Autor/a:
|
Vivanco Hidalgo, Rosa Maria; Wellenius, Gregory A.; Basagaña, Xavier; Cirach, Marta; Gonzalez, Alejandra Gómez; Ceballos, Pablo de; Zabalza, Ana; Jimenez Conde, Jordi; Soriano Tarraga, Carolina; Giralt Steinhauer, Eva; Alastuey, Andrés; Querol, Xavier; Sunyer Deu, Jordi; Roquer, Jaume
|
Abstract:
|
OBJECTIVE: To assess the relationship between short-term
exposure to outdoor ambient air pollutants (fine particulate
matter [PM2.5] and black carbon [BC]), ischemic stroke (IS) and
its different subtypes, and the potential modifying effect of
neighborhood greenspace and noise. METHODS: This time-stratified
case-crossover study was based on IS and transient ischemic
attacks (TIA) recorded in a hospital-based prospective stroke
register (BASICMAR 2005-2014) in Barcelona (Catalonia, Spain).
Daily and hourly pollutant concentrations and meteorological
data were obtained from monitoring stations in the city.
Time-lags (from previous 72h to acute stroke onset) were
analyzed. Greenness and noise were determined from the
Normalized Difference Vegetation Index (NDVI) and daily average
noise level at the street nearest to residential address,
respectively. RESULTS: The 2742 cases with known onset date and
time, living in the study area, were analyzed. After adjusting
for temperature, no statistically significant association
between pollutants exposure and overall stroke risk was found.
In subtype analysis, an association was detected between BC
exposure at 24-47h (odds ratio, 1.251; 95% confidence interval
[CI], 1.001-1.552; P = 0.042) and 48-72h (1.211; 95% CI,
0.988-1.484; P = 0.065) time-lag prior to stroke onset and
large-artery atherosclerosis subtype. No clear modifying effect
of greenness or noise was observed. CONCLUSIONS: Overall, no
association was found between PM2.5 and BC exposure and acute IS
risk. By stroke subtype, large-artery atherosclerotic stroke
could be triggered by daily increases in BC, a diesel
fuel-related pollutant in the study area. |