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Short-term effects of exposure to ambient PM 1 , PM 2.5 , and PM 10 on ischemic and hemorrhagic stroke incidence in Shandong Province, China.

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Title: Short-term effects of exposure to ambient PM 1 , PM 2.5 , and PM 10 on ischemic and hemorrhagic stroke incidence in Shandong Province, China.
Authors: Wu, H., Zhang, B., Wei, J., Lu, Z., Zhao, M., Liu, W., Bovet, P., Guo, X., Xi, B.
Publication Year: 2025
Collection: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Subject Terms: China/epidemiology, Environmental Exposure/adverse effects, Hemorrhagic Stroke/epidemiology, Humans, Incidence, Ischemic Stroke/epidemiology, Particulate Matter/toxicity, Disease burden, Hemorrhagic stroke, Ischemic stroke, Particulate matter
Description: Short-term exposure to ambient PM 2.5 and PM 10 is associated with increased risk of mortality and hospital admissions for stroke. However, there is less evidence regarding the effect of exposure to PM 1 on stroke incidence. We estimated the incidence risk of stroke and the attributable fractions related to short-term exposure to ambient PM 1 , PM 2.5 and PM 10 in China. County-specific incidence of stroke was obtained from health statistics in years 2014-2019. We linked county-level mean daily concentrations of PM 1 , PM 2.5 and PM 10 with stroke incidence. We used the time stratified case-crossover design to estimate the associations between stroke incidence and exposure to PM 1 , PM 2.5 and PM 10 . We also estimated the disease burden fractions attributable to PM 1 , PM 2.5 , and PM 10 . The study included a total of 2,193,954 stroke, from which 1,861,331 were ischemic and 332,623 were hemorrhagic stroke. PM 1 , PM 2.5 , and PM 10 levels were associated with increased risks of total stroke and ischemic stroke at when assessing the associations in exposure at lag0-4 days. The increase of 10 μg/m 3 in PM 1 , PM 2.5 , and PM 10 was associated with total stroke, and the relative risks were 1.012 (95% confidence interval: 1.008, 1.015), 1.006 (1.004, 1.007) and 1.003 (1.002, 1.004), while the associations with ischemic stroke were 1.013 (1.010, 1.017), 1.006 (1.005, 1.008) and 1.003 (1.002, 1.004), respectively. There was no significant association between PM and risk of hemorrhagic stroke. The attributable fractions of total stroke were 6.9% (5.1%, 8.5%), 5.6% (4.2%, 6.8%) and 5.6% (3.9%, 7.1%) for PM 1 , PM 2.5 , and PM 10 , respectively. PM 1 showed a stronger association with stroke, with a larger attributable fraction of outcomes, than PM 2.5 and PM 10 . Clean air policies should target the whole scope of PM, including PM 1 .
Document Type: article in journal/newspaper
Language: English
ISSN: 1096-0953
35487259
Relation: Environmental Research; https://iris.unil.ch/handle/iris/84389; serval:BIB_34ACA891E086; 000831635400008
DOI: 10.1016/j.envres.2022.113350
Availability: https://iris.unil.ch/handle/iris/84389
https://doi.org/10.1016/j.envres.2022.113350
Accession Number: edsbas.AE5F5547
Database: BASE
Description
Abstract:Short-term exposure to ambient PM 2.5 and PM 10 is associated with increased risk of mortality and hospital admissions for stroke. However, there is less evidence regarding the effect of exposure to PM 1 on stroke incidence. We estimated the incidence risk of stroke and the attributable fractions related to short-term exposure to ambient PM 1 , PM 2.5 and PM 10 in China. County-specific incidence of stroke was obtained from health statistics in years 2014-2019. We linked county-level mean daily concentrations of PM 1 , PM 2.5 and PM 10 with stroke incidence. We used the time stratified case-crossover design to estimate the associations between stroke incidence and exposure to PM 1 , PM 2.5 and PM 10 . We also estimated the disease burden fractions attributable to PM 1 , PM 2.5 , and PM 10 . The study included a total of 2,193,954 stroke, from which 1,861,331 were ischemic and 332,623 were hemorrhagic stroke. PM 1 , PM 2.5 , and PM 10 levels were associated with increased risks of total stroke and ischemic stroke at when assessing the associations in exposure at lag0-4 days. The increase of 10 μg/m 3 in PM 1 , PM 2.5 , and PM 10 was associated with total stroke, and the relative risks were 1.012 (95% confidence interval: 1.008, 1.015), 1.006 (1.004, 1.007) and 1.003 (1.002, 1.004), while the associations with ischemic stroke were 1.013 (1.010, 1.017), 1.006 (1.005, 1.008) and 1.003 (1.002, 1.004), respectively. There was no significant association between PM and risk of hemorrhagic stroke. The attributable fractions of total stroke were 6.9% (5.1%, 8.5%), 5.6% (4.2%, 6.8%) and 5.6% (3.9%, 7.1%) for PM 1 , PM 2.5 , and PM 10 , respectively. PM 1 showed a stronger association with stroke, with a larger attributable fraction of outcomes, than PM 2.5 and PM 10 . Clean air policies should target the whole scope of PM, including PM 1 .
ISSN:10960953
35487259
DOI:10.1016/j.envres.2022.113350