Increased hospitalizations for ischemic stroke with comorbid diabetes and residential proximity to sources of organic pollutants: a 12-year population-based study.
BACKGROUND
Evidence is emerging that exposure to persistent organic pollutants (POP) is a risk factor for atherosclerosis-related diseases and for diabetes mellitus (DM). We hypothesized that residential proximity to sources of POP will be associated with an increase in hospitalization rates for ischemic stroke (IS) with comorbid DM (IS-DM).


METHODS
We examined IS-DM hospitalization rates in the New York State (exclusive of New York City) during a 12-year period. POP exposure status was assessed based on residency in a zip code containing or abutting environmental sources of POP. Adjusted relative risks (RR) of IS-DM hospitalization were estimated by multivariate Poisson regression.


RESULTS
A statistically significant 10% increase in IS-DM hospitalization rates was observed in populations environmentally exposed to POP (adjusted RR 1.10, 95% confidence interval, CI, 1.01-1.20; p = 0.031). IS-DM hospitalization rates were also higher in males (adjusted RR 1.34, 95% CI 1.30-1.39; p < 0.001), in blacks (adjusted RR 4.54, 95% CI 4.16-4.94; p < 0.001) and in older age groups (p for trend <0.001).


CONCLUSIONS
Residential proximity to sources of POP is associated with an increase in RR of IS-DM hospitalization. Our findings support the hypothesis of POP being a risk factor for IS. Further studies are warranted.
Sergeev
Alexander V
AV
School of Public Health Sciences and Professions, Ohio University, Athens, Ohio 45701, USA. sergeev@ohio.edu
Carpenter
David O
DO
D000328:Adult; D000367:Age Factors; D000368:Aged; D000393:Air Pollutants; D044383:Black People / Q000706:statistics & numerical data; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009930:Organic Chemicals; D020521:Stroke / Q000453:epidemiology*; D001741:Black or African American
D000393:Air Pollutants; D009930:Organic Chemicals