RT Journal Article
SR Electronic
T1 Fine particulate matter exposure and incidence of stroke
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1709
OP 1717
DO 10.1212/WNL.0000000000003903
VO 88
IS 18
A1 Qiu, Hong
A1 Sun, Shengzhi
A1 Tsang, Hilda
A1 Wong, Chit-Ming
A1 Lee, Ruby Siu-yin
A1 Schooling, C. Mary
A1 Tian, Linwei
YR 2017
UL http://n.neurology.org/content/88/18/1709.abstract
AB Objective: We aimed to assess the association of long-term residential exposure to fine particulate matter (PM) with aerodynamic diameter less than 2.5 μm (PM2.5) with the incidence of stroke and its major subtypes.Methods: We ascertained the first occurrence of emergency hospital admission for stroke in a Hong Kong Chinese cohort of 66,820 older people (65+ years) who enrolled during 1998–2001 (baseline) and were followed up to December 31, 2010. High-resolution (1 × 1 km) yearly mean concentrations of PM2.5 were predicted from local monitoring data and US National Aeronautics and Space Administration satellite data using linear regression. Baseline residential PM2.5 exposure was used as a proxy for long-term exposure. We used Cox proportional hazards to evaluate the risk of incident stroke associated with PM2.5 exposure adjusted for potential confounders, including individual and neighborhood factors.Results: Over a mean follow-up of 9.4 years, we ascertained 6,733 cases of incident stroke, of which 3,526 (52.4%) were ischemic and 1,175 (17.5%) were hemorrhagic. The hazard ratio for every 10 μg/m3 higher PM2.5 concentration was statistically significant at 1.21 (95% confidence interval [CI] 1.04–1.41) for ischemic and non-statistically significant at 0.90 (95% CI 0.70–1.17) for hemorrhagic stroke in fully adjusted model 3. The estimates for ischemic stroke were higher in older participants (>70 years), less educated participants, and in men for current smokers.Conclusion: Long-term PM2.5 exposure was associated with higher risk of incident ischemic stroke, but the association with incident hemorrhagic stroke was less clear.AOD=aerosol optical depth; BMI=body mass index; CI=confidence interval; COPD=chronic obstructive pulmonary disease; EPD=Environmental Protection Department; ESCAPE=European Study of Cohorts for Air Pollution Effects; HR=hazard ratio; ICD-9=International Classification of Diseases–9; NASA=National Aeronautics and Space Administration; PM=particulate matter; PM2.5=particulate matter with aerodynamic diameter less than 2.5 μm; SEC=surface extinction coefficients