Air pollution and hospital admissions for ischemic and hemorrhagic stroke among medicare beneficiaries.

Content Provider	Semantic Scholar
Author	Schwartz, Joel
Copyright Year	2005
Abstract	BACKGROUND AND PURPOSE The association between short-term elevations in ambient air particles and increased cardiovascular morbidity and mortality is well documented. Ambient particles may similarly increase the risk of stroke. METHODS We evaluated the association between daily levels of respirable particulate matter (aerodynamic diameter < or =10 microm, PM10) and hospital admission for ischemic and hemorrhagic stroke among Medicare recipients (age > or =65 years) in 9 US cities using a 2-stage hierarchical model. In the first stage, we applied the time-stratified case-crossover design to estimate the effect of PM10 in each city. We used a 3-day unconstrained, distributed lag model to simultaneously estimate the effect of PM10 0 to 2 days before the admission day and controlled for meteorological covariates in all of the models. In the second stage, we used random-effects metaanalytic techniques to combine the city-specific effect estimates. RESULTS Ischemic (n=155,503) and hemorrhagic (19,314) stroke admissions were examined separately. For ischemic stroke, an interquartile range increase in PM10 was associated with a 1.03% (95% CI, 0.04% to 2.04%) increase in admissions on the same day only. Similar results were observed with CO, NO2, and SO2. For hemorrhagic stroke, no association was observed with any pollutant 0 to 2 days before admission. CONCLUSIONS These results suggest that elevations in ambient particles may transiently increase the risk of ischemic, but not hemorrhagic, stroke. Studies with more accurate assessment of timing of stroke onset are necessary to confirm or refute these findings.
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Alternate Webpage(s)	http://stroke.ahajournals.org/content/strokeaha/36/12/2549.full.pdf?download=true
Alternate Webpage(s)	http://stroke.ahajournals.org/content/strokeaha/36/12/2549.full.pdf
Alternate Webpage(s)	http://stroke.ahajournals.org/content/strokeaha/early/2005/10/27/01.STR.0000189687.78760.47.full.pdf
Alternate Webpage(s)	https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.files/fileID/14052
PubMed reference number	16254223v1
Volume Number	36
Issue Number	12
Journal	Stroke
Language	English
Access Restriction	Open
Subject Keyword	Air Embolism Brain hemorrhage Cerebral Infarction Cerebrovascular accident Diameter (qualifier value) Document completion status - Documented Elfacos OW 100 Estimated Gastrointestinal Hemorrhage Hospital admission Medicare Part B Morbidity - disease rate Particulate (substance) Particulate Matter STMN1 gene Stage level 1 Stage level 2 Sulfur Dioxide pollutant
Content Type	Text
Resource Type	Article