Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.
Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China.
Environ Health Prev Med. 2021 Jan 26;26(1):15. doi: 10.1186/s12199-021-00937-1.
Previous studies have suggested that exposure to air pollution may increase stroke risk, but the results remain inconsistent. Evidence of more recent studies is highly warranted, especially gas air pollutants.
We searched PubMed, Embase, and Web of Science to identify studies till February 2020 and conducted a meta-analysis on the association between air pollution (PM, particulate matter with aerodynamic diameter less than 2.5 μm; PM, particulate matter with aerodynamic diameter less than 10 μm; NO, nitrogen dioxide; SO, sulfur dioxide; CO, carbon monoxide; O, ozone) and stroke (hospital admission, incidence, and mortality). Fixed- or random-effects model was used to calculate pooled odds ratios (OR)/hazard ratio (HR) and their 95% confidence intervals (CI) for a 10 μg/m increase in air pollutant concentration.
A total of 68 studies conducted from more than 23 million participants were included in our meta-analysis. Meta-analyses showed significant associations of all six air pollutants and stroke hospital admission (e.g., PM: OR = 1.008 (95% CI 1.005, 1.011); NO: OR = 1.023 (95% CI 1.015, 1.030), per 10 μg/m increases in air pollutant concentration). Exposure to PM, SO, and NO was associated with increased risks of stroke incidence (PM: HR = 1.048 (95% CI 1.020, 1.076); SO: HR = 1.002 (95% CI 1.000, 1.003); NO: HR = 1.002 (95% CI 1.000, 1.003), respectively). However, no significant differences were found in associations of PM, CO, O, and stroke incidence. Except for CO and O, we found that higher level of air pollution (PM, PM, SO, and NO) exposure was associated with higher stroke mortality (e.g., PM: OR = 1.006 (95% CI 1.003, 1.010), SO: OR = 1.006 (95% CI 1.005, 1.008).
Exposure to air pollution was positively associated with an increased risk of stroke hospital admission (PM, PM, SO, NO, CO, and O), incidence (PM, SO, and NO), and mortality (PM, PM, SO, and NO). Our study would provide a more comprehensive evidence of air pollution and stroke, especially SO and NO.
先前的研究表明，暴露于空气污染可能会增加中风风险，但结果仍不一致。因此，非常需要最新研究的证据，尤其是气体空气污染物。
我们检索了 PubMed、Embase 和 Web of Science，以确定截至 2020 年 2 月的研究，并对空气污染（PM，空气动力学直径小于 2.5μm 的颗粒物；PM，空气动力学直径小于 10μm 的颗粒物；NO，二氧化氮；SO，二氧化硫；CO，一氧化碳；O，臭氧）与中风（住院、发病和死亡）之间的关系进行了荟萃分析。使用固定效应或随机效应模型计算了空气中污染物浓度每增加 10μg/m 时的汇总比值比（OR）/风险比（HR）及其 95%置信区间（CI）。
共有来自超过 2300 万名参与者的 68 项研究纳入了我们的荟萃分析。荟萃分析显示，所有六种空气污染物与中风住院（例如，PM：OR=1.008（95%CI 1.005，1.011）；NO：OR=1.023（95%CI 1.015，1.030））呈显著相关，每增加 10μg/m 的空气污染物浓度。暴露于 PM、SO 和 NO 与中风发病率增加相关（PM：HR=1.048（95%CI 1.020，1.076）；SO：HR=1.002（95%CI 1.000，1.003）；NO：HR=1.002（95%CI 1.000，1.003））。然而，在 PM、CO、O 与中风发病率之间的相关性方面没有发现显著差异。除 CO 和 O 外，我们发现更高水平的空气污染（PM、PM、SO 和 NO）暴露与更高的中风死亡率相关（例如，PM：OR=1.006（95%CI 1.003，1.010）；SO：OR=1.006（95%CI 1.005，1.008））。
暴露于空气污染与中风住院（PM、PM、SO、NO、CO 和 O）、发病（PM、SO 和 NO）和死亡率（PM、PM、SO 和 NO）增加呈正相关。我们的研究将为空气污染与中风（尤其是 SO 和 NO）提供更全面的证据。
