Stroke mortality associated with living near main roads in England and Wales - A geographical study
Stroke mortality associated with living near main roads in England and Wales - A geographical study
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DOI：
10.1161/01.str.0000101750.77547.11
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发表时间：
2003-12-01
期刊：
影响因子：
8.3
通讯作者：
Elliott, P
中科院分区：
文献类型：
--
作者：
Maheswaran, R;Elliott, P
背景和目的-空气污染与中风有关，道路交通是室外空气污染的主要来源。我们使用靠近道路作为暴露于道路交通污染的代理，检验了居住在主要道路附近会增加中风死亡率的假设。方法：我们在英格兰和威尔士的113465个人口普查区进行了小范围的生态研究设计。通过使用1991年人口分母，研究了1990年至1992年英格兰和威尔士45岁以上或等于45岁的人的中风死亡率（《国际疾病分类》第9版，编号430至438）。暴露量计算为每个点查区人口中心点到最近的主要道路的距离。我们使用泊松回归调整了年龄、性别、社会经济剥夺（Carstairs指数）、区域差异、城市化和大都市区。结果-分析基于189 966例中风死亡和19 083 979例人口。在对潜在混杂因素进行调整后，居住在主干道200米以内的男性中风死亡率比居住在主干道1000米以上的男性高7%（95%可信区间[CI]， 4 - 9）。女性相应增加的风险为4% (95% CI, 2 - 6)，男性和女性合并的风险为5% （95% CI, 4 - 7）。这些增加的风险随着离主要道路的距离增加而减少。结论——居住在主要道路附近与中风死亡风险增加有关，如果假定因果关系，每年约有990例中风死亡可归因于道路交通污染。
Background and Purpose - Air pollution is associated with stroke, and road traffic is a major source of outdoor air pollution. Using proximity to roads as a proxy for exposure to road traffic pollution, we examined the hypothesis that living near main roads increases the risk of stroke mortality.Methods - We used a small- area ecological study design based on 113 465 census enumeration districts in England and Wales. Stroke mortality ( International Classification of Disease, 9th revision, codes 430 through 438) in England and Wales from 1990 to 1992 for people greater than or equal to 45 years of age was examined through the use of 1991 population denominators. Exposure was calculated as distance from each enumeration district population centroid to the nearest main road. We adjusted for age, sex, socioeconomic deprivation ( using Carstairs index), regional variation, urbanization, and metropolitan area using Poisson regression.Results - The analysis was based on 189 966 stroke deaths and a population of 19 083 979. After adjustment for potential confounders, stroke mortality was 7% ( 95% confidence interval [ CI], 4 to 9) higher in men living within 200 m of a main road compared with men living greater than or equal to 1000 m away. The corresponding increase in risk for women was 4% ( 95% CI, 2 to 6) and the risk for men and women combined was 5% ( 95% CI, 4 to 7). These raised risks diminished with increasing distance from main roads.Conclusions - Living near main roads is associated with excess risk of mortality from stroke, and if causality were assumed, approximate to 990 stroke deaths per year would have been attributable to road traffic pollution.