Hourly Air Pollution Exposure and Emergency Hospital Admissions for Stroke: A Multicenter Case-Crossover Study

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...

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Bibliographic Details
Published in:Stroke (1970) 2023-12, Vol.54 (12), p.3038-3045
Main Authors: Lv, Xin, Shi, Wanying, Yuan, Kun, Zhang, Yangchang, Cao, Wangnan, Li, Chunrong, Xu, Lufei, Wu, Lizhi, Sun, Shengzhi, Hong, Feng
Format: Article
Language:English
Subjects:
Aged
Air Pollutants - adverse effects
Air Pollutants - analysis
Air Pollution - adverse effects
Air Pollution - analysis
China - epidemiology
Cross-Over Studies
Environmental Exposure - adverse effects
Hospitals
Humans
Ischemic Stroke - chemically induced
Male
Nitrogen Dioxide - adverse effects
Nitrogen Dioxide - analysis
Ozone - adverse effects
Ozone - analysis
Particulate Matter - adverse effects
Particulate Matter - analysis
Stroke - chemically induced
Stroke - epidemiology
Sulfur Dioxide - adverse effects
Sulfur Dioxide - analysis
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Summary: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 ), respirable particulate matter (PM ), nitrogen dioxide (NO ), sulfur dioxide (SO ), ozone (O ), and carbon monoxide (CO) from the China National Environmental Monitoring Center. We conducted a time-stratified case-crossover study among 86 635 emergency hospital admissions for stroke across 10 hospitals in 3 cities (Jinhua, Hangzhou, and Zhoushan) in Zhejiang province, China, between January 1, 2016 and December 31, 2021. Using a conditional logistic regression combined with a distributed lag linear model, we estimated the association between hourly exposure to multiple air pollutants and risk of emergency hospital admissions for total stroke, ischemic stroke, hemorrhagic stroke, and undetermined type. Hourly exposure to PM , PM , NO , and SO was associated with an increased risk of hospital admissions for total stroke and ischemic stroke. The associations were most pronounced during the concurrent hour of exposure and lasted for ≈2 hours. We found that the risk was more pronounced among male patients or those aged
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.123.044191