Abstract
Numerous studies have examined the associations between air pollution and stroke. However, little is known about the associations between air pollution and transient ischemic attack (TIA). In this study, we aimed to conduct a time-series study to systematically examine the associations between hospital admissions for TIA and air pollutants. Admissions for TIA (ICD-10: G45) from 1 January 2014 to 31 December 2016 were identified based on the primary diagnosis from 134 hospitals in Beijing, China. Hourly measurements of air pollutants were obtained from the National Air Pollution Monitoring System. Generalized additive models with quasi-Poisson regression were used to determine the associations for each pollutant. Additionally, stratified analysis was implemented to examine whether age, gender, temperature, and season were the potential effect modifiers. Restricted cubic spline was applied to investigate the exposure-response curve. In total, 109,975 hospital admissions for TIA were included. The positive associations were detected between PM2.5, PM10, SO2, NO2, and CO and hospital admissions for TIA. The effects of PM2.5 and PM10 in men are stronger than in women. Additionally, the effects of PM2.5, PM10, SO2, and O3 are more pronounced on warm days than cool days. From exposure-response curves, we observe a nearly linear relationship for PM2.5, PM10, CO, and NO2. Further studies are needed to verify the association. This research contributes evidence on the association between air pollution and admissions for TIA in the low- and middle-income countries and may promote related public health policy development.
Highlights
Air pollution is one of the leading causes of risk-attributable death, accounting for over 4 million worldwide deaths each year (Stanaway et al 2018)
Our findings suggest that the concentrations of all analyzed air pollutants, except for O3, were positively associated with daily hospital admissions for transient ischemic attack (TIA)
It was on the same day that the highest effects of PM2.5, PM10, carbon monoxide (CO), NO2, and SO2 on hospital admissions for TIA were observed
Summary
Air pollution is one of the leading causes of risk-attributable death, accounting for over 4 million worldwide deaths each year (Stanaway et al 2018). As a potentially modifiable risk factor, the effects of air pollution on human health are a topic that has received much attention in recent decades. TIA has been recognized as a strong predictor of subsequent stroke and is associated with poorer long-term survival The risk of subsequent stroke after experiencing a TIA was 17.3% at 3 months (Coull et al 2004), and the mortality after experiencing a TIA was 12% in 1 year (Kleindorfer et al 2005). Whether air pollution is the modifiable risk factor for TIA is uncertain. The majority of previous studies (Bedada et al 2012; Lisabeth et al 2008) were conducted in high-income countries, with limited studies from low- and middle-income countries, where levels and components of various air pollutants were markedly different from highincome countries (Li et al 2015)
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