Abstract
Exposure to air pollutants is known to have adverse effects on human health; however, little is known about the association between hydrocarbons in air and an ischemic stroke (IS) event. We investigated whether long-term exposure to airborne hydrocarbons, including volatile organic compounds, increased IS risk. This retrospective cohort study included 283,666 people aged 40 years or older in Taiwan. Cox proportional hazards regression analysis was used to fit single- and multiple-pollutant models for two targeted pollutants, total hydrocarbons (THC) and nonmethane hydrocarbons (NMHC), and estimated the risk of IS. Before controlling for multiple pollutants, hazard ratios (HRs) of IS with 95% confidence intervals for the overall population were 2.69 (2.64–2.74) at 0.16-ppm increase in THC and 1.62 (1.59–1.66) at 0.11-ppm increase in NMHC. For the multiple-pollutant models controlling for PM2.5, the adjusted HR was 3.64 (3.56–3.72) for THC and 2.21 (2.16–2.26) for NMHC. Our findings suggest that long-term exposure to THC and NMHC may be a risk factor for IS development.
Highlights
MethodsHealth data were obtained from the Longitudinal Health Insurance Database 2000 (LHID2000) within National Health Insurance Research Database (NHIRD), including claims data for 1 million random samples from 1996 to 2013
Cerebrovascular diseases (CVDs) comprise conditions that lead to a cerebrovascular event, including stroke, which can be caused by a blocked artery, called ischemic stroke (IS)
In both total hydrocarbons (THC) and nonmethane hydrocarbons (NMHC), the patients were slightly older in the highest level of the tertile (T3) and more frequently exhibited comorbidities at T3 for THC compared with other tertiles
Summary
Health data were obtained from the Longitudinal Health Insurance Database 2000 (LHID2000) within NHIRD, including claims data for 1 million random samples from 1996 to 2013. To enhance NHIRD data reliability, the observation period was set as 2000–2013. The Environment Resource Dataset [17] was publicly available from open government data. This dataset was obtained by the Environmental Protection Administration of Taiwan, which determined the levels of ambient pollutants and temperatures at 76 monitoring stations across Taiwan from 1993 to 2013. The Research Ethics Committee of China Medical University and Hospital in Taiwan approved the study (certificate number: CMUH-104-REC2-115-CR3). Because de-identified/anonymized data were used from NHIRD, the Research Ethics Committee did not require the right of obtaining informed consent from the patients
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