Abstract
Air pollution and ischemic stroke (IS) are both vital factors affecting the health of Beijing citizens. This study aims at exploring the associations between air pollution, meteorology, and the hospital admission of IS (IS HA). Information on 476,659 IS inpatients in secondary and higher hospitals in Beijing from 2013 to 2018 were collected. A time-stratified case-crossover design with the generalized additive model and the distributed lag nonlinear model were used. In the single-pollutant models, an inter-quartile range increase in O3, SO2, CO, and NO2 resulted in a significant highest increase in IS HA by 2.23% (95% CI: 1.56%, 2.90%), 1.53% (95% CI: 1.12%, 1.95%), 1.05% (95% CI: 0.70%, 1.40%), and 0.51% (95% CI: 0.24%, 0.79%) on the day of pollution, so did PM2.5 and PM10 by 1.13% (95% CI: 0.68%, 1.59%) and 1.19% (95% CI: 0.74%, 1.64%) at a lag of 0–5 days. There was a nonlinear relationship between meteorology and IS HA. In the multivariate model, the cumulative relative risks with a maximum lag time of 21 days of PM2.5 and NO2 were 1.11 (95% CI: 1.04, 1.19) and 0.88 (95% CI: 0.82, 0.94), while the effects of SO2, O3, and meteorology were insignificant. The findings suggested that particulate pollutants could increase the risk of IS, and the elderly were more sensitive to it, while the results of gaseous pollutants are still discordant. The control of air pollution and the protection of susceptible populations should receive higher attention from policymakers.
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Data availability
The data that support the findings of this study are available from the Beijing Municipal Commission of Health and Family Planning Information Center and the Beijing Municipal Commission of Health and Family Planning Policy Research Center. But restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.
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This work was supported by the National Natural Science Foundation of China (grant numbers 81773512). The funding source had no role in the design of the study; in the collection, analysis, and interpretation of data; or in the writing of the manuscript.
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YZ and MG conceptualized the article. MG and PT collected and collated data. YZ and JA performed the data analysis. YZ drafted the work. LZ, XT, LL, ZZ, XW, XL, and XG critically revised the work. YL performed funding acquisition. All authors read and approved the final manuscript.
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The personal privacy information of IS inpatients has been deleted in the process of data provision, so this paper does not involve personal information and related ethical issues. This study is in accordance with the 2013 revision of the Declaration of Helsinki, and in line with national laws.
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Zhao, Y., Guo, M., An, J. et al. Associations between ambient air pollution, meteorology, and daily hospital admissions for ischemic stroke: a time-stratified case-crossover study in Beijing. Environ Sci Pollut Res 29, 53704–53717 (2022). https://doi.org/10.1007/s11356-021-18461-8
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DOI: https://doi.org/10.1007/s11356-021-18461-8