Long-term exposure to air pollution and stroke incidence: A Danish Nurse cohort study

Environment International

Matthias Ketzel¹  Camilla Geels²  Jørgen Brandt³  Youn-Hee Lim⁴  Christian Dehlendorff⁵  Zorana J. Andersen⁶  Lise M. Frohn⁷  Tom Cole-Hunter⁸  Rudi Westendorp⁸  Mette K. Simonsen⁹  Claus Backalarz^1,10  Ole Hertel^1,11  Jeanette T. Jørgensen^1,12  Barbara Hoffmann^1,12  Heresh Amini^1,12  Jesper H. Christensen^1,12  Steen Solvang Jensen^1,12  Elvira V. Bräuner^1,13  Steffen Loft^1,14  Laust H. Mortensen^1,14  Amar Mehta^1,15 

[1] Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark;Centre for Air Pollution, Energy, and Health Research, University of New South Wales, Sydney, NSW, Australia;Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany;Corresponding author at: Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark..;Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States;Global Centre for Clean Air Research (GCARE), University of Surrey, United Kingdom;International Laboratory for Air Quality and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia;Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Department of Environmental Science, Aarhus University, Aarhus, Denmark;Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark;Institute for Occupational, Social and Environmental Medicine;Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Statistics Denmark, Copenhagen, Denmark;Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark;

关键词: Air pollution;    Nitrogen dioxide (NO2);    Noise;    Particulate matter <2.5 µm (PM2.5);    Particulate matter <10 µm (PM10);    Ischemic and hemorrhagic stroke;   

DOI  :  

来源: DOAJ

【 摘 要 】

Ambient air pollution has been linked to stroke, but few studies have examined in detail stroke subtypes and confounding by road traffic noise, which was recently associated with stroke. Here we examined the association between long-term exposure to air pollution and incidence of stroke (overall, ischemic, hemorrhagic), adjusting for road traffic noise. In a nationwide Danish Nurse Cohort consisting of 23,423 nurses, recruited in 1993 or 1999, we identified 1,078 incident cases of stroke (944 ischemic and 134 hemorrhagic) up to December 31, 2014, defined as first-ever hospital contact. The full residential address histories since 1970 were obtained for each participant and the annual means of air pollutants (particulate matter with diameter < 2.5 µm and < 10 µm (PM2.5 and PM10), nitrogen dioxide (NO2), nitrogen oxides (NOx)) and road traffic noise were determined using validated models. Time-varying Cox regression models were used to estimate hazard ratios (HR) (95% confidence intervals (CI)) for the associations of one-, three, and 23-year running mean of air pollutants with stroke adjusting for potential confounders and noise. In fully adjusted models, the HRs (95% CI) per interquartile range increase in one-year running mean of PM2.5 and overall, ischemic, and hemorrhagic stroke were 1.12 (1.01–1.25), 1.13 (1.01–1.26), and 1.07 (0.80–1.44), respectively, and remained unchanged after adjustment for noise. Long-term exposure to ambient PM2.5 was associated with the risk of stroke independent of road traffic noise.

【 授权许可】

Unknown