Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Shanghai 200032, China; Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China.
Ecotoxicol Environ Saf. 2022 Mar 1;232:113237. doi: 10.1016/j.ecoenv.2022.113237. Epub 2022 Jan 29.
Fine particulate matter (PM) has been associated with increased risks of stroke, but it remains unclear which specific size ranges and chemical constituents dominate the effects of PM on stroke. We aimed to evaluate the associations of size-segregated particles and various constituents of PM with daily emergency-room visits for stroke.
We conducted a time-series study to investigate the associations of 5 particle size ranges from 0.01 to 2.5 µm and 35 constituents of PM with the daily emergency-room visits for stroke in Shanghai, from 2014 to 2019. Over-dispersed generalized additive models were used to estimate the associations. The robustness of these associations was evaluated by additionally controlling for PM mass.
For size ranges from 0.01 to 0.3 µm, there were significant positive associations between particle number concentrations and daily emergency-room visits for stroke with the strongest associations occurring for the size range 0.05-0.1 µm. The size-dependent pattern was not changed by adjusting for PM and gaseous pollutants. The associations of daily emergency-room visits for stroke also varied considerably by various PM constituents. After controlling for the simultaneous exposure to PM and gaseous pollutants in two-pollutant models, we identified 11 out of 35 constituents that had robust associations, these being organic carbon, elemental carbon, chlorine, magnesium, ammonium, nitrate, sulfate, copper, manganese, lead and zinc.
Ultra-fine particles and some PM constituents (i.e., carbonaceous fractions, inorganic ions and some elements) may be mainly responsible for the excess risk of stroke induced by PM.
细颗粒物（PM）与中风风险增加有关，但目前尚不清楚哪些特定的粒径范围和化学组分主导着 PM 对中风的影响。我们旨在评估粒径分段颗粒和 PM 的各种组分与中风每日急诊就诊之间的关联。
我们进行了一项时间序列研究，以调查从 2014 年到 2019 年在上海，粒径范围从 0.01 到 2.5 µm 的 5 个粒径范围和 PM 的 35 种组分与中风每日急诊就诊之间的关联。使用过分散广义加性模型来估计关联。通过额外控制 PM 质量来评估这些关联的稳健性。
对于 0.01 到 0.3 µm 的粒径范围，颗粒物数浓度与中风每日急诊就诊之间存在显著的正相关，其中最强的关联发生在 0.05-0.1 µm 的粒径范围内。通过调整 PM 和气态污染物，粒径依赖性模式没有改变。中风每日急诊就诊的关联也因 PM 的各种组分而异。在双污染物模型中同时控制 PM 和气态污染物的暴露后，我们确定了 35 种组分中有 11 种与中风每日急诊就诊有显著关联，这些组分为有机碳、元素碳、氯、镁、铵、硝酸盐、硫酸盐、铜、锰、铅和锌。
超细颗粒和一些 PM 组分（即碳质组分、无机离子和一些元素）可能是 PM 导致中风风险增加的主要原因。
