Rosa Maria Vivanco-Hidalgo1, Carla Avellaneda-Gómez2, Payam Dadvand3, Marta Cirach4, Ángel Ois5, Alejandra Gómez González6, Ana Rodriguez-Campello7, Pablo de Ceballos8, Xavier Basagaña9, Ana Zabalza10, Elisa Cuadrado-Godia11, Jordi Sunyer12, Jaume Roquer13, Gregory A Wellenius14. 1. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: rvivanco@imim.es. 2. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. Electronic address: cavellaneda@parcdesalutmar.cat. 3. BarcelonaInstitute for Global Health (ISGlobal), C/DrAiguader 88, CP08003, Barcelona, Spain; Universitat PompeuFabra (UPF), Barcelona, Spain. Electronic address: payam.dadvand@isglobal.org. 4. BarcelonaInstitute for Global Health (ISGlobal), C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: marta.cirach@isglobal.org. 5. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: aois@parcdesalutmar.cat. 6. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: 60558@parcdesalutmar.cat. 7. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: 92269@parcdesalutmar.cat. 8. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: PDeCeballos@parcdesalutmar.cat. 9. BarcelonaInstitute for Global Health (ISGlobal), C/DrAiguader 88, CP08003, Barcelona, Spain; Universitat PompeuFabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Electronic address: xavier.basagana@isglobal.org. 10. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: anazabalza@gmail.com. 11. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: ecuadrado@parcdesalutmar.cat. 12. BarcelonaInstitute for Global Health (ISGlobal), C/DrAiguader 88, CP08003, Barcelona, Spain; Universitat PompeuFabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Electronic address: jordi.sunyer@isglobal.org. 13. Hospital del Mar Medical Research Institute, C/DrAiguader 88, CP08003, Barcelona, Spain. Electronic address: jroquer@parcdesalutmar.cat. 14. Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA. Electronic address: gregory_wellenius@brown.edu.
Abstract
BACKGROUND AND PURPOSE: A number of environmental risk factors of acute ischemic stroke have been identified, but few studies have evaluated the influence of the outdoor environment on stroke severity. We assessed the association of residential ambient fine particulate matter air pollution (PM2.5), noise, and surrounding greenspace with initial stroke severity. METHODS: We obtained data on patients hospitalized with acute ischemic stroke from a hospital-based prospective stroke register (2005-2014) in Barcelona. We estimated residential PM2.5 based on an established land use regression model, greenspace as the average satellite-based Normalized Difference Vegetation Index (NDVI) within a 300 m buffer of the residence, and daily (Lday), evening (Levening), night (Lnight) and average noise (Lden) level at the street nearest to the residential address using municipal noise models. Stroke severity was assessed at the time of hospital presentation using the National Institute of Health Stroke Scale (NIHSS).We used logistic regression and binomial models to evaluate the associations of PM2.5, greenspace, and noise with initial stroke severity adjusting for potential confounders. RESULTS: Among 2761 patients, higher residential surrounding greenspace was associated with lower risk of severe stroke (OR for NIHSS>5, 0.75; 95% CI: 0.60-0.95), while, living in areas with higher Lden was associated with a higher risk of severe stroke (OR, 1.30; 95% CI: 1.02-1.65). PM2.5 was not associated with initial stroke severity. CONCLUSIONS: In an urban setting, surrounding greenspace and traffic noise at home are associated with initial stroke severity, suggesting an important influence of the built environment on the global burden of ischemic stroke.
BACKGROUND AND PURPOSE: A number of environmental risk factors of acute ischemic stroke have been identified, but few studies have evaluated the influence of the outdoor environment on stroke severity. We assessed the association of residential ambient fine particulate matter air pollution (PM2.5), noise, and surrounding greenspace with initial stroke severity. METHODS: We obtained data on patients hospitalized with acute ischemic stroke from a hospital-based prospective stroke register (2005-2014) in Barcelona. We estimated residential PM2.5 based on an established land use regression model, greenspace as the average satellite-based Normalized Difference Vegetation Index (NDVI) within a 300 m buffer of the residence, and daily (Lday), evening (Levening), night (Lnight) and average noise (Lden) level at the street nearest to the residential address using municipal noise models. Stroke severity was assessed at the time of hospital presentation using the National Institute of Health Stroke Scale (NIHSS).We used logistic regression and binomial models to evaluate the associations of PM2.5, greenspace, and noise with initial stroke severity adjusting for potential confounders. RESULTS: Among 2761 patients, higher residential surrounding greenspace was associated with lower risk of severe stroke (OR for NIHSS>5, 0.75; 95% CI: 0.60-0.95), while, living in areas with higher Lden was associated with a higher risk of severe stroke (OR, 1.30; 95% CI: 1.02-1.65). PM2.5 was not associated with initial stroke severity. CONCLUSIONS: In an urban setting, surrounding greenspace and traffic noise at home are associated with initial stroke severity, suggesting an important influence of the built environment on the global burden of ischemic stroke.
Authors: Robert B Hood; Peter James; Kelvin C Fong; Lidia Mínguez-Alarcón; Brent A Coull; Joel Schwartz; Itai Kloog; Francine Laden; Audrey J Gaskins Journal: Environ Res Date: 2021-04-24 Impact factor: 8.431
Authors: Omar Hahad; Jos Lelieveld; Frank Birklein; Klaus Lieb; Andreas Daiber; Thomas Münzel Journal: Int J Mol Sci Date: 2020-06-17 Impact factor: 5.923
Authors: Silvestre García de Jalón; Aline Chiabai; Alyvia Mc Tague; Naiara Artaza; Amaia de Ayala; Sonia Quiroga; Hanneke Kruize; Cristina Suárez; Ruth Bell; Timothy Taylor Journal: Int J Environ Res Public Health Date: 2020-04-19 Impact factor: 3.390
Authors: Tom Cole-Hunter; Christian Dehlendorff; Heresh Amini; Amar Mehta; Youn-Hee Lim; Jeanette T Jørgensen; Shuo Li; Rina So; Laust H Mortensen; Rudi Westendorp; Barbara Hoffmann; Elvira V Bräuner; Matthias Ketzel; Ole Hertel; Jørgen Brandt; Steen Solvang Jensen; Jesper H Christensen; Camilla Geels; Lise M Frohn; Claus Backalarz; Mette K Simonsen; Steffen Loft; Zorana J Andersen Journal: Environ Health Date: 2021-11-06 Impact factor: 5.984