Abstract
The primary objective of this study was to assess the association between short-term changes in ambient fine particulate matter (PM2.5) and first hospital admissions for ischemic stroke. We identified 63,956 first hospital admissions for ischemic stroke from the Beijing Medical Claim Data for Employees from January 1, 2010, through June 30, 2012. A generalized additive Poisson model was applied to explore the association between PM2.5 and admissions for ischemic stroke. We also explore the effect modification of risk by age and gender. The exposure–response relationship between PM2.5 and admissions for ischemic stroke was approximately linear, with a relatively stable response at lower concentrations (<100 μg/m3) and a steeper response at higher concentrations. A 10 μg/m3 increase in the same-day PM2.5 concentration was associated with 0.31% (95% CI, 0.17–0.45%, P < 1.57 × 10−5) increase in the daily admissions for ischemic stroke. The association was also statistically significant at lag 1, 2, 3, 0–2 and 0–4 days. Subgroup analyses showed that the association was not different between patients ≥65 years and <65 years old or between males and females. In conclusion, short-term exposure to PM2.5 was positively associated with first hospital admissions for ischemic stroke in Beijing, China.
Highlights
Stroke is the second most common cause of death and the third leading cause of disability-adjusted life years globally[1, 2]
A total of 63,956 first hospital admissions for ischemic stroke were identified from Beijing Medical Claim Data for Employees (BMCDE) database between January 1, 2010 and June 30, 2012
The present study provides strong evidence of the association between PM2.5 and ischemic stroke in Beijing
Summary
Stroke is the second most common cause of death and the third leading cause of disability-adjusted life years globally[1, 2]. In China, stroke is the leading cause of death and adult disability, with an estimated 2.5 million new stroke cases and 1.6 million deaths from stroke occurring each year. Only a mere handful of studies have been undertaken which evaluated the health effects of PM2.5 on ischemic stroke, due primarily to the lack of PM2.5 monitoring data. On the other hand, repeated admissions could cause a temporal dependence among the hospitalization counts, leading to an underestimation of the variance of air pollution risk estimates[20]. Based on these findings, it seems plausible that air pollution may have a differential effect on first-ever vs recurrent stroke events. Studies that examine the association between PM2.5 and first-ever stroke are needed to better understand the real impact of ambient fine particulate matter on public health
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