Short-term exposure to nitrogen dioxide and emergency department visits for cause-stroke: a time-series study in Shanghai, China, 2013-2022.

IF 4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Environmental Health and Preventive Medicine Pub Date : 2024-01-01 DOI:10.1265/ehpm.24-00304

Yonghong Zhou, Yi Jin, Zheng Zhang

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引用次数: 0

Abstract

Background: The association between air pollution and an increased risk of cardiovascular diseases, including stroke, is well-established. However, it remains unclear how reductions in pollutant levels-resulting from clean air policies and the COVID-19 lockdown-affect this relationship.

Methods: A time-series study was conducted using data from Shanghai, China, spanning from 2013 to 2022, divided into two periods (2013-2019 and 2020-2022). Daily air pollution data were obtained from China's air quality platform, while stroke emergency department (ED) visits were sourced from Renhe Hospital. We employed quasi-Poisson regression to analyze the relationship between daily pollutant levels and stroke ED visits, with stratified analyses by sex, age, season, and period. The study identified significant reductions in six pollutants (PM_2.5, PM_10-2.5, PM₁₀, SO₂, NO₂, CO) during the 2020-2022 period compared to 2013-2019.

Results: Significant reductions in six air pollutants (NO₂, PM_2.5, PM_10-2.5, PM₁₀, SO₂, CO) were observed during 2020-2022 compared to 2013-2019. Higher daily NO₂ levels were associated with an increased risk of stroke and its subtypes throughout the study, with a stronger correlation observed in the 2020-2022 period (P < 0.001). Subgroup analyses indicated that females and individuals aged 65-74 experienced the highest risks. The elevated stroke risk was particularly pronounced in the summer during 2020-2022. A two-factor model demonstrated that combined exposure to NO₂ and other pollutants increased stroke risk.

Conclusions: This study heightened that reduced NO₂ levels generally mitigate the adverse effects of short-term exposure to air pollutants on stroke risk, although the benefits vary among subgroups. The persistent stroke risk despite lower pollutant levels underscores the complex factors influencing stroke risk, highlighting the need for comprehensive intervention strategies.

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短期暴露于二氧化氮与因中风而急诊就诊：2013-2022年中国上海的时间序列研究

背景：空气污染与心血管疾病（包括中风）风险增加之间的关系已得到证实。然而，清洁空气政策和 COVID-19 封锁导致的污染物水平下降如何影响这种关系，目前仍不清楚：我们使用中国上海的数据进行了一项时间序列研究，时间跨度为 2013 年至 2022 年，分为两个时期（2013-2019 年和 2020-2022 年）。每日空气污染数据来自中国空气质量平台，脑卒中急诊科（ED）就诊人数来自仁和医院。我们采用准泊松回归分析了每日污染物水平与脑卒中急诊就诊率之间的关系，并按性别、年龄、季节和时期进行了分层分析。研究发现，与2013-2019年相比，2020-2022年期间六种污染物（PM2.5、PM10-2.5、PM10、二氧化硫、二氧化氮、一氧化碳）的浓度明显下降：与 2013-2019 年相比，2020-2022 年期间六种空气污染物（二氧化氮、PM2.5、PM10-2.5、PM10、二氧化硫、一氧化碳）均有显著下降。在整个研究过程中，较高的日二氧化氮水平与中风及其亚型风险的增加有关，在 2020-2022 年期间观察到更强的相关性（P < 0.001）。亚组分析表明，女性和 65-74 岁人群的风险最高。中风风险的升高在 2020-2022 年的夏季尤为明显。双因素模型表明，二氧化氮和其他污染物的综合暴露会增加中风风险：这项研究表明，降低二氧化氮水平通常会减轻短期暴露于空气污染物对中风风险的不利影响，尽管不同亚群的获益情况不同。尽管污染物水平降低了，但中风风险依然存在，这凸显了影响中风风险的复杂因素，强调了采取综合干预策略的必要性。

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来源期刊

Environmental Health and Preventive Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -

CiteScore

7.90

自引率

2.10%

发文量

审稿时长

10 weeks

期刊介绍： The official journal of the Japanese Society for Hygiene, Environmental Health and Preventive Medicine (EHPM) brings a comprehensive approach to prevention and environmental health related to medical, biological, molecular biological, genetic, physical, psychosocial, chemical, and other environmental factors. Environmental Health and Preventive Medicine features definitive studies on human health sciences and provides comprehensive and unique information to a worldwide readership.