06), respectively]. Associations of similar magnitude were found in various sensitivity analyses. Furthermore, we found a near-linear association for stroke with [Formula: see text], whereas [Formula: see text], [Formula: see text]-, and [Formula: see text] relationships exhibited sublinear shapes.. Air pollution was associated with stroke and AF onset, even at very low concentrations. https://doi.org/10.1289/EHP4883.

Topics: Adult; Aged; Aged, 80 and over; Air Pollution; Atrial Fibrillation; Environmental Exposure; Female; Humans; Incidence; Male; Middle Aged; Nitrogen Dioxide; Ontario; Ozone; Particulate Matter; Risk; Stroke

The exposure to air pollutants may increase both incidence and mortality of stroke. We aimed to investigate the association of short- and medium-term exposure to particulate matter (PM) and nitrogen dioxide (NO

Topics: Adult; Aged; Air Pollution; Brain Edema; Environmental Exposure; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Retrospective Studies; Stroke; Thrombolytic Therapy; Time Factors

To investigate the acute effect of air pollutants on ischaemic stroke (IS) and IS-related death.. Five urban districts in Changzhou, China, between 9 January 2015 and 31 December 2016.. A total of 32 840 IS cases and 4028 IS deaths were enrolled.. A time-series design, generalised additive model and multivariable regression model were used to examine the percentage change (95% CI) in daily IS counts and deaths with an IQR increase in air pollutant levels for different single or multiple lag days in single-pollutant and two-pollutant models.. Daily IS counts increased 0.208% (95% CI 0.036% to 0.381%) with an IQR increment in the levels of nitrogen dioxide (NO. This study suggested that short-term exposure to ambient NO

Topics: Adult; Age Distribution; Aged; Air Pollutants; Air Pollution; Brain Ischemia; Carbon Monoxide; China; Environmental Exposure; Female; Humans; Male; Middle Aged; Multivariate Analysis; Nitrogen Dioxide; Particulate Matter; Regression Analysis; Sex Distribution; Stroke; Sulfur Dioxide

Evidence of the short-term effects of ambient air pollution on the risk of ischemic stroke in low- and middle-income countries is limited and inconsistent. We aimed to examine the associations between air pollution and daily hospital admissions for ischemic stroke in China.. We identified hospital admissions for ischemic stroke in 2014-2016 from the national database covering up to 0.28 billion people who received Urban Employee Basic Medical Insurance (UEBMI) in China. We examined the associations between air pollution and daily ischemic stroke admission using a two-stage method. Poisson time-series regression models were firstly fitted to estimate the effects of air pollution in each city. Random-effects meta-analyses were then conducted to combine the estimates. Meta-regression models were applied to explore potential effect modifiers. More than 2 million hospital admissions for ischemic stroke were identified in 172 cities in China. In single-pollutant models, increases of 10 μg/m3 in particulate matter with aerodynamic diameter <2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) and 1 mg/m3 in carbon monoxide (CO) concentrations were associated with 0.34% (95% confidence interval [CI], 0.20%-0.48%), 1.37% (1.05%-1.70%), 1.82% (1.45%-2.19%), 0.01% (-0.14%-0.16%), and 3.24% (2.05%-4.43%) increases in hospital admissions for ischemic stroke on the same day, respectively. SO2 and NO2 associations remained significant in two-pollutant models, but not PM2.5 and CO associations. The effect estimates were greater in cities with lower air pollutant levels and higher air temperatures, as well as in elderly subgroups. The main limitation of the present study was the unavailability of data on individual exposure to ambient air pollution.. As the first national study in China to systematically examine the associations between short-term exposure to ambient air pollution and ischemic stroke, our findings indicate that transient increase in air pollution levels may increase the risk of ischemic stroke, which may have significant public health implications for the reduction of ischemic stroke burden in China.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Brain Ischemia; Carbon Monoxide; China; Cities; Databases, Factual; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Particle Size; Particulate Matter; Patient Admission; Stroke; Sulfur Dioxide; Temperature; Time Factors; Young Adult

Pathways through which air pollution may impact cognitive function are poorly understood, particularly with regard to whether and how air pollution interacts with social and emotional factors to influence cognitive health.. To examine the association between air pollutant exposures and cognitive outcomes among older adults participating in the National Social Life, Health, and Aging Project (NSHAP) cohort study.. Measures of cognitive function, social connectedness, and physical and mental health were obtained for each NSHAP participant starting with Wave 1 of the study in 2005. Cognitive function was assessed using the Chicago Cognitive Function Measure (CCFM) for 3377 participants. Exposures to fine particles (PM. In adjusted linear regression models, IQR increases in 1 to 7year PM. Exposures to long-term PM

Topics: Activities of Daily Living; Aged; Aged, 80 and over; Aging; Air Pollutants; Air Pollution; Anxiety; Cognition; Cohort Studies; Depression; Female; Health Status; Humans; Linear Models; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Social Support; Stress, Psychological; Stroke

There is growing interest in the association between ambient air pollution and stroke, but few studies have investigated the association in developing countries. The primary objective of this study was to examine the association between levels of ambient air pollutants and hospital admission for stroke in China. A time-stratified case-crossover analysis was conducted between 2014 and 2015 in 14 large Chinese cities among 200,958 ischemic stroke and 41,746 hemorrhagic stroke hospitalizations. We used conditional logistic regression to estimate the percentage changes in stroke admissions in relation to interquartile range increases in air pollutants. Air pollution was positively associated with ischemic stroke. A difference of an interquartile range of the 6-day average for particulate matter less than 10 μm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone corresponded to 0.7% (95% CI: 0%, 1.4%), 1.6% (95% CI: 1.0%, 2.3%), 2.6% (95% CI: 1.8%, 3.5%), 0.5% (95% CI: -0.2%, 1.1%), and 1.3% (95% CI: 0.3%, 2.3%) increases in ischemic stroke admissions, respectively. For hemorrhagic stroke, we observed the only significant association in relation to nitrogen dioxide on the current day (percentage change: 1.6%; 95% CI: 0.3%, 2.9%). Our findings contribute to the limited scientific literature concerning the effect of ambient air pollution on stroke in developing countries. Our findings may have significant public health implications for primary prevention of stroke in China.

Topics: Air Pollutants; Air Pollution; Carbon Monoxide; China; Cities; Cross-Over Studies; Developing Countries; Environmental Exposure; Hospitalization; Humans; Logistic Models; Nitrogen Dioxide; Ozone; Particulate Matter; Public Health; Stroke; Sulfur Dioxide

Data on the association between air pollution and risk of ischemic stroke in China are still limited. This study aimed to investigate the association between short-term exposure to ambient air pollution and risk of ischemic strokes in Guangzhou, the most densely-populated city in south China, using a large-scale multicenter database of stroke hospital admissions. Daily counts of ischemic stroke admissions over the study years 2013-2015 were obtained from the Guangzhou Cardiovascular and Cerebrovascular Disease Event Surveillance System. Daily particulate matter <2.5 μm in diameter (PM

Topics: Adult; Aged; Air Pollutants; Air Pollution; China; Cities; Environmental Exposure; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Risk; Stroke; Sulfur Dioxide; Temperature; Young Adult

Increasing ozone concentrations have been known to damage human health and ecosystems. Although ozone tends to display diurnal variation, most studies have reported only on the association between daily ozone concentrations and ischemic stroke occurrence on the same day, or with a 1-day lag. We investigated the effect of the diurnal variation of ozone on ischemic stroke occurrence during the same day.. We included a consecutive series of 1,734 patients from January 1, 2008, to December 31, 2014, at a single tertiary hospital in Seoul, South Korea. We evaluated differences between temperature and pollutants at the time of stroke onset for each time interval and averaged those parameters across the 7-year study period.. During the interval from 13:00 to 16:59, we found a positive association between ischemic stroke occurrence and ozone concentration relative to other time periods. Upper median ozone levels from 13:00 to 16:59 were positively correlated with ischemic stroke (odds ratio, 1.550; 95% confidence intervals, 1.220 to 1.970; P = <0.001) when compared with lower median levels.. The results show diurnal patterns of ischemic stroke occurrence based on upper and lower median ozone levels for a 24-hour period, which extends understanding of the association between stroke occurrence and environmental influences.

Topics: Aged; Air Pollutants; Circadian Rhythm; Female; Humans; Ischemia; Male; Middle Aged; Nitrogen Dioxide; Odds Ratio; Ozone; Republic of Korea; Retrospective Studies; Stroke; Temperature

Airborne particulate matter (PM) consists of particles from diverse sources, including vehicle exhausts. Associations between short-term PM changes and stroke incidence have been shown. Cumulative exposures over several months, or years, are less well studied; few studies examined ischaemic subtypes or PM source.. This study combines a high resolution urban air quality model with a population-based stroke register to explore associations between long-term exposure to PM and stroke incidence.. Data from the South London Stroke Register from 2005-2012 were included. Poisson regression explored association between stroke incidence and long-term (averaged across the study period) exposure to PM2.5(PM<2.5μm diameter) and PM10(PM<10μm), nitric oxide, nitrogen dioxide, nitrogen oxides and ozone, at the output area level (average population=309). Estimates were standardised for age and sex and adjusted for socio-economic deprivation. Models were stratified for ischaemic and haemorrhagic strokes and further broken down by Oxford Community Stroke Project classification and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification.. 1800 strokes were recorded (incidence=42.6/100,000 person-years). No associations were observed between PM and overall ischaemic or haemorrhagic incidence. For an interquartile range increase in PM2.5, there was a 23% increase in incidence (Incidence rate ratio=1.23 (95%CI: 1.03-1.44)) of total anterior circulation infarcts (TACI) and 20% increase for PM2.5 from exhausts (1.20(1.01-1.41)). There were similar associations with PM10, overall (1.21(1.01-1.44)) and from exhausts (1.20(1.01-1.41)). TACI incidence was not associated with non-exhaust sources. There were no associations with other stroke subtypes or pollutants.. Outdoor air pollution, particularly that arising from vehicle exhausts, may increase risk of TACI but not other stroke subtypes.

Topics: Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Environmental Exposure; Environmental Monitoring; Female; Humans; Incidence; London; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Stroke; Vehicle Emissions

To study the association of air pollution with health service demand of the elderly and middle-age patients with cardiovascular and cerebrovascular diseases, and to provide a scientific basis for development of environmental protection policy and health service policy of the Chinese government.. This study included survey data on self-evaluated health, outpatient service demand and inpatient service demand of the patients with hypertension, heart disease and stroke in 62 cities of 17 provinces from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2013, and combined it with the data on the annual concentrations of inhalable particulate matter (PM(10)), sulfur dioxide(SO(2)) and nitrogen dioxide (NO(2)) of those provinces and cities. Conditional Logistic regression was carried out to assess the possible effects of air pollutants on self-evaluated health and health service utilization.. The results showed that turning points existed in the effects of concentrations of NO(2) and SO(2) on the health service demand of the patients with hypertension, heart disease and stroke. The inpatient service demand of the hypertension patients increased with NO(2) concentration when it was lower than 35.1 μg/m(3) and decreased with NO(2) concentration for higher value. Self-evaluated health of the patients with heart disease and stroke decreased with SO(2) concentration when it was lower than 63.8 μg/m(3) and increased with SO(2) concentration for higher value. In addition, no evidence was found for the association between PM(10) and health service demand.. Air pollution may have effects on health service demand of the patients with hypertension,cardiovascular and cerebrovascular diseases, and different air pollutants at high or low concentration may have different health effects.

Topics: Aged; Air Pollutants; Air Pollution; Cerebrovascular Disorders; China; Cities; Health Services; Health Services Needs and Demand; Humans; Hypertension; Longitudinal Studies; Middle Aged; Nitrogen Dioxide; Particulate Matter; Stroke; Sulfur Dioxide

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

Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China.. We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25-29.9 and ≥30 kg/m(2), respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006-2008) average concentrations of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates.. We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15-1.47 for stroke, 1.33-1.59 for CVDs), less strong in overweight subjects (OR 1.22-1.35 for stroke, 1.07-1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98-1.01 for stroke, 0.93-1.15 for CVDs). When stratified by gender, these interactions were significant only in women.. Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality of BMI relative to exposure and onset of disease.

Topics: Adolescent; Adult; Aged; Air Pollutants; Air Pollution; Cardiovascular Diseases; China; Environmental Exposure; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Obesity; Ozone; Particulate Matter; Risk Factors; Sex Factors; Stroke; Sulfur Dioxide; Young Adult

Using time-series analyses to determine the association between ambient air pollution and stroke mortality in Jiang'an District of Wuhan, China from 2003 to 2010.. Data on daily stroke mortality for the period 2003 January 1 to 2010 December 31 was obtained from Jiang'an District Center for Disease Control and Prevention, Wuhan and data on relevant air pollution and meteorological factors from the local municipal environmental monitoring center and meteorology bureau of Wuhan, respectively. Application of a time-series analysis in generalized additive model was applied to evaluate the association between air pollution and stroke mortality.. Annual average concentrations of PM10, SO(2) and NO(2) during the study period were (115.0 ± 60.0), (50.2 ± 33.7), and (57.6 ± 25.3) µg/m³ respectively. The total stroke death was 9 204, including 4 495 women, and 7 628 people aged over 65-years old. In single-pollutant model, a 10 µg/m³ increase in previous day (lag 1 d) ambient pollutants was associated with 0.67% (95% CI: 0.25%-1.10%) excess risk in stroke mortality for PM10, 0.87% (95% CI: 0.13%-1.63%) excess risk for SO(2) and 2.07% (95% CI: 1.08%-3.07%) excess risk for NO(2), respectively. When co-pollutants were involved into the models, only NO(2) remained strongly associated with stroke mortality (β = 2.07, 95% CI: 1.08-3.07, P < 0.001). A 10 µg/m³, increase of NO(2) in lag 1 d was associated with 1.77% (95% CI: 0.54%-3.01%), 2.27% (95% CI: 0.98%-3.57%) and 2.00% (95% CI: 0.59%-3.43%) excess risk in stroke mortality, respectively, after adjusting for PM10, SO(2)th PM10 and SO(2) e-specific and gender-specific analyses showed that the association between ambient air pollution and stroke mortality was stronger in the elderly (≥ 65 years old) people and women. A 10 µg/m, increase of PM10, SO(2) NO(2) in lag 1 d was associated with excess stroke mortality of 0.97% (95% CI: 0.37%-1.57%), 1.73% (95% CI: 0.69%-2.78%) and 2.98% (95% CI: 1.59%-4.39%) for women, respectively and 0.94% (95% CI: 0.47%-1.42%), 1.06% (95% CI: 0.23%-1.90%) and 2.50% (95% CI: 1.40%-3.62%) for the elderly people (> 65 years old), respectively.. PM10 and gaseous pollutants (SO(2), NO(2)) were significant risk factors for acute stroke death, and people aged over 65-years old and women were more susceptible to the effect of ambient pollutants on stroke mortality.

Topics: Aged; Air Pollutants; Air Pollution; China; Environmental Monitoring; Female; Humans; Models, Theoretical; Mortality; Nitrogen Dioxide; Particulate Matter; Risk; Risk Factors; Stroke; Sulfur Dioxide

Exposure to road traffic noise and air pollution have both been associated with risk for stroke. The few studies including both exposures show inconsistent results. We aimed to investigate potential mutual confounding and combined effects between road traffic noise and air pollution in association with risk for stroke. In a population-based cohort of 57,053 people aged 50-64 years at enrollment, we identified 1999 incident stroke cases in national registries, followed by validation through medical records. Mean follow-up time was 11.2 years. Present and historical residential addresses from 1987 to 2009 were identified in national registers and road traffic noise and air pollution were modeled for all addresses. Analyses were done using Cox regression. A higher mean annual exposure at time of diagnosis of 10 µg/m(3) nitrogen dioxide (NO2) and 10 dB road traffic noise at the residential address was associated with ischemic stroke with incidence rate ratios (IRR) of 1.11 (95% CI: 1.03, 1.20) and 1.16 (95% CI: 1.07, 1.24), respectively, in single exposure models. In two-exposure models road traffic noise (IRR: 1.15) and not NO2 (IRR: 1.02) was associated with ischemic stroke. The strongest association was found for combination of high noise and high NO2 (IRR=1.28; 95% CI=1.09-1.52). Fatal stroke was positively associated with air pollution and not with traffic noise. In conclusion, in mutually adjusted models road traffic noise and not air pollution was associated ischemic stroke, while only air pollution affected risk for fatal strokes. There were indications of combined effects.

Topics: Air Pollutants; Air Pollution; Brain Ischemia; Denmark; Female; Humans; Male; Middle Aged; Nitrogen Dioxide; Noise; Stroke; Vehicle Emissions

Recent epidemiological literatures reported that NO(2) is a potential risk factor of ischemic stroke in polluted area. Meanwhile, our previous in vivo study found that NO(2) could delay the recovery of nerve function after stroke, implying a possible risk of vascular dementia (VaD) with NO(2) inhalation, which is often a common cognitive complication resulting from stroke. However, the effect and detailed mechanisms have not been fully elucidated. In the present study, synaptic mechanisms, the foundation of neuronal function and viability, were investigated in both model rats of ischemic stroke and healthy rats after NO(2) exposure. Transmission electron microscope (TEM) observation showed that 5 mg m(-3) NO(2) exposure not only exacerbated the ultrastructural impairment of synapses in stroke model rats, but also induced neuronal damage in healthy rats. Meantime, we found that the expression of synaptophysin (SYP) and postsynaptic density protein 95 (PSD-95), two structural markers of synapses in ischemic stroke model were inhibited by NO(2) inhalation; and so it was with the key proteins mediating long-term potentiation (LTP), the major form of synaptic plasticity. On the contrary, NO(2) inhalation induced the expression of nearly all these proteins in healthy rats in a concentration-dependent manner. Our results implied that NO(2) exposure could increase the risk of VaD through inducing excitotoxicity in healthy rats but weakening synaptic plasticity directly in stroke model rats.

Topics: Air Pollutants; Animals; Dementia, Vascular; Disease Models, Animal; Disks Large Homolog 4 Protein; Hippocampus; Intracellular Signaling Peptides and Proteins; Male; Membrane Proteins; Neuronal Plasticity; Nitrogen Dioxide; Protein Kinases; Rats; Rats, Wistar; Risk Factors; Stroke; Synapses; Synaptophysin; Transcription Factors

Air pollution exposure is associated with hospital admissions and emergency room visits for cardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but traffic and natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O3), nitrogen dioxide (NO2), and particulate matter (PM10) in the Icelandic capital area.. We constructed a time series of the daily number of adults who visited the emergency room, or were acutely admitted for stroke or cardiorespiratory causes to Landspitali University Hospital 1 January 2003 - 31 December 2009 from the hospital in-patient register. We used generalized additive models assuming Poisson distribution, to analyze the daily emergency hospital visits as a function of the pollutant levels, and adjusted for meteorological variables, day of week, and time trend with splines.. Daily emergency hospital visits increased 3.9% (95% confidence interval (CI) 1.7-6.1%) per interquartile (IQR) change in average O3 the same and two previous days. For females, the increase was 7.8% (95% CI 3.6-12.1) for elderly (70+), the increase was 3.9% (95% CI 0.6-7.3%) per IQR increase of NO2. There were no associations with PM10.. We found an increase in daily emergency hospital visits associated with O3, indicating that low-level exposure may trigger cardiopulmonary events or stroke.

Topics: Adult; Aged; Air Pollutants; Cardiovascular Diseases; Comorbidity; Emergency Service, Hospital; Environmental Exposure; Environmental Monitoring; Female; Hospitalization; Humans; Iceland; Incidence; Male; Middle Aged; Nitrogen Dioxide; Ozone; Particulate Matter; Poisson Distribution; Respiratory Tract Diseases; Seasons; Stroke; Time Factors; Urban Health

There are several plausible mechanisms whereby either short or long term exposure to pollution can increase the risk of stroke. Over the last decade, several studies have reported associations between short-term (day-to-day) increases in ambient air pollution and stroke. The findings from a smaller number of studies that have looked at long-term exposure to air pollution and stroke have been mixed. Most of these epidemiological studies have assigned exposure to air pollution based on place of residence, but these assignments are typically based on relatively coarse spatial resolutions. To date, few studies have evaluated medium-term exposures (i.e, exposures over the past season or year). To address this research gap, we evaluated associations between highly spatially resolved estimates of ambient nitrogen dioxide (NO2), a marker of traffic pollution, and emergency department visits for stroke in Edmonton, Canada.. This was a case-control study with cases defined as those who presented to an Edmonton area hospital emergency department between 2007 and 2009 with an acute ischemic stroke, hemorrhagic stroke, or transient ischemic attack. Controls were patients who presented to the same emergency departments for lacerations, sprains, or strains. A land-use regression model provided estimates of NO2 that were assigned to the place of residence. Logistic regression methods were used to estimate odds ratios for stroke in relation to an increase in the interquartile range of NO2 (5 ppb), adjusted for age, sex, meteorological variables, and neighborhood effects.. The study included 4,696 stroke (cases) and 37,723 injury patients (controls). For all strokes combined, there was no association with NO2. Namely, the odds ratio associated with an interquartile increase in NO2 was 1.01 (95% confidence interval {CI}: 0.94-1.08). No associations were evident for any of the stroke subtypes examined.. When combined with our earlier work in Edmonton, our findings suggest that day-to-day fluctuations in air pollution increase the risk of ischemic stroke during the summer season, while medium term exposures are unrelated to stroke risk. The findings for medium term exposure should be interpreted cautiously due to limited individual-level risk factor data.

Topics: Adult; Aged; Air Pollution; Canada; Case-Control Studies; Environmental Exposure; Female; Hospitalization; Humans; Male; Middle Aged; Nitrogen Dioxide; Odds Ratio; Particulate Matter; Risk Factors; Social Class; Stroke; Vehicle Emissions

Inconsistent results have been found on the association between air pollution and stroke mortality. Additionally, evidence on people who are potentially sensitive to air pollution-associated stroke mortality is limited.. Daily stroke mortality of adults aged over 65 between 2003 and 2008 in Shanghai, China were collected. The time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants including particles with size <10 µm, sulfur dioxide (SO2) and nitrogen dioxide (NO2) and stroke mortality.. Both total-stroke and ischaemic-stroke mortalities were found to be significantly associated with all three air pollutants. Haemorrhagic stroke was significantly associated with SO2 and NO2 only. Substantial differences were observed for effect estimates of ischaemic-stroke mortality in relation to NO2 among people with cardiac diseases compared with those without; for an increase of 10 μg/m(3) in NO2, the increase in ischaemic-stroke mortality was 7.05% (95% CI 1.92% to 12.17%) for people with comorbid cardiac diseases versus 0.60% (95% CI -0.49% to 1.68%) for those without. We did not find evidence of effect modification by hypertension and diabetes.. This study provides new evidence for the association between exposure to ambient air pollution and stroke mortality. Our results also suggest that underlying cardiac disorder may increase the risk for ischaemic-stroke mortality in relation to air pollution exposure, especially NO2. .

Topics: Age Distribution; Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Brain Ischemia; China; Cross-Over Studies; Female; Humans; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Seasons; Sex Distribution; Stroke; Sulfur Dioxide; Time Factors

Although a number of studies have found an association between aircraft noise and hypertension, there is a lack of evidence on associations with other cardiovascular disease. For road traffic noise, more studies are available but the extent of possible confounding by air pollution has not been established.. This study used data from the Hypertension and Environmental Noise near Airports (HYENA) study. Cross-sectional associations between self-reported 'heart disease and stroke' and aircraft noise and road traffic noise were examined using data collected between 2004 and 2006 on 4712 participants (276 cases), who lived near airports in six European countries (UK, Germany, Netherlands, Sweden, Greece, Italy). Data were available to assess potential confounding by NO2 air pollution in a subsample of three countries (UK, Netherlands, Sweden).. An association between night-time average aircraft noise and 'heart disease and stroke' was found after adjustment for socio-demographic confounders for participants who had lived in the same place for ≥ 20 years (odds ratio (OR): 1.25 (95% confidence interval (CI) 1.03, 1.51) per 10 dB (A)); this association was robust to adjustment for exposure to air pollution in the subsample. 24 hour average road traffic noise exposure was associated with 'heart disease and stroke' (OR: 1.19 (95% CI 1.00, 1.41), but adjustment for air pollution in the subsample suggested this may have been due to confounding by air pollution. Statistical assessment (correlations and variance inflation factor) suggested only modest collinearity between noise and NO2 exposures.. Exposure to aircraft noise over many years may increase risks of heart disease and stroke, although more studies are needed to establish how much the risks associated with road traffic noise may be explained by air pollution.

Topics: Aged; Air Pollutants; Aircraft; Automobiles; Circadian Rhythm; Cross-Sectional Studies; Environmental Exposure; Europe; Female; Heart Diseases; Humans; Male; Middle Aged; Nitrogen Dioxide; Noise, Transportation; Prevalence; Risk Factors; Stroke

There have been no multicity studies on the acute effects of air pollution on stroke mortality in China. This study was undertaken to examine the associations between daily stroke mortality and outdoor air pollution (particulate matter <10 μm in aerodynamic diameter, sulfur dioxide, and nitrogen dioxide) in 8 Chinese cities.. We used Poisson regression models with natural spline-smoothing functions to adjust for long-term and seasonal trends, as well as other time-varying covariates. We applied 2-stage Bayesian hierarchical statistical models to estimate city-specific and national average associations of air pollution with daily stroke mortality.. Air pollution was associated with daily stroke mortality in 8 Chinese cities. In the combined analysis, an increase of 10 μg/m(3) of 2-day moving average concentrations of particulate matter <10 μm in aerodynamic diameter, sulfur dioxide, and nitrogen dioxide corresponded to 0.54% (95% posterior intervals, 0.28-0.81), 0.88% (95% posterior intervals, 0.54-1.22), and 1.47% (95% posterior intervals, 0.88-2.06) increase of stroke mortality, respectively. The concentration-response curves indicated linear nonthreshold associations between air pollution and risk of stroke mortality.. To our knowledge, this is the first multicity study in China, or even in other developing countries, to report the acute effect of air pollution on stroke mortality. Our results contribute to very limited data on the effect of air pollution on stroke for high-exposure settings typical in developing countries.

Topics: Air Pollutants; Air Pollution; Bayes Theorem; China; Cities; Developing Countries; Environmental Exposure; Geography; Humans; Models, Statistical; Nitrogen Dioxide; Particulate Matter; Poisson Distribution; Regression Analysis; Stroke; Sulfur Dioxide

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

Several studies have demonstrated positive associations between day-to-day increases in air pollution and stroke. These findings have been inconsistent, and the influence of patient characteristics has been largely ignored. In this study, we investigated the short-term effects of air pollution on stroke using a time-stratified case-crossover design. Data for hospital visits for stroke were extracted from 5927 medical charts of patients who presented to emergency departments between 2003 and 2009 in Edmonton, Canada. Daily concentrations of five air pollutants (NO(2), PM (2.5), CO, O(3), and SO(2)) were obtained from fixed-site monitors. Relative humidity and temperature were obtained from a metrological station operating at the city's airport. Chart data included: disease history, medication use, and smoking status. Conditional logistic regression was used to estimate the odds ratio (OR) of stroke in relation to an increase in the interquartile range for each pollutant. Positive associations were observed between ischemic stroke and air pollution during the 'warm' season (April through September). Specifically, the OR for an increase in 9.4 ppb in the 3-day average of NO(2) was 1.50 (95% CI: 1.12, 2.01). There were no statistically significant associations with any of the other pollutants after adjusting for NO(2) concentrations. Associations with ischemic stroke were stronger for those with a history of stroke (OR=2.31; 95% CI: 1.39, 3.83), heart disease (OR=1.99; 95% CI: 1.20, 3.28), and taking medication for diabetes (OR=2.03; 95% CI: 1.14, 3.59). Temperature was inversely associated with ischemic stroke during the 'warm' season, but no associations were evident with the other stroke subtypes. Air pollution was not associated with hemorrhagic stroke or transient ischemic attacks. The findings suggest that specific patient characteristics modify associations between air pollution and ischemic stroke.

Topics: Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Alberta; Case-Control Studies; Cross-Over Studies; Emergency Service, Hospital; Female; Heart Diseases; Hospitalization; Humans; Hypoglycemic Agents; Logistic Models; Male; Middle Aged; Nitrogen Dioxide; Odds Ratio; Risk Factors; Seasons; Stroke; Time Factors

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

Here the correlativity between NO(2), a representative pollutant of vehicle exhaust, and ischemic stroke was first determined under experimental conditions following some epidemiological reports. First, we found that blood viscosity, red blood cell (RBC) aggregation-, electrophoresis- and rigidity-index in healthy rats were increased after exposure to 5mg/m(3) NO(2) for one- and three-month. Based on this, we set up stroke rat model and exposed them to NO(2) at the same concentration for one week, and found that NO(2) exposure time-dependently delayed neurological structure and function recovery of MCAO (middle cerebral artery occlusion) rat, and worsened pathological injuries and apoptosis induced by MCAO operation. Endothelial and inflammatory responses, two common cellular pathomechanisms involved in ischemic brain damage, were induced in cortex by MCAO treatment and exacerbated by followed NO(2) inhalation. Expression of the endothelial and inflammatory biomarkers in stroke displayed the same tendency in healthy rats after sub-acute and sub-chronic NO(2) exposure as in MCAO model in a concentration-dependent manner. Our data provide evidence that environmental NO(2) is an important inducer, and also a promoter of ischemic stroke, with endothelial nitric oxide synthase (eNOS), cyclooxygenase-2 (COX-2) and intercellular adhesion molecule 1 (ICAM-1) being potential indicators of this effect.

Topics: Air Pollutants; Animals; Cyclooxygenase 2; Infarction, Middle Cerebral Artery; Intercellular Adhesion Molecule-1; Male; Nitric Oxide Synthase Type III; Nitrogen Dioxide; Random Allocation; Rats; Rats, Wistar; Reverse Transcriptase Polymerase Chain Reaction; RNA; Specific Pathogen-Free Organisms; Stroke

While several studies have investigated the effects of short-term air pollution on cardiovascular disease, less is known about its effects on cerebrovascular disease, including stroke and transient ischaemic attack (TIA). The aim of the study was to assess the effects of short-term variation in air pollutants on the onset of TIA and minor stroke.. We performed secondary analyses of data collected prospectively in the North West of England in a multi-centre study (NORTHSTAR) of patients with recent TIA or minor stroke. A case-crossover study was conducted to determine the association between occurrence of TIA and the concentration of ambient PM10 or gaseous pollutants.. A total of 709 cases were recruited from the Manchester (n = 335) and Liverpool (n = 374) areas. Data for the Manchester cohort showed an association between ambient nitric oxide (NO) and risk of occurrence of TIA and minor stroke with a lag of 3 days (odds ratio 1.06, 95% CI: 1.01 - 1.11), whereas negative association was found for the patients from Liverpool. Effects of similar magnitude, although not statistically significant, were generally observed with other pollutants. In a two pollutant model the effect of NO remained stronger and statistically significant when analysed in combination with CO or SO2, but was marginal in combination with NO2 or ozone and non-significant with PM10. There was evidence of effect modification by age, gender and season.. Our data suggest an association between NO and occurrence of TIA and minor stroke in Greater Manchester.

Topics: Adult; Aged; Aged, 80 and over; Air Pollutants; Carbon Monoxide; England; Female; Humans; Incidence; Ischemic Attack, Transient; Male; Middle Aged; Nitric Oxide; Nitrogen Dioxide; Particulate Matter; Stroke; Sulfur Dioxide

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

Case-crossover studies used to investigate associations between an environmental exposure and an acute health response, such as stroke, will often use the day an individual presents to an emergency department (ED) or is admitted to hospital to infer when the stroke occurred. Similarly, they will use patient's place of residence to assign exposure. The validity of using these two data elements, typically extracted from administrative databases or patient charts, to define the time of stroke onset and to assign exposure are critical in this field of research as air pollutant concentrations are temporally and spatially variable. Our a priori hypotheses were that date of presentation differs from the date of stroke onset for a substantial number of patients, and that assigning exposure to ambient pollution using place of residence introduces an important source of exposure measurement error. The objective of this study was to improve our understanding on how these sources of errors influence risk estimates derived using a case-crossover study design.. We sought to collect survey data from stroke patients presenting to hospital EDs in Edmonton, Canada on the date, time, location and nature of activities at onset of stroke symptoms. The daily mean ambient concentrations of NO₂ and PM(2.5) on the self-reported day of stroke onset was estimated from continuous fixed-site monitoring stations.. Of the 336 participating patients, 241 were able to recall when their stroke started and 72.6% (95% confidence interval [CI]: 66.9-78.3%) experienced stroke onset the same day they presented to the ED. For subjects whose day of stroke onset differed from the day of presentation to the ED, this difference ranged from 1 to 12 days (mean = 1.8; median = 1). In these subjects, there were no systematic differences in assigned pollution levels for either NO₂ or PM(2.5) when day of presentation rather than day of stroke onset was used. At the time of stroke onset, 89.9% (95% CI: 86.6-93.1%) reported that they were inside, while 84.5% (95% CI: 80.6 - 88.4%) reported that for most of the day they were within a 15 minute drive from home. We estimated that due to the mis-specification of the day of stroke onset, the risk of hospitalization for stroke would be understated by 15% and 20%, for NO₂ and PM(2.5), respectively.. Our data suggest that day of presentation and residential location data obtained from administrative records reasonably captures the time and location of stroke onset for most patients. Under these conditions, any associated errors are unlikely to be an important source of bias when estimating air pollution risks in this population.

Topics: Aged; Aged, 80 and over; Air Pollutants; Alberta; Cities; Cohort Studies; Cross-Over Studies; Environmental Exposure; Female; Humans; Ischemic Attack, Transient; Male; Middle Aged; Nitrogen Dioxide; Particulate Matter; Retrospective Studies; Risk Assessment; Stroke; Time Factors

Some current evidences suggest that stroke incidence and mortality may be higher in elevated air pollution areas. Our study examined the hypothesis of a correlation between air pollution level and ischemic stroke admission and in Hospital mortality in an urban population. Data on a total of 759 stroke admissions and 180 deaths have been obtained over a 4-year period (2000-2003). Five air ambient particles have been studied. A general additive model estimating Poisson distribution has been used, adding meteorological variables as covariates. NO(2) and PM(10) were significantly associated with admission and mortality (P value < 0.05) and with estimated RR of 1.039 (95% CI 1.066-1.013) and 1.078 (95% CI 1.104-1.052) for hospital admission at 2- and 4-day lags, respectively. In conclusion, this study suggests an association between short-term outdoor air pollution exposure and ischemic stroke admission and mortality.

Topics: Aged; Air Pollution; Brain Ischemia; Female; Hospital Mortality; Hospitalization; Humans; Italy; Male; Models, Statistical; Nitrogen Dioxide; Particulate Matter; Poisson Distribution; Stroke; Time Factors; Urban Population

To investigate the short-term effect of particulate matter in air on the mortality of stroke.. Using time-stratified case-crossover study design, an association was examined between stroke mortality and particulate matter with aerodynamic diameter of < 10 microm (PM10) of 2002 - 2004 in Hangzhou city. Meanwhile, the acute health effect of other gaseous pollutants (sulfur dioxide, SO2 and nitrogen dioxide, NO2) was also analyzed.. A total of 9906 deaths of stroke were included. The crude stroke mortality was 83.54 per 100 000. After being adjusted for meteorological factors, when an increase of 10 microg/m3 in PM10, SO2 and NO2 in three days was noticed, it appeared that the increases of mortality of stroke were 0.56% (95% CI: 0.14%-0.99%), 1.62% (95% CI: 0.26% - 3.01%) and 2.07% (95% CI: 0.54% - 3.62%) respectively. There was no distinct association in multi-pollutant models. In sensitivity analysis, the associations were found in all single-pollutant models but not statistically significant in multi-pollutant models after replacing the missing values.. It is suggested that the short-term elevation in PM10 as well as SO2 and NO2 daily concentrations were related to the increase of stroke mortality in Hangzhou city.

Topics: Aged; Aged, 80 and over; Air Pollutants; Cause of Death; China; Cross-Over Studies; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Models, Theoretical; Nitrogen Dioxide; Particulate Matter; Stroke; Sulfur Dioxide; Time Factors

To evaluate the association between air pollutants and the occurrence of acute stroke from 10-year population-based study.. The daily stroke count was obtained from Dijon Stroke Register between March 1994 and December 2004. The register recorded all first-ever strokes among residents of Dijon (150,000 inhabitants) in France, using standard diagnostic criteria. Pollutant concentrations (SO2, CO, NO2, O3 and PM10) were measured hourly. A bi-directional case-crossover design was used to examine the association between air pollutant and stroke onset. The conditional logistic regression model included the meteorological parameters (temperature, relative humidity), influenza epidemics and holidays.. The authors collected 493 large artery infarcts, 397 small artery infarcts, 530 cardio-embolic infarcts, 67 undeterminate infarcts, 371 transient ischaemic attacks and 220 haemorrhagic strokes. For single-pollutant model and for a 10 mg/m(3) increase of O3 exposure, a positive association was observed only in men, over 40 years of age, between ischaemic stroke occurrence and O3 levels with 1-day lag, (OR 1.133, 95% CI 1.052 to 1.220) and 0-day lag (OR 1.058, 95% CI 0.987 to 1.134). No significant associations were found for haemorrhagic stroke. In two-pollutant models, the effects of O3 remained significant after each of the other pollutants were included in the model, in particular with PM10. A significant association was observed for ischaemic strokes of large arteries (p = 0.02) and for transient ischaemic attacks (p = 0.01). Moreover, the authors found an exposure-response relations between O3 exposure and ischaemic stroke (test for trend, p = 0.01). An increase in association in men with several cardiovascular risk factors (smoker, dyslipidemia and hypertension) was also observed.. These observational data argue for an association between ischaemic stroke occurrence and O3 pollution levels; these results still need to be confirmed by other studies.

Topics: Acute Disease; Adult; Age Factors; Aged; Air Pollutants; Arteries; Carbon Monoxide; Climate; Epidemiologic Methods; Female; France; Holidays; Humans; Ischemic Attack, Transient; Male; Middle Aged; Nitrogen Dioxide; Ozone; Registries; Sex Factors; Stroke; Sulfur Dioxide

We plan to conduct a case-control study to investigate whether exposure to nitrogen dioxide (NO2) increases the risk of stroke. In case-control studies, selective participation can lead to bias and loss of efficiency. A two-phase design can reduce bias and improve efficiency by combining information on the non-participating subjects with information from the participating subjects. In our planned study, we will have access to individual disease status and data on NO2 exposure on group (area) level for a large population sample of Scania, southern Sweden. A smaller sub-sample will be selected to the second phase for individual-level assessment on exposure and covariables. In this paper, we simulate a case-control study based on our planned study. We develop a two-phase method for this study and compare the performance of our method with the performance of other two-phase methods.. A two-phase case-control study was simulated with a varying number of first- and second-phase subjects. Estimation methods: Method 1: Effect estimation with second-phase data only. Method 2: Effect estimation by adjusting the first-phase estimate with the difference between the adjusted and unadjusted second-phase estimate. The first-phase estimate is based on individual disease status and residential address for all study subjects that are linked to register data on NO2-exposure for each geographical area. Method 3: Effect estimation by using the expectation-maximization (EM) algorithm without taking area-level register data on exposure into account. Method 4: Effect estimation by using the EM algorithm and incorporating group-level register data on NO2-exposure.. The simulated scenarios were such that, unbiased or marginally biased (< 7%) odds ratio (OR) estimates were obtained with all methods. The efficiencies of method 4, are generally higher than those of methods 1 and 2. The standard errors in method 4 decreased further when the case/control ratio is above one in the second phase. For all methods, the standard errors do not become substantially reduced when the number of first-phase controls is increased.. In the setting described here, method 4 had the best performance in order to improve efficiency, while adjusting for varying participation rates across areas.

Topics: Air Pollutants; Algorithms; Case-Control Studies; Computer Simulation; Humans; Likelihood Functions; Models, Biological; Nitrogen Dioxide; Odds Ratio; Pilot Projects; Research Design; Risk Assessment; Stroke; Sweden

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

This study was undertaken to determine whether there is an association between air pollutants levels and increased number of hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions records for CVD and ambient air contaminant data collected from monitoring station in Kaohsiung were obtained for the period 1997-2000. The relative risk of hospital admission for CVD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant model, on warm days (> or =25 degrees C) statistically significant positive associations were found between levels of particular matter of < 10 microm aerodynamic diameter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). On cool days (< 25 degrees C), all pollutants except O3 were significantly associated with increased CVD admissions. For the two-pollutant model, CO and O3 were both significant in combination with each of the other four contaminants on warm days. PM10 and NO2 remained significantly associated with elevated CVD admissions on warm days. On cool days, CO and NO2 remained statistically significant in all the two-pollutant models. This study provides evidence that higher levels of ambient contaminants, particularly CO, increase the risk of increased hospital admissions for CVD.

Topics: Air Pollution; Carbon Monoxide; Cardiovascular Diseases; Cross-Over Studies; Environmental Monitoring; Epidemiological Monitoring; Hospitalization; Humans; Nitrogen Dioxide; Ozone; Stroke; Taiwan; Temperature

To assess the association between air pollution and daily stroke mortality.. All death records of the decreased who lived in one urban district of Shanghai and died from stroke from January 1 to December 31, 2001 were collected. We used a time series approach to study the acute effects of air pollution on stroke mortality after controlling for long-term trends, weather variables, and day of the week.. An increase of 10 micrograms/m3 of PM10, SO2 and NO2 corresponds to 1.008 (95% CI 1.000-1.016), 1.017 (95% CI 0.998-1.036), and 1.029 (95% CI 1.001-1.057) relative risk of stroke mortality, respectively in Shanghai.. Our findings provide new evidence for the association between air pollution and acute stroke mortality risk.

Topics: Air Pollutants; China; Female; Humans; Male; Nitrogen Dioxide; Risk Factors; Stroke; Sulfur Dioxide; Time Factors

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