Ambient Pollutants and Spontaneous Intracerebral Hemorrhage in Greater Boston
- 1 November 2018
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 49 (11), 2764-2766
- https://doi.org/10.1161/strokeaha.118.023128
Abstract
Background and Purpose Associations between exposures to ambient air pollution and spontaneous intracerebral hemorrhage (ICH) have been inconsistent, and data on stroke subtypes are currently limited. Methods We obtained information on all cases of deep or lobar hematomas from ICH patients who were admitted to the Massachusetts General Hospital in Boston, MA, between 2006 and 2011. We linked the date of admission with 1- to 7-day moving averages of fine particulate matter (PM2.5), black carbon, nitrogen dioxide, and ozone from area monitors. We conducted time-stratified bidirectional case-crossover analyses to assess associations between pollutants and stroke. We also investigated whether associations differed by hemorrhage location and type. Results There were 577 cases of ICH (295 deep, 282 lobar). Overall, there was no evidence of elevated ICH risk after increases in PM2.5, black carbon, or nitrogen dioxide in the whole population. However, there was suggestion of heightened risk with higher levels of ozone for averages longer than 1 day although CIs were wide. In models stratified by ICH location, associations with ozone remained positive for patients with lobar (3-day moving average odds ratio, 1.62; 95% CI, 1.18-2.22) but not deep ICH (odds ratio, 0.88; 95% CI, 0.65-1.20). Larger estimates were observed among participants with a probable diagnosis of cerebral amyloid angiopathy (odds ratio, 2.23; 95% CI, 1.25-3.96). Conclusions Exposure to ozone may be associated with incidence of lobar ICH, especially among those who have confirmed or probable cerebral amyloid angiopathy.This publication has 14 references indexed in Scilit:
- Short-term association between environmental factors and hospital admissions due to dementia in MadridEnvironmental Research, 2017
- Short-term exposure to ambient ozone and stroke hospital admission: A case-crossover analysisJournal of Exposure Science & Environmental Epidemiology, 2015
- Association Between Blood Pressure Control and Risk of Recurrent Intracerebral HemorrhageJAMA, 2015
- Oxidative stress caused by ozone exposure induces β-amyloid 1–42 overproduction and mitochondrial accumulation by activating the amyloidogenic pathwayNeuroscience, 2015
- Ambient Air Pollution and StrokeStroke, 2014
- Association between Ozone Exposure and Onset of Stroke in Allegheny County, Pennsylvania, USA, 1994-2000Neuroepidemiology, 2013
- Ambient Air Pollution and the Risk of Acute Ischemic StrokeJAMA Internal Medicine, 2012
- Neurobehavioral effects of ambient air pollution on cognitive performance in US adultsNeuroToxicology, 2009
- Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, CanadaEuropean Journal of Epidemiology, 2006
- Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage?Journal of Neurology, Neurosurgery & Psychiatry, 2006