title: Increased hospitalizations for ischemic stroke with comorbid diabetes and residential proximity to sources of organic pollutants: a 12-year population-based study.
abstract: 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.
authors.affiliation: School of Public Health Sciences and Professions, Ohio University, Athens, Ohio 45701, USA. sergeev@ohio.edu
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Sergeev
authors.forename: David O
authors.initials: DO
authors.lastname: Carpenter
mesh_terms: 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
chemical_list: D000393:Air Pollutants; D009930:Organic Chemicals