Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
Department of Occupational Medicine, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
Environ Sci Pollut Res Int. 2022 Nov;29(52):78821-78831. doi: 10.1007/s11356-022-21206-w. Epub 2022 Jun 14.
The short-term association between ambient air pollution and hospital admissions for ischemic stroke is not fully understood. We examined the association between four regularly measured major ambient air pollutants, i.e., sulfur dioxide (SO), nitrogen dioxide (NO), photochemical oxidants (O), and particulate matter with aerodynamic diameters ≤ 2.5 μm (PM), and hospital admissions for ischemic stroke by analyzing 3 years of nationwide claims data from 97 cities in Japan. We first estimated city-specific results by using generalized additive models with a quasi-Poisson regression, and we obtained the national average by combining city-specific results with the use of random-effect models. We identified a total of 335,248 hospital admissions for ischemic stroke during the 3-year period. Our analysis results demonstrated that interquartile range increases in the following four ambient air pollutants were significantly associated with hospital admissions for ischemic stroke on the same day: SO (1.05 ppb), 1.05% (95% CI: 0.59-1.50%); NO (6.40 ppb), 1.10% (95% CI: 0.61-1.59%); O (18.32 ppb), 1.43% (95% CI: 0.81-2.06%); and PM (7.86 μg/m), 0.90% (95% CI: 0.35-1.45%). When the data were stratified by the hospital admittees' medication use, we observed stronger associations with SO, NO, and PM among the patients who were taking antihypertensive drugs and weaker associations with SO, NO, and O among those taking antiplatelet drugs. Short-term exposure to ambient air pollution was associated with increased hospital admissions for ischemic stroke, and medication use and season may modify the association.
短期暴露于环境空气污染与缺血性脑卒中住院之间的关联尚未完全明确。我们通过分析日本 97 个城市的 3 年全国范围内的索赔数据，研究了四种常规测量的主要环境空气污染物（即二氧化硫（SO 2 ）、二氧化氮（NO 2 ）、光化学氧化剂（O 3 ）和空气动力学直径≤2.5μm 的颗粒物（PM 2.5 ）与缺血性脑卒中住院之间的关联。我们首先使用准泊松回归的广义加性模型来估计城市特异性结果，并通过使用随机效应模型将城市特异性结果结合起来获得全国平均水平。在 3 年期间，我们共确定了 335248 例缺血性脑卒中住院病例。我们的分析结果表明，四种环境空气污染物的四分位距增加与当天缺血性脑卒中住院显著相关：SO 2 （1.05 ppb），1.05%（95%CI：0.59-1.50%）；NO 2 （6.40 ppb），1.10%（95%CI：0.61-1.59%）；O 3 （18.32 ppb），1.43%（95%CI：0.81-2.06%）；和 PM 2.5 （7.86 μg/m 3 ），0.90%（95%CI：0.35-1.45%）。当根据住院患者的用药情况对数据进行分层时，我们观察到在服用抗高血压药物的患者中，SO 2 、NO 2 和 PM 2.5 与缺血性脑卒中住院的相关性更强，而在服用抗血小板药物的患者中，SO 2 、NO 2 和 O 3 的相关性更弱。短期暴露于环境空气污染与缺血性脑卒中住院人数的增加有关，而药物使用和季节可能会改变这种关联。
