BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK
BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK.
BMJ. 2015 Mar 24;350:h1295. doi: 10.1136/bmj.h1295.
To review the evidence for the short term association between air pollution and stroke.
Systematic review and meta-analysis of observational studies
Medline, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science searched to January 2014 with no language restrictions.
Studies investigating the short term associations (up to lag of seven days) between daily increases in gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate matter (<2.5 µm or <10 µm diameter (PM2.5 and PM10)), and admission to hospital for stroke or mortality.
Admission to hospital and mortality from stroke.
From 2748 articles, 238 were reviewed in depth with 103 satisfying our inclusion criteria and 94 contributing to our meta-estimates. This provided a total of 6.2 million events across 28 countries. Admission to hospital for stroke or mortality from stroke was associated with an increase in concentrations of carbon monoxide (relative risk 1.015 per 1 ppm, 95% confidence interval 1.004 to 1.026), sulphur dioxide (1.019 per 10 ppb, 1.011 to 1.027), and nitrogen dioxide (1.014 per 10 ppb, 1.009 to 1.019). Increases in PM2.5 and PM10 concentration were also associated with admission and mortality (1.011 per 10 μg/m(3) (1.011 to 1.012) and 1.003 per 10 µg/m(3) (1.002 to 1.004), respectively). The weakest association was seen with ozone (1.001 per 10 ppb, 1.000 to 1.002). Strongest associations were observed on the day of exposure with more persistent effects observed for PM(2·5).
Gaseous and particulate air pollutants have a marked and close temporal association with admissions to hospital for stroke or mortality from stroke. Public and environmental health policies to reduce air pollution could reduce the burden of stroke.
PROSPERO-CRD42014009225.
综述短期空气污染与中风之间关联的证据。
对观察性研究进行系统回顾和荟萃分析。
使用无语言限制的 Medline、Embase、全球健康、护理与联合健康文献累积索引（CINAHL）和 Web of Science 对 2014 年 1 月前的数据进行了搜索。
研究短期（最长滞后 7 天）内每日气体污染物（一氧化碳、二氧化硫、二氧化氮、臭氧）和颗粒物（<2.5 µm 或 <10 µm 直径（PM2.5 和 PM10））浓度增加与因中风住院或死亡之间的关系。
因中风住院和中风死亡。
从 2748 篇文章中，有 238 篇进行了深入审查，其中 103 篇符合纳入标准，94 篇有助于我们的荟萃估计。这总共提供了 28 个国家的 620 万例事件。因中风住院或因中风死亡与一氧化碳浓度增加相关（每增加 1 ppm 的相对风险为 1.015，95%置信区间为 1.004 至 1.026）、二氧化硫（每增加 10 ppb 为 1.019，1.011 至 1.027）和二氧化氮（每增加 10 ppb 为 1.014，1.009 至 1.019）。PM2.5 和 PM10 浓度的增加也与住院和死亡相关（每增加 10 μg/m3 为 1.011（1.011 至 1.012）和每增加 10 µg/m3 为 1.003（1.002 至 1.004））。臭氧的相关性最弱（每增加 10 ppb 为 1.001，1.000 至 1.002）。暴露当天观察到最强的关联，并且 PM（2·5）的持续影响更为持久。
气态和颗粒态空气污染物与中风住院或中风死亡之间存在明显且密切的时间关联。减少空气污染的公共和环境健康政策可以减轻中风的负担。
PROSPERO-CRD42014009225。
