Association between ambient air pollution and ischemic stroke hospitalization: A multicenter case-crossover study in Tianjin, China

IF 4.2 2区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES

Atmospheric Environment Pub Date : 2025-07-08 DOI:10.1016/j.atmosenv.2025.121400

Fuyin Wang , Kun Hua , Yingze Tian , Miaomiao Wei , Xiaoshuang Xia , Lin Wang , Yinchang Feng , Xin Li

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引用次数: 0

Abstract

Objective

This study aims at exploring the associations between six major ambient air pollutants, including PM_2.5, PM₁₀, NO₂, SO₂, CO, O₃, and IS incidence in a Chinese megacity (Tianjin), and finding out susceptible populations, to provide insights for public IS prevention in areas facing relatively higher level of air pollution and heavier IS burden.

Method

We collected IS admissions data across 5 hospitals in Tianjin from January 1, 2016 to December 31, 2019. The daily mean concentrations of ambient air pollutants were used as exposure parameters. We applied a time-stratified case-crossover design combined with quasi-poisson regression to examine short term effects of air pollution on IS hospitalizations and performed subgroup analyses stratified by gender, age, and season.

Results

75132 IS cases were enrolled finally. We found that increases of 10 μg/m³ in PM_2.5 and NO₂ were associated with 0.26 %(95 % CI: 0.01 %–0.53 %) and 1.05 % (95 % CI: 0.34 %–1.76 %) increases in IS hospitalization at the same day (Lag0 day) respectively, but no lag effects were observed in the single-day lag structure. And the cumulative lag effects of PM_2.5 and NO₂ were only observed at lag01 day with the percentage increases of IS for 10 μg/m³ of their concentrations being 0.36 %(95 % CI: 0.04 %–0.68 %) and 1.21 %(95 % CI: 0.43 %–2.04 %). The effects were more pronounced in the male and younger populations for PM_2.5 and NO₂ in the warm season, and a positive association was also observed between PM₁₀ and IS in the younger group. As for SO₂, CO and O₃, no statistically significant associations were found between them and IS.

Conclusion

Our findings suggested that short-term exposures to PM_2.5, NO₂, PM₁₀ increase the risk of IS hospitalizations, especially in the male and younger populations. Reducing targeted pollution emission may have significant public health effects in reducing IS burden.

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环境空气污染与缺血性卒中住院之间的关系：中国天津的一项多中心病例交叉研究

目的探讨中国特大城市（天津）PM2.5、PM10、NO2、SO2、CO、O3等6种主要环境空气污染物与IS发病率之间的关系，并找出易感人群，为空气污染水平较高、IS负担较重地区的公共IS预防提供参考。方法收集天津市5家医院2016年1月1日至2019年12月31日的IS住院数据。以环境空气污染物的日平均浓度为暴露参数。我们采用时间分层病例交叉设计结合准泊松回归来检验空气污染对IS住院的短期影响，并按性别、年龄和季节分层进行亚组分析。结果最终纳入IS病例75132例。我们发现，PM2.5和NO2浓度每增加10 μg/m3，当天（Lag0天）IS住院率分别增加0.26% （95% CI: 0.01% - 0.53%）和1.05% (95% CI: 0.34% - 1.76%)，但在单日滞后结构中未观察到滞后效应。PM2.5和NO2的累积滞后效应仅在lag01 d出现，浓度为10 μg/m3时IS的增幅分别为0.36% （95% CI: 0.04% ~ 0.68%）和1.21% （95% CI: 0.43% ~ 2.04%）。暖季PM2.5和NO2的影响在男性和年轻人群中更为明显，PM10和IS在年轻人群中也呈正相关。SO2、CO、O3与IS的相关性无统计学意义。结论：短期暴露于PM2.5、NO2、PM10环境中会增加IS住院的风险，尤其是男性和年轻人群。减少有针对性的污染排放可能对减轻IS负担具有重大的公共卫生影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atmospheric Environment 环境科学-环境科学

CiteScore

9.40

自引率

8.00%

发文量

458

审稿时长

53 days

期刊介绍： Atmospheric Environment has an open access mirror journal Atmospheric Environment: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atmospheric Environment is the international journal for scientists in different disciplines related to atmospheric composition and its impacts. The journal publishes scientific articles with atmospheric relevance of emissions and depositions of gaseous and particulate compounds, chemical processes and physical effects in the atmosphere, as well as impacts of the changing atmospheric composition on human health, air quality, climate change, and ecosystems.