title: Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study.
abstract: OBJECTIVE
  Little has been discussed about the increased risk of stroke after exposure to air pollutants, particularly in Brazil. The mechanisms through which air pollution can influence occurrences of vascular events such as stroke are still poorly understood. The aim of this study was to estimate the association between exposure to some air pollutants and risk of death due to stroke.
  
  
  METHODS
  Ecological time series study with data from São José dos Campos, Brazil.
  
  
  METHODS
  Data on deaths due to stroke among individuals of all ages living in São José dos Campos and on particulate matter, sulfur dioxide and ozone were used. Statistical analysis was performed using a generalized additive model of Poisson regression with the Statistica software, in unipollutant and multipollutant models. The percentage increase in the risk of increased interquartile difference was calculated.
  
  
  RESULTS
  There were 1,032 deaths due to stroke, ranging from 0 to 5 per day. The statistical significance of the exposure to particulate matter was ascertained in the unipollutant model and the importance of particulate matter and sulfur dioxide, in the multipollutant model. The increases in risk were 10% and 7%, for particulate matter and sulfur dioxide, respectively.
  
  
  CONCLUSIONS
  It was possible to identify exposure to air pollutants as a risk factor for death due to stroke, even in a city with low levels of air pollution.
authors.affiliation: Department of Medicine, Universidade de Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Camila Trolez
authors.initials: CT
authors.lastname: Amancio
authors.affiliation: Department of Medicine, Universidade de Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Luiz Fernando
authors.initials: LF
authors.lastname: Nascimento
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects*; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D002947:Cities; D004787:Environmental Pollution / Q000009:adverse effects* / Q000032:analysis; D006801:Humans; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D013458:Sulfur Dioxide / Q000032:analysis; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D013458:Sulfur Dioxide; D010126:Ozone