Jared A Fisher1, Robin C Puett2, Francine Laden3, Gregory A Wellenius4, Amir Sapkota2, Duanping Liao5, Jeff D Yanosky5, Olivia Carter-Pokras6, Xin He6, Jaime E Hart7. 1. Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. Electronic address: jared.fisher@nih.gov. 2. Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. 3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 4. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. 5. Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA. 6. Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA. 7. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: Stroke is a leading cause of morbidity and mortality in the United States. Associations between short-term exposures to particulate matter (PM) air pollution and stroke are inconsistent. Many prior studies have used administrative and hospitalization databases where misclassification of the type and timing of the stroke event may be problematic. METHODS: In this case-crossover study, we used a nationwide kriging model to examine short-term ambient exposure to PM10 and PM2.5 and risk of ischemic and hemorrhagic stroke among men enrolled in the Health Professionals Follow-up Study. Conditional logistic regression models were used to obtain estimates of odds ratios (OR) and 95% confidence intervals (CI) associated with an interquartile range (IQR) increase in PM2.5 or PM10. Lag periods up to 3 days prior to the stroke event were considered in addition to a 4-day average. Stratified models were used to examine effect modification by patient characteristics. RESULTS: Of the 727 strokes that occurred between 1999 and 2010, 539 were ischemic and 122 were hemorrhagic. We observed positive statistically significant associations between PM10 and ischemic stroke (ORlag0-3 = 1.26; 95% CI: 1.03-1.55 per IQR increase [14.46 μg/m3]), and associations were elevated for nonsmokers, aspirin nonusers, and those without a history of high cholesterol. However, we observed no evidence of a positive association between short-term exposure to PM and hemorrhagic stroke or between PM2.5 and ischemic stroke in this cohort. CONCLUSIONS: Our study provides evidence that ambient PM10 may be associated with higher risk of ischemic stroke and highlights that ischemic and hemorrhagic strokes are heterogeneous outcomes that should be treated as such in analyses related to air pollution.
BACKGROUND:Stroke is a leading cause of morbidity and mortality in the United States. Associations between short-term exposures to particulate matter (PM) air pollution and stroke are inconsistent. Many prior studies have used administrative and hospitalization databases where misclassification of the type and timing of the stroke event may be problematic. METHODS: In this case-crossover study, we used a nationwide kriging model to examine short-term ambient exposure to PM10 and PM2.5 and risk of ischemic and hemorrhagic stroke among men enrolled in the Health Professionals Follow-up Study. Conditional logistic regression models were used to obtain estimates of odds ratios (OR) and 95% confidence intervals (CI) associated with an interquartile range (IQR) increase in PM2.5 or PM10. Lag periods up to 3 days prior to the stroke event were considered in addition to a 4-day average. Stratified models were used to examine effect modification by patient characteristics. RESULTS: Of the 727 strokes that occurred between 1999 and 2010, 539 were ischemic and 122 were hemorrhagic. We observed positive statistically significant associations between PM10 and ischemic stroke (ORlag0-3 = 1.26; 95% CI: 1.03-1.55 per IQR increase [14.46 μg/m3]), and associations were elevated for nonsmokers, aspirin nonusers, and those without a history of high cholesterol. However, we observed no evidence of a positive association between short-term exposure to PM and hemorrhagic stroke or between PM2.5 and ischemic stroke in this cohort. CONCLUSIONS: Our study provides evidence that ambient PM10 may be associated with higher risk of ischemic stroke and highlights that ischemic and hemorrhagic strokes are heterogeneous outcomes that should be treated as such in analyses related to air pollution.
Authors: Richard V Remigio; Hao He; Jochen G Raimann; Peter Kotanko; Frank W Maddux; Amy Rebecca Sapkota; Xin-Zhong Liang; Robin Puett; Xin He; Amir Sapkota Journal: Sci Total Environ Date: 2021-12-16 Impact factor: 7.963
Authors: Yenan Xu; Jarvis T Chen; Isabel Holland; Jeff D Yanosky; Duanping Liao; Brent A Coull; Dong Wang; Kathryn Rexrode; Eric A Whitsel; Gregory A Wellenius; Francine Laden; Jaime E Hart Journal: Environ Epidemiol Date: 2021-11-11
Authors: Alan P Jacobsen; Yii Chun Khiew; Eamon Duffy; James O'Connell; Evans Brown; Paul G Auwaerter; Roger S Blumenthal; Brian S Schwartz; John William McEvoy Journal: Am J Prev Cardiol Date: 2022-09-11