Air pollution: a new risk factor in ischemic stroke mortality.
OBJECTIVE
Air pollution is known to be associated with cardiovascular disease, but little is known about the occurrence of stroke in relation to air pollution. We investigated the association between acute stroke mortality and air pollution over a 7-year period (January 1991 through December 1997) in Seoul, Korea.


METHODS
A generalized additive model was used to regress daily stroke death counts for each air pollutant, controlling for time trends, day of the week, and meteorological influences such as temperature, relative humidity, and atmospheric pressure. Ischemic and hemorrhagic stroke deaths were examined separately.


RESULTS
The effects of air pollutants on ischemic stroke mortality were statistically significant, whereas this was not the case for hemorrhagic stroke mortality. We observed estimated relative risks of 1.03 (95% CI, 1.00 to 1.06) and 1.04 (95% CI, 1.01 to 1.08) for ischemic stroke mortality for each interquartile range increase in total suspended particulates and sulfur dioxide concentrations on the same day. We also found significantly increased relative risks of 1.04 (95% CI, 1.01 to 1.07) for nitrogen dioxide with a 1-day lag, of 1.06 (95% CI, 1.02 to 1.09) for carbon monoxide with a 1-day lag, and of 1.06 (95% CI, 1.02 to 1.10) for ozone with a 3-day lag for each interquartile range increase.


CONCLUSIONS
These findings indicate that air pollutants are significantly associated with ischemic stroke mortality, which suggests an acute pathogenetic process in the cerebrovascular system induced by air pollution.
Hong
Yun-Chul
YC
Department of Occupational and Environmental Medicine, Inha University College of Medicine, Jung-Gu, Incheon, Korea. ychong@inha.ac.kr
Lee
Jong-Tae
JT
Kim
Ho
H
Kwon
Ho-Jang
HJ
D000397:Air Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D002545:Brain Ischemia / Q000209:etiology / Q000401:mortality; D002248:Carbon Monoxide / Q000009:adverse effects / Q000032:analysis; D002543:Cerebral Hemorrhage / Q000401:mortality; D015897:Comorbidity; D004784:Environmental Monitoring / Q000706:statistics & numerical data; D062665:Epidemiological Monitoring; D006801:Humans; D007723:Korea / Q000453:epidemiology; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis; D010126:Ozone / Q000009:adverse effects / Q000032:analysis; D016012:Poisson Distribution; D012044:Regression Analysis; D012306:Risk; D012906:Smoke / Q000009:adverse effects / Q000032:analysis; D020521:Stroke / Q000209:etiology* / Q000401:mortality*; D013458:Sulfur Dioxide / Q000009:adverse effects / Q000032:analysis
D012906:Smoke; D013458:Sulfur Dioxide; D010126:Ozone; D002248:Carbon Monoxide; D009585:Nitrogen Dioxide