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research
Estimation of Short-Term Effects of Air Pollution on Stroke Hospital Admissions in Wuhan, China
Authors
A Le Tertre
A Nemmar
+44 more
A Peters
A Ponka
A Seaton
A Zeka
CC Chan
CY Yang
D D’Ippoliti
D Levy
DQ Rich
E Carracedo-Martinez
Evelyn O. Talbott
F Ballester
GA Wellenius
GA Wellenius
H Janes
H Kan
Hao Xiang
J Schwartz
J Sunyer
J Wichmann
J Wordley
JD Poloniecki
JH Abraham
K Katsouyanni
Kristen J. Mertz
Luann L. Brink
M Maclure
Michelle L. Block
R Ali
RT Burnett
S Tong
SC Fang
SF van Eeden
SH Moolgavkar
SL Zeger
SS Tsai
TW Wong
VC Arena
Vincent C. Arena
WS Linn
Xiaohui Xu
YC Hong
Yongyi Bi
Z Qian
Publication date
1 January 2013
Publisher
'Public Library of Science (PLoS)'
Doi
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on
PubMed
Abstract
Background and Objective:High concentrations of air pollutants have been linked to increased incidence of stroke in North America and Europe but not yet assessed in mainland China. The aim of this study is to evaluate the association between stroke hospitalization and short-term elevation of air pollutants in Wuhan, China.Methods:Daily mean NO2, SO2 and PM10 levels, temperature and humidity were obtained from 2006 through 2008. Data on stroke hospitalizations (ICD 10: I60-I69) at four hospitals in Wuhan were obtained for the same period. A time-stratified case-crossover design was performed by season (April-September and October-March) to assess effects of pollutants on stroke hospital admissions.Results:Pollution levels were higher in October-March with averages of 136.1 μg/m3 for PM10, 63.6 μg/m3 for NO2 and 71.0 μg/m3 for SO2 than in April-September when averages were 102.0 μg/m3, 41.7 μg/m3 and 41.7 μg/m3, respectively (p<.001). During the cold season, every 10 μg/m3 increase in NO2 was associated with a 2.9% (95%C.I. 1.2%-4.6%) increase in stroke admissions on the same day. Every 10 ug/m3 increase in PM10 daily concentration was significantly associated with an approximate 1% (95% C.I. 0.1%-1.4%) increase in stroke hospitalization. A two-pollutant model indicated that NO2 was associated with stroke admissions when controlling for PM10. During the warm season, no significant associations were noted for any of the pollutants.Conclusions:Exposure to NO2 is significantly associated with stroke hospitalizations during the cold season in Wuhan, China when pollution levels are 50% greater than in the warm season. Larger and multi-center studies in Chinese cities are warranted to validate our findings. © 2013 Xiang et al
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