Short-term exposure to ambient ozone and stroke hospital admission: A case-crossover analysis.
We evaluated the association between short-term exposure to ambient ozone air pollution and stroke hospital admissions among adult residents of South Carolina (SC). Data on all incident stroke hospitalizations from 2002 to 2006 were obtained from the SC Office of Research and Statistics. Ozone exposure data were obtained from the US Environmental Protection Agency's Hierarchical Bayesian Model. A semi-symmetric bidirectional case-crossover design was used to examine the association between ozone exposure on lag days 0-2 (0 to 2 days before admission) and stroke hospitalization. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). No significant associations were observed between short-term ozone exposure and hospitalization for all stroke (e.g., lag day 0: OR=0.98; 95% CI=0.96, 1.00) or ischemic stroke (lag day 0: OR=0.98; 95% CI=0.96, 1.01). Risk of hospitalization for hemorrhagic stroke appeared to be higher among African Americans than European Americans; however, the majority of these associations did not reach statistical significance. Among adults in SC from 2002 to 2006, there was no evidence of an association between ozone exposure and risk of hospitalization for all stroke or ischemic stroke; however, African Americans may have an increased risk of hemorrhagic stroke.
Department of Epidemiology and Biostatistics, Maryland Institute of Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA.
Jessica A
JA
Montresor-López
Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
Jeff D
JD
Yanosky
Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Department of Epidemiology, Harvard University School of Public Health, Boston, Massachusetts, USA.
Murray A
MA
Mittleman
Department of Epidemiology and Biostatistics, Maryland Institute of Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA.
Amir
A
Sapkota
Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA.
Xin
X
He
Center for Research and Nutrition and Health Disparities, University of South Carolina School of Public Health, Columbia, South Carolina, USA.
James D
JD
Hibbert
Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina School of Public Health, Columbia, South Carolina, USA.
Michael D
MD
Wirth
Department of Epidemiology and Biostatistics, Maryland Institute of Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA.
Robin C
RC
Puett
D001741:Black or African American / Q000706:statistics & numerical data; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis; D002545:Brain Ischemia / Q000139:chemically induced* / Q000453:epidemiology*; D018592:Cross-Over Studies; D004784:Environmental Monitoring; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D010126:Ozone / Q000009:adverse effects* / Q000032:analysis; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology; D020521:Stroke / Q000139:chemically induced* / Q000453:epidemiology*; D014481:United States; D014484:United States Environmental Protection Agency; D044465:White People
D000393:Air Pollutants; D010126:Ozone