Lisabeth Lynda D, Escobar James D, Dvonch J Timothy, Sánchez Brisa N, Majersik Jennifer J, Brown Devin L, Smith Melinda A, Morgenstern Lewis B
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
Ann Neurol. 2008 Jul;64(1):53-9. doi: 10.1002/ana.21403.
Data on the association between air pollution and cerebrovascular disease in the United States are limited. The objective of this study was to investigate the association between short-term exposure to ambient air pollution and risk for ischemic cerebrovascular events in a US community.
Daily counts of ischemic strokes/transient ischemic attacks (TIAs) (2001-2005) were obtained from the population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project. Daily particulate matter less than 2.5microm in diameter (PM(2.5)), ozone (O(3)), and meteorological data were obtained from Texas Commission on Environmental Quality. To examine the association between PM(2.5) and stroke/TIA risk, we used Poisson regression. Separate models included same-day PM(2.5), PM(2.5) lagged 1 to 5 days, and an averaged lag effect. All models were adjusted for temperature, day of week, and temporal trends in stroke/TIA. The effects of O(3) were also investigated.
Median PM(2.5) was 7.0microg/m(3) (interquartile range, 4.8-10.0microg/m(3)). There were borderline significant associations between same-day (relative risk [RR], 1.03; 95% confidence interval [CI], 0.99-1.07 for an interquartile range increase in PM(2.5)) and previous-day (RR, 1.03; 95% CI, 1.00-1.07) PM(2.5) and stroke/TIA risk. These associations were independent of O(3), which demonstrated similar associations with stroke/TIA risk (same-day RR, 1.02; 95% CI, 0.97-1.08; previous-day RR, 1.04; 95% CI, 0.99-1.09).
We observed associations between recent PM(2.5) and O(3) exposure and ischemic stroke/TIA risk even in this community with relatively low pollutant levels. This study provides data on environmental exposures and stroke risk in the United States, and suggests future research on ambient air pollution and stroke is warranted.
美国关于空气污染与脑血管疾病之间关联的数据有限。本研究的目的是调查美国一个社区短期暴露于环境空气污染与缺血性脑血管事件风险之间的关联。
缺血性中风/短暂性脑缺血发作（TIA）的每日计数（2001 - 2005年）来自基于人群的科珀斯克里斯蒂脑卒监测（BASIC）项目。直径小于2.5微米的每日颗粒物（PM2.5）、臭氧（O3）和气象数据来自德克萨斯环境质量委员会。为了检验PM2.5与中风/TIA风险之间的关联，我们使用了泊松回归。单独的模型包括当日PM2.5、滞后1至5天的PM2.5以及平均滞后效应。所有模型均针对温度、星期几以及中风/TIA的时间趋势进行了调整。还研究了O3的影响。
PM2.5的中位数为每立方米7微克（四分位间距，4.8 - 10.0微克/立方米）。当日（相对风险[RR]，1.03；95%置信区间[CI]，PM2.5四分位间距增加时为0.99 - 1.07）和前一日（RR，1.03；95% CI，1.00 - 1.07）的PM2.5与中风/TIA风险之间存在临界显著关联。这些关联独立于O3，O3与中风/TIA风险也呈现类似关联（当日RR，1.02；95% CI，0.97 - 1.08；前一日RR，1.04；95% CI，0.99 - 1.09）。
即使在这个污染物水平相对较低的社区，我们也观察到近期PM2.5和O3暴露与缺血性中风/TIA风险之间存在关联。本研究提供了美国环境暴露与中风风险的数据，并表明有必要对环境空气污染与中风进行未来研究。
