Association between short-term exposure to ambient air pollution and hospital admissions for transient ischemic attacks
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RESEARCH ARTICLE
Association between short-term exposure to ambient air pollution and hospital admissions for transient ischemic attacks in Beijing, China Runhua Zhang 1,2 & Yong Jiang 1,2 & Guitao Zhang 1,2 & Miaoxin Yu 1,2 & Yongjun Wang 1,2 & Gaifen Liu 1,2 Received: 1 June 2020 / Accepted: 21 September 2020 # The Author(s) 2020
Abstract Numerous studies have examined the associations between air pollution and stroke. However, little is known about the associations between air pollution and transient ischemic attack (TIA). In this study, we aimed to conduct a time-series study to systematically examine the associations between hospital admissions for TIA and air pollutants. Admissions for TIA (ICD-10: G45) from 1 January 2014 to 31 December 2016 were identified based on the primary diagnosis from 134 hospitals in Beijing, China. Hourly measurements of air pollutants were obtained from the National Air Pollution Monitoring System. Generalized additive models with quasi-Poisson regression were used to determine the associations for each pollutant. Additionally, stratified analysis was implemented to examine whether age, gender, temperature, and season were the potential effect modifiers. Restricted cubic spline was applied to investigate the exposure-response curve. In total, 109,975 hospital admissions for TIA were included. The positive associations were detected between PM2.5, PM10, SO2, NO2, and CO and hospital admissions for TIA. The effects of PM2.5 and PM10 in men are stronger than in women. Additionally, the effects of PM2.5, PM10, SO2, and O3 are more pronounced on warm days than cool days. From exposure-response curves, we observe a nearly linear relationship for PM2.5, PM10, CO, and NO2. Further studies are needed to verify the association. This research contributes evidence on the association between air pollution and admissions for TIA in the low- and middle-income countries and may promote related public health policy development. Keywords Transient ischemic attack . Air pollution . Particulate matter . Time-series . Hospital admissions
Introduction Air pollution is one of the leading causes of risk-attributable death, accounting for over 4 million worldwide deaths each year (Stanaway et al. 2018). As a potentially modifiable risk factor, the effects of air pollution on human health are a topic that has received much attention in recent decades. A large Responsible Editor: Lotfi Aleya * Yongjun Wang [email protected] * Gaifen Liu [email protected] 1
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing 100070, China
2
China National Clinical Research Center for Neurological Diseases, Beijing 10070, China
body of epidemiological and clinical studies supports the existence of positive associations between air pollution and the morbidity and mortality of ischemic stroke, as well as hemorrhagic stroke (Andersen et al. 2012; Huang et al. 2019; Sun et al. 2019; Zhang et al. 2018). According to the Inte
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