title: Occupational exposure to particles and incidence of stroke.
abstract: OBJECTIVE
  This paper aims to investigate the relation between occupational exposure to particles, particle size, and the incidence of ischemic and hemorrhagic stroke.
  
  
  METHODS
  The cohort included all manual workers identified from the Swedish National Census in 1980, who were alive as of 1 January 1987. First time events of ischemic or hemorrhagic stroke during the period 1987-2005 were identified through linkage to the Hospital Discharge Register and the National Cause of Death Register. A job-exposure matrix for exposure to small (<1 µm) and large (>1 µm) particles was developed and applied. Hazard ratios (HR) were estimated by Cox regression with adjustment for age, socioeconomic group, and residential area.
  
  
  RESULTS
  Increased HR of ischemic stroke were found among both women and men occupationally exposed to small as well as large particles for ≥5 years. The risks were higher for workers exposed for ≥5 years compared to "ever exposed" participants indicating a dose-response relationship, but no trend with exposure intensity was observed. A tentative association between particle exposure and hemorrhagic stroke was also found.
  
  
  CONCLUSIONS
  Occupational exposure to small and large particles was associated with increased risks of ischemic stroke. Further studies are needed to explore the relationships between exposure to different types of particles and various doses and the occurrence of stroke among women as well as men.
authors.affiliation: Work Environment Toxicology Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. bengt.sjogren@ki.se
authors.forename: Bengt
authors.initials: B
authors.lastname: Sjögren
authors.forename: Maria
authors.initials: M
authors.lastname: Lönn
authors.forename: Karin
authors.initials: K
authors.lastname: Fremling
authors.forename: Maria
authors.initials: M
authors.lastname: Feychting
authors.forename: Gun
authors.initials: G
authors.lastname: Nise
authors.forename: Timo
authors.initials: T
authors.lastname: Kauppinen
authors.forename: Nils
authors.initials: N
authors.lastname: Plato
authors.forename: Pernilla
authors.initials: P
authors.lastname: Wiebert
authors.forename: Per
authors.initials: P
authors.lastname: Gustavsson
mesh_terms: D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D052638:Particulate Matter