Associations between exhaust and non-exhaust particulate matter and stroke incidence by stroke subtype in South London
Associations between exhaust and non-exhaust particulate matter and stroke incidence by stroke subtype in South London
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DOI：
10.1016/j.scitotenv.2016.06.009
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发表时间：
2016-10-15
影响因子：
9.8
通讯作者：
Wolfe, Charles D. A.
中科院分区：
文献类型：
--
作者：
Crichton, Siobhan;Barratt, Benjamin;Wolfe, Charles D. A.
背景：空气中的颗粒物（PM）由来自不同来源的颗粒组成，包括汽车尾气。短期PM变化与中风发病率之间的关联已被证明。几个月或几年的累积暴露研究较少;很少有研究检查缺血亚型或PM来源。目的：这项研究结合了高分辨率的城市空气质量模型和基于人群的中风登记，以探讨长期暴露于PM和中风发病率之间的关系。方法：纳入了2005-2012年南伦敦卒中登记的数据。Poisson回归分析了中风发病率与长期（研究期间的平均值）暴露于PM2.5（PM < 2.5 μ m直径）和PM w（PM < 10 μ m），一氧化氮，二氧化氮，氮氧化物和臭氧之间的关系，在输出区域水平（平均人口= 309）。估计值按年龄和性别进行标准化，并根据社会经济贫困进行调整。对模型进行缺血性和出血性卒中分层，并根据牛津社区卒中项目分类和急性卒中治疗中的ORG 10172试验（吐司）分类进一步细分。结果：记录了1800例卒中（发病率= 42.6/10万人-年）。PM与总体缺血或出血发生率之间未观察到相关性。对于PM-2.5的四分位数范围增加，总前循环梗死（TACI）的发病率增加23%（发病率比1.23（95%CI：1.03-1.44）），排气引起的PM2.5增加20%（120（1.01-141））。总体（1.21（1.01-1.44））和废气（1.20（1.01- 1.41））与PM10的相关性相似。TACI发病率与非排气源无关。与其他中风亚型或污染物没有关联。结论：室外空气污染，特别是机动车尾气污染，可能增加TAO的风险，但不会增加其他卒中亚型的风险。(C)© 2016 Elsevier B. V.版权所有。
Background: Airborne particulate matter (PM) consists of particles from diverse sources, including vehicle exhausts. Associations between short-term PM changes and stroke incidence have been shown. Cumulative exposures over several months, or years, arc less well studied; few studies examined ischaemic subtypes or PM source. Aims: This study combines a high resolution urban air quality model with a population-based stroke register to explore associations between long-term exposure to PM and stroke incidence. Method: Data from the South London Stroke Register from 2005-2012 were included. Poisson regression explored association between stroke incidence and long-term (averaged across the study period) exposure to PM2.5(PM < 2.5 mu m diameter) and PM w(PM < 10 mu m), nitric oxide, nitrogen dioxide, nitrogen oxides and ozone, at the output area level (average population = 309). Estimates were standardised for age and sex and adjusted for socio-economic deprivation. Models were stratified for ischaemic and haemorrhagic strokes and further broken down by Oxford Community Stroke Project classification and Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. Results: 1800 strokes were recorded (incidence = 42.6/100,000 person-years). No associations were observed between PM and overall ischaemic or haemorrhagic incidence. For an interquartile range increase in PM-2.5, there was a 23% increase in incidence (Incidence rate ratio 1.23 (95%CI: 1.03-1.44)) of total anterior circulation infarcts (TACI) and 20% increase for PM2.5 from exhausts (120(1.01-141)). There were similar associations with PM10, overall (1.21(1.01-1.44)) and from exhausts (1.20(1.01-1.41)). TACI incidence was not associated with non-exhaust sources. There were no associations with other stroke subtypes or pollutants. Conclusion: Outdoor air pollution, particularly that arising from vehicle exhausts, may increase risk of TAO but not other stroke subtypes. (C) 2016 Elsevier B.V. All rights reserved.