Fine particulate air pollution (PM2.5) and the risk of acute ischemic stroke
OʼDonnell, MJ; Fang, J; Mittleman, MA; Kapral, MK; Wellenius, GA
HERO ID
709973
Reference Type
Journal Article
Year
2011
Language
English
PMID
| HERO ID | 709973 |
|---|---|
| In Press | No |
| Year | 2011 |
| Title | Fine particulate air pollution (PM2.5) and the risk of acute ischemic stroke |
| Authors | OʼDonnell, MJ; Fang, J; Mittleman, MA; Kapral, MK; Wellenius, GA |
| Journal | Epidemiology |
| Volume | 22 |
| Issue | 3 |
| Page Numbers | 422 |
| Abstract | BACKGROUND: Short-term changes in levels of fine ambient particulate matter (PM2.5) may increase the risk of acute ischemic stroke; however, results from prior studies have been inconsistent. We examined this hypothesis using data from a multicenter prospective stroke registry. METHODS: We analyzed data from 9202 patients hospitalized with acute ischemic stroke, having a documented date and time of stroke onset, and residing within 50 km of a PM2.5 monitor in 8 cities in Ontario, Canada. We evaluated the risk of ischemic stroke onset associated with PM2.5 in each city using a time-stratified case-crossover design, matching on day of week and time of day. We then combined these city-specific estimates using random-effects meta-analysis techniques. We examined whether the effects of PM2.5 differed across strata defined by patient characteristics and ischemic stroke etiology. RESULTS: Overall, PM2.5 was associated with a -0.7% change in ischemic stroke risk per 10-μg/m increase in PM2.5 (95% confidence interval = -6.3% to 5.1%). These overall negative results were robust to a number of sensitivity analyses. Among patients with diabetes mellitus, PM2.5 was associated with an 11% increase in ischemic stroke risk (1% to 22%). The association between PM2.5 and ischemic stroke risk varied according to stroke etiology, with the strongest associations observed for strokes due to large-artery atherosclerosis and small-vessel occlusion. CONCLUSIONS: These results do not support the hypothesis that short-term increases in PM2.5 levels are associated with ischemic stroke risk overall. However, specific patient subgroups may be at increased risk of particulate-related ischemic strokes. |
| Doi | 10.1097/EDE.0b013e3182126580 |
| Pmid | 21399501 |
| Wosid | WOS:000289144600025 |
| Is Certified Translation | No |
| Dupe Override | No |
| Is Public | Yes |
| Language Text | English |