Dataset Information

Short-Term Association of Air Pollutant Levels and Hospital Admissions for Stroke and Effect Modification by Apparent Temperature: Evidence From Shanghai, China.

ABSTRACT: The epidemiological evidence on relationships between air pollution, temperature, and stroke remains inconclusive. Limited evidence is available for the effect modification by apparent temperature, an indicator reflecting reactions to the thermal environment, on short-term associations between air pollution and hospital admissions for stroke. We used a generalized additive model with Poisson regression to estimate the relative risk (RR) of stroke admissions in Shanghai, China, between 2014 and 2016 associated with air pollutants, with subgroup analyses by age, sex, apparent temperature, and season. During the study period, changes in the daily number of stroke admissions per 10 μg/m³ increase in nitrogen dioxide (at lags 0, 1, 0-1, and 0-2) ranged from 1.05 (95% CI: 0.82%, 2.88%) to 2.24% (95% CI: 0.84%, 3.65%). For each 10 μg/m³ increase in sulfur dioxide concentrations at lags 1, 2, 0-1, and 0-2, the RR of daily stroke admissions increased by 3.34 (95% CI: 0.955%, 5.79%), 0.32 (95% CI: -1.97%, 2.67%), 3.33 (95% CI: 0.38%, 6.37%), and 2.86% (95% CI: -0.45%, 6.28%), respectively. The associations of same-day exposure to nitrogen dioxide with stroke admissions remained significant after adjustment for ozone levels. These associations were not modified by sex, age, apparent temperature, or season. More research is warranted to determine whether apparent temperature modifies the associations between air pollution and stroke admissions.

SUBMITTER: Weng L

PROVIDER: S-EPMC8503471 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Short-Term Association of Air Pollutant Levels and Hospital Admissions for Stroke and Effect Modification by Apparent Temperature: Evidence From Shanghai, China.

Weng Lvkan L Li Na N Feng Tienan T Zhu Rongjia R Zheng Zhi-Jie ZJ

Frontiers in public health 20210927

The epidemiological evidence on relationships between air pollution, temperature, and stroke remains inconclusive. Limited evidence is available for the effect modification by apparent temperature, an indicator reflecting reactions to the thermal environment, on short-term associations between air pollution and hospital admissions for stroke. We used a generalized additive model with Poisson regression to estimate the relative risk (RR) of stroke admissions in Shanghai, China, between 2014 and 2 ...[more]

PMID: 34646803

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Project description:To curb the spread of the coronavirus, China implemented lockdown policies on January 23, 2020. The resulting extreme changes in human behavior may have influenced the air pollutants concentration. However, despite these changes, hazy weather persisted in Shanghai and became a public issue. This study aims to investigate air pollutant mass concentration changes during the lockdown in Shanghai. Air pollutant mass concentration data and meteorological data during the pre-lockdown period and the level I response lockdown period were analyzed by statistical analysis and a Lagrangian particle diffusion model. The data was classified in three periods: P1 (pre-lockdown: 10 days before the Spring Festival), P2 (the first 10 days after lockdown: during the Spring Festival celebration), and P3 (the second 10 days after lockdown: after the Spring Festival). Data for the same period in 2019 were used as a reference. The results indicate that the Spring Festival holiday in 2019 resulted in a reduction in energy consumption, which led to a decrease in PM2.5 (26.4%) and NO2 (43.41%) mass concentration, but an increase in ozone mass concentration (31.39%) in P2 compared with P1. The integrated effect of the Spring Festival holiday and lockdown in 2020 resulted in a decrease in PM2.5 (36.5%) and NO2 (51.9%) mass concentrations, but an increase in ozone mass concentration (43.8%) in P2 compared with P1. After the Spring Festival, the mass concentrations of PM2.5, SO2, and NO2 increased by 74.41%, 5.52%, and 53.28%, respectively in P3 compared with P2 in 2019. However, PM2.5 and SO2 concentrations in 2020 continued to decrease, by 14.74% and 4.61%, respectively, while NO2 mass concentration increased by 7.82% in P3 compared with P2. We also found that PM2.5 mass concentration is susceptible to regional transmission from the surrounding cities. PM2.5 and other gaseous pollutants show different correlations in different periods, while NO2 and O3 always show a strong negative correlation. The principal components before the Spring Festival in 2019 were O3 and NO2, and after the Spring Festival, they were PM2.5 and CO, while the principal components before the lockdown in 2020 were PM2.5 and CO, and during lockdown they were O3 and NO2.

Project description:BackgroundLittle is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA.MethodsFor this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM2·5], ozone, and nitrogen dioxide [NO2]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated.FindingsFor each 5°C increase in short-term exposure to cold season temperature, the relative risk of acute hospital admission increased by 3·66% (95% CI 3·06-4·26) for depression, by 3·03% (2·04-4·02) for schizophrenia, and by 3·52% (2·38-4·68) for bipolar disorder in the US Medicare population. Increased short-term exposure to PM2·5 and NO2 was also associated with a significant increase in the risk of acute hospital admissions for psychiatric disorders. Each 5 μg/m3 increase in PM2·5 was associated with an increase in hospital admission rates of 0·62% (95% CI 0·23-1·02) for depression, 0·77% (0·11-1·44) for schizophrenia, and 1·19% (0·49-1·90) for bipolar disorder; each 5 parts per billion (ppb) increase in NO2, meanwhile, was linked to an increase in hospital admission rates of 0·35% (95% CI 0·03-0·66) for depression and 0·64% (0·20-1·08) for schizophrenia. No such associations were found with warm season temperature.InterpretationIn the US Medicare population, short-term exposure to elevated concentrations of PM2·5 and NO2 and cold season ambient temperature were significantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden.FundingUS National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.

Project description:BackgroundEvidence of the short-term effects of ambient air pollution on the risk of ischemic stroke in low- and middle-income countries is limited and inconsistent. We aimed to examine the associations between air pollution and daily hospital admissions for ischemic stroke in China.Methods and findingsWe identified hospital admissions for ischemic stroke in 2014-2016 from the national database covering up to 0.28 billion people who received Urban Employee Basic Medical Insurance (UEBMI) in China. We examined the associations between air pollution and daily ischemic stroke admission using a two-stage method. Poisson time-series regression models were firstly fitted to estimate the effects of air pollution in each city. Random-effects meta-analyses were then conducted to combine the estimates. Meta-regression models were applied to explore potential effect modifiers. More than 2 million hospital admissions for ischemic stroke were identified in 172 cities in China. In single-pollutant models, increases of 10 μg/m3 in particulate matter with aerodynamic diameter <2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) and 1 mg/m3 in carbon monoxide (CO) concentrations were associated with 0.34% (95% confidence interval [CI], 0.20%-0.48%), 1.37% (1.05%-1.70%), 1.82% (1.45%-2.19%), 0.01% (-0.14%-0.16%), and 3.24% (2.05%-4.43%) increases in hospital admissions for ischemic stroke on the same day, respectively. SO2 and NO2 associations remained significant in two-pollutant models, but not PM2.5 and CO associations. The effect estimates were greater in cities with lower air pollutant levels and higher air temperatures, as well as in elderly subgroups. The main limitation of the present study was the unavailability of data on individual exposure to ambient air pollution.ConclusionsAs the first national study in China to systematically examine the associations between short-term exposure to ambient air pollution and ischemic stroke, our findings indicate that transient increase in air pollution levels may increase the risk of ischemic stroke, which may have significant public health implications for the reduction of ischemic stroke burden in China.

Dataset Information

Short-Term Association of Air Pollutant Levels and Hospital Admissions for Stroke and Effect Modification by Apparent Temperature: Evidence From Shanghai, China.

Publications

Short-Term Association of Air Pollutant Levels and Hospital Admissions for Stroke and Effect Modification by Apparent Temperature: Evidence From Shanghai, China.

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