Kim Honghyok, Festa Natalia, Burrows Kate, Kim Dae Cheol, Gill Thomas M, Bell Michelle L
School of the Environment, Yale University, New Haven, CT, the United States.
Veterans Affairs (VA) Office of Academic Affiliations through the VA/National Clinician Scholars Program and Yale University.
Environ Res Lett. 2022;17(9). doi: 10.1088/1748-9326/ac8943. Epub 2022 Sep 8.
The southern United States (U.S.) sustains a disproportionate burden of incident stroke and associated mortality, compared to other parts of the U.S. A large proportion of this risk remains unexplained. Petroleum production and refining (PPR) is concentrated within this region and emits multiple pollutants implicated in stroke pathogenesis. The relationship between residential PPR exposure and stroke has not been studied.
We aimed to investigate the census tract-level association between residential PPR exposure and stroke prevalence for adults (≥18 years) in seven southern U.S. states in 2018.
We conducted spatial distance- and generalized propensity score-matched analysis that adjusts for sociodemographic factors, smoking, and unmeasured spatial confounding. PPR was measured as inverse-distance weighted averages of petroleum production within 2.5km or 5km from refineries, which was strongly correlated with measured levels of sulfur dioxide, a byproduct of PPR.
The prevalence of self-reported stroke ranged from 0.4% to 12.7% for all the census tracts of the seven states. People with low socioeconomic status and of Hispanic ethnicity resided closer to petroleum refineries. The non-Hispanic Black population was exposed to higher PPR, while the non-Hispanic White population was exposed to lower PPR. Residential PPR exposure was significantly associated with stroke prevalence. One standard deviation increase in PPR within 5km from refineries was associated with 0.22 (95% confidence interval: 0.09, 0.34) percentage point increase in stroke prevalence. PPR explained 5.6% (2.4, 8.9) of stroke prevalence in the exposed areas. These values differed by states: 1.1% (0.5, 1.7) in Alabama to 11.7% (4.9, 18.6) in Mississippi, and by census tract-level: 0.08% (0.03, 0.13) to 25.3% (10.6, 40.0).
PPR is associated with self-reported stroke prevalence, suggesting possible links between pollutants emitted from refineries and stroke. The increased prevalence due to PPR may differ by sociodemographic factors.
与美国其他地区相比，美国南部承受着不成比例的中风发病率和相关死亡率负担。很大一部分这种风险仍无法解释。石油生产和精炼（PPR）集中在该地区，会排放多种与中风发病机制有关的污染物。住宅PPR暴露与中风之间的关系尚未得到研究。
我们旨在调查2018年美国南部七个州成年人（≥18岁）的人口普查区层面住宅PPR暴露与中风患病率之间的关联。
我们进行了空间距离和广义倾向得分匹配分析，对社会人口学因素、吸烟情况和未测量的空间混杂因素进行了调整。PPR被测量为距炼油厂2.5公里或5公里范围内石油产量的反距离加权平均值，这与PPR副产品二氧化硫的测量水平密切相关。
七个州所有普查区自我报告的中风患病率在0.4%至12.7%之间。社会经济地位低和西班牙裔的人居住得离炼油厂更近。非西班牙裔黑人人口接触到更高的PPR，而非西班牙裔白人人口接触到较低的PPR。住宅PPR暴露与中风患病率显著相关。距炼油厂5公里范围内PPR每增加一个标准差，中风患病率就增加0.22（95%置信区间：0.09，0.34）个百分点。PPR解释了暴露地区中风患病率的5.6%（2.4，8.9）。这些数值因州而异：阿拉巴马州为1.1%（0.5，1.7），密西西比州为11.7%（4.9，18.6），也因普查区层面而异：0.08%（0.03，0.13）至25.3%（10.6，40.0）。
PPR与自我报告的中风患病率相关，表明炼油厂排放的污染物与中风之间可能存在联系。由于PPR导致的患病率增加可能因社会人口学因素而异。
