scholarly journals Association of air pollution with acute ischemic stroke risk in Singapore: a time-stratified case-crossover study

2022 ◽  
pp. 174749302110667
Author(s):  
Andrew Fu Wah Ho ◽  
Benjamin Yong-Qiang Tan ◽  
Huili Zheng ◽  
Aloysius Sheng-Ting Leow ◽  
Pin Pin Pek ◽  
...  
Keyword(s):  
Air Pollution ◽  
Ischemic Stroke ◽  
Air Quality ◽  
Acute Ischemic Stroke ◽  
Cardiovascular Health ◽  
Ambient Air ◽  
Population Based ◽  
Mortality And Morbidity ◽  
Stroke Registry ◽  
Case Crossover

Background: Air quality is an important determinant of cardiovascular health such as ischemic heart disease and acute ischemic stroke (AIS) with substantial mortality and morbidity reported across the globe. However, associations between air quality and AIS in the current literature remain inconsistent, with few studies undertaken in cosmopolitan cities located in the tropics. Objectives: We evaluated the associations between individual ambient air pollutants and AIS. Methods: We performed a nationwide, population-based, time-stratified case-crossover analysis on all AIS cases reported to the Singapore Stroke Registry from 2009 to 2018. We estimated the incidence rate ratio (IRR) of AIS across different concentrations of each pollutant by quartiles (referencing the 25th percentile), in single-pollutant conditional Poisson models adjusted for time-varying meteorological effects. We stratified our analysis by predetermined subgroups deemed at higher risk. Results: A total of 51,675 episodes of AIS were included. Ozone (O3) (IRR4th quartile: 1.05, 95% confidence interval (CI): 1.01–1.08) and carbon monoxide (CO) (IRR2nd quartile: 1.05, 95% CI: 1.02–1.08, IRR3rd quartile: 1.07, 95% CI: 1.04–1.10, IRR4th quartile: 1.07, 95% CI: 1.04–1.11) were positively associated with AIS incidence. The increased incidence of AIS due to O3 and CO persisted for 5 days after exposure. Those under 65 years of age were more likely to experience AIS when exposed to CO. Individuals with atrial fibrillation (AF) were more susceptible to exposure from O3, CO, and PM10. Current/ex-smokers were more vulnerable to the effect of O3. Conclusion: Air pollution increases the incidence of AIS, especially in those with AF and in those who are current or ex-smokers.

Association of ambient air pollution with risk of hemorrhagic stroke: A time-stratified case crossover analysis of the Singapore stroke registry

2022 ◽  
Vol 240 ◽  
pp. 113908
Author(s):  
Andrew Fu Wah Ho ◽  
Mervyn Jun Rui Lim ◽  
Huili Zheng ◽  
Aloysius Sheng-Ting Leow ◽  
Benjamin Yong-Qiang Tan ◽  
...  
Keyword(s):  
Air Pollution ◽  
Hemorrhagic Stroke ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Stroke Registry ◽  
Case Crossover ◽  
Crossover Analysis

scholarly journals Ethnic differences in ambient air pollution and risk of acute ischemic stroke

2015 ◽  
Vol 143 ◽  
pp. 62-67 ◽  
Author(s):  
Jeffrey J. Wing ◽  
Sara D. Adar ◽  
Brisa N. Sánchez ◽  
Lewis B. Morgenstern ◽  
Melinda A. Smith ◽  
...  
Keyword(s):  
Air Pollution ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ethnic Differences ◽  
Ambient Air ◽  
Ambient Air Pollution

scholarly journals Ambient nitrogen dioxide is associated with emergency hospital visits for atrial fibrillation: a population-based case-crossover study in Reykjavik, Iceland

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Solveig Halldorsdottir ◽  
Ragnhildur Gudrun Finnbjornsdottir ◽  
Bjarki Thor Elvarsson ◽  
Gunnar Gudmundsson ◽  
Vilhjalmur Rafnsson
Keyword(s):  
Atrial Fibrillation ◽  
Air Pollution ◽  
Heart Diseases ◽  
Ambient Air ◽  
Population Based ◽  
Emergency Hospital ◽  
Case Crossover ◽  
Increased Risk ◽  
Icd 10 ◽  
Hospital Visits

Abstract Background In Iceland air quality is generally good; however, previous studies indicate that there is an association between air pollution in Reykjavik and adverse health effects as measured by dispensing of medications, mortality, and increase in health care utilisation. The aim was to study the association between traffic-related ambient air pollution in the Reykjavik capital area and emergency hospital visits for heart diseases and particularly atrial fibrillation and flutter (AF). Methods A multivariate time-stratified case-crossover design was used to study the association. Cases were those patients aged 18 years or older living in the Reykjavik capital area during the study period, 2006–2017, who made emergency visits to Landspitali University Hospital for heart diseases. In this population-based study, the primary discharge diagnoses were registered according to International Classification of Diseases, 10th edition (ICD-10). The pollutants studied were NO2, PM10, PM2.5, and SO2, with adjustment for H2S, temperature, and relative humidity. The 24-h mean of pollutants was used with lag 0 to lag 4. Results During the study period 9536 cases of AF were identified. The 24-h mean NO2 was 20.7 μg/m3. Each 10 μg/m3 increase in NO2 was associated with increased risk of heart diseases (ICD-10: I20-I25, I44-I50), odds ratio (OR) 1.023 (95% CI 1.012–1.034) at lag 0. Each 10 μg/m3 increase in NO2 was associated with an increased risk of AF (ICD-10: I48) on the same day, OR 1.030 (95% CI: 1.011–1.049). Females were at higher risk for AF, OR 1.051 (95% CI 1.019–1.083) at lag 0, and OR 1.050 (95% CI 1.019–1.083) at lag 1. Females aged younger than 71 years had even higher risk for AF, OR 1.077 (95% CI: 1.025–1.131) at lag 0. Significant associations were found for other pollutants and emergency hospital visits, but they were weaker and did not show a discernable pattern. Conclusions Short-term increase in NO2 concentrations was associated with heart diseases, more precisely with AF. The associations were stronger among females, and among females at younger age. This is the first study in Iceland that finds an association between air pollution and cardiac arrhythmias, so the results should be interpreted with caution.

scholarly journals Air Pollution and Subtypes, Severity and Vulnerability to Ischemic Stroke—A Population Based Case-Crossover Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. e0158556 ◽  
Author(s):  
Ravi Maheswaran ◽  
Tim Pearson ◽  
Sean D. Beevers ◽  
Michael J. Campbell ◽  
Charles D. Wolfe
Keyword(s):  
Air Pollution ◽  
Ischemic Stroke ◽  
Crossover Study ◽  
Population Based ◽  
Case Crossover

Abstract TP167: Short-Term Exposures to Ambient Air Pollution and Risk of Recurrent Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Jeffrey J Wing ◽  
Sara D Adar ◽  
Brisa N Sanchez ◽  
Lewis B Morgenstern ◽  
Melinda A Smith ◽  
...  
Keyword(s):  
Air Pollution ◽  
Ischemic Stroke ◽  
Conditional Logistic Regression ◽  
Ambient Air ◽  
Population Based ◽  
Ambient Air Pollution ◽  
Stroke Recurrence ◽  
Short Term ◽  
Logistic Regression Models ◽  
Poor Outcomes

Background: Recurrent strokes are associated with poor outcomes and mortality. Short-term ambient air pollution may be an important environmental risk factor for stroke recurrence. Although associations between air pollution and stroke risk have been observed, the evidence for short-term effects of air pollution on risk of stroke recurrence is in its infancy. We investigated the association between short-term changes in ambient pollution (particulate matter <2.5μm (PM 2.5 ) and ozone (O 3 )) and the risk of recurrent ischemic stroke among individuals living in a bi-ethnic community. Methods: We identified recurrent ischemic stroke cases from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project, an ongoing population-based stroke surveillance study in Nueces County, Texas, between 2000 and 2012. Associations between lags of 0 to 3 days PM 2.5 and O 3 levels and odds of ischemic stroke were assessed using a time-stratified case-crossover design. Conditional logistic regression models were used to calculate odds ratios (ORs) for a 10 unit change in exposure. Results: There were 317 recurrent ischemic strokes with mean age of 72 years (SD=12). Median levels of PM 2.5 and O 3 over the study period were 7.7μg/m 3 (IQR: 5.6-10.7μg/m 3 ) and 35.2ppb (IQR: 25.0-46.1ppb), respectively. No associations were observed across the different lagged exposures (0 to 3 days) after adjusting for ambient temperature and relative humidity (Figure). Co-adjustment of both pollutants results did not change the results. Conclusion: No association between PM 2.5 and O 3 and risk of recurrences was observed. Research on the influence of air pollutants on risk of recurrence is still in its infancy, and more research is needed to understand the relation.

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