Background and Purpose:Current evidence suggests that stroke mortality and hospital admissions should be higher in areas with elevat ed levels of outdoor air pollution because of the combined acute and chronic exp osu...Background and Purpose:Current evidence suggests that stroke mortality and hospital admissions should be higher in areas with elevat ed levels of outdoor air pollution because of the combined acute and chronic exp osure effects of air pollution.We examined this hypothesis using a small-area l evel ecological correlation study. Methods:We used 1030 census enumeration dist ricts as the unit of analysis and examined stroke deaths and hospital admissions from 1994 to 1998, with census denominator counts for people ≥45 years. Modele d air pollution data for particulate matter (PM10), nitrogen oxides (NOx), and c arbonmonoxide (CO) were interpolated to census enumeration districts. We adjuste d for age, sex, socioeconomic deprivation,and smoking prevalence. Results:The a nalysis was based on 2979 deaths, 5122 admissions, and a population of 199 682.A fter adjustment for potential confounders, stroke mortality was 37%(95%CI, 19 to 57), 33%(95%CI, 14 to 56), and 26%(95%CI, 10 to 46) higher in the highest , relative to the lowest, NOx, PM10, and CO quintile categories, respectively.Co rresponding increases in risk for admissions were 13%(95%CI, 1 to 27), 13%(95 %CI, -1 to 29), and 11%(95%CI, -1 to25). Conclusion:The results are consis tent with an excess risk of stroke mortality and, to a lesser extent, hospital a dmissionsin are as with high outdoor air pollution levels. If causality were ass umed, 11%of stroke deaths would have been attributable to outdoor air pollution . Targeting policy interventions at high pollution areas may be a feasible optio n for stroke prevention.展开更多
文摘Background and Purpose:Current evidence suggests that stroke mortality and hospital admissions should be higher in areas with elevat ed levels of outdoor air pollution because of the combined acute and chronic exp osure effects of air pollution.We examined this hypothesis using a small-area l evel ecological correlation study. Methods:We used 1030 census enumeration dist ricts as the unit of analysis and examined stroke deaths and hospital admissions from 1994 to 1998, with census denominator counts for people ≥45 years. Modele d air pollution data for particulate matter (PM10), nitrogen oxides (NOx), and c arbonmonoxide (CO) were interpolated to census enumeration districts. We adjuste d for age, sex, socioeconomic deprivation,and smoking prevalence. Results:The a nalysis was based on 2979 deaths, 5122 admissions, and a population of 199 682.A fter adjustment for potential confounders, stroke mortality was 37%(95%CI, 19 to 57), 33%(95%CI, 14 to 56), and 26%(95%CI, 10 to 46) higher in the highest , relative to the lowest, NOx, PM10, and CO quintile categories, respectively.Co rresponding increases in risk for admissions were 13%(95%CI, 1 to 27), 13%(95 %CI, -1 to 29), and 11%(95%CI, -1 to25). Conclusion:The results are consis tent with an excess risk of stroke mortality and, to a lesser extent, hospital a dmissionsin are as with high outdoor air pollution levels. If causality were ass umed, 11%of stroke deaths would have been attributable to outdoor air pollution . Targeting policy interventions at high pollution areas may be a feasible optio n for stroke prevention.
