Fine Particulate Air Pollution (PM2.5) and the Risk of Acute Ischemic Stroke
- 1 May 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Epidemiology
- Vol. 22 (3), 422-431
- https://doi.org/10.1097/ede.0b013e3182126580
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/m3 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.This publication has 47 references indexed in Scilit:
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