Associations between exhaust and non-exhaust particulate matter and stroke incidence by stroke subtype in South London

Crichton, Siobhan and Barratt, Benjamin and Spiridou, Anastassia and Hoang, Uy and Liang, Shao Fen and Kovalchuk, Yevgeniya and Beevers, Sean and Kelly, Frank and Delaney, Brendan and Wolfe, Charles (2016) Associations between exhaust and non-exhaust particulate matter and stroke incidence by stroke subtype in South London. Science of the Total Environment, 568. pp. 278-284. ISSN 0048-9697

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Background: Airborne particulate matter (PM) consists of particles from diverse sources, including vehicle exhausts.
Associations between short-term PM changes and stroke incidence have been shown. Cumulative exposures over several months, or years, are less well studied; few studies examined ischaemic subtypes or PM
Aims: This study combines a high resolution urban air quality model with a population-based stroke register to
explore associations between long-term exposure to PM and stroke incidence.
Method: Data from the South London Stroke Register from 2005–2012 were included. Poisson regression explored
association between stroke incidence and long-term (averaged across the study period) exposure to
PM2.5(PM b 2.5 μm diameter) and PM10(PM b 10 μm), nitric oxide, nitrogen dioxide, nitrogen oxides and
ozone, at the output area level (average population=309). Estimates were standardised for age and sex and adjusted
for socio-economic deprivation. Models were stratified for ischaemic and haemorrhagic strokes and further
broken down by Oxford Community Stroke Project classification and Trial of ORG 10172 in Acute Stroke
Treatment (TOAST) classification.
Results: 1800 strokes were recorded (incidence= 42.6/100,000 person-years). No associations were observed between PM and overall ischaemic or haemorrhagic incidence. For an interquartile range increase in PM2.5, there was a 23% increase in incidence (Incidence rate ratio=1.23 (95%CI: 1.03–1.44)) of total anterior circulation infarcts (TACI) and 20% increase for PM2.5 from exhausts (1.20(1.01–1.41)). Therewere similar associations with PM10, overall (1.21(1.01–1.44)) and from exhausts (1.20(1.01–1.41)). TACI incidence was not associated with non-exhaust sources. There were no associations with other stroke subtypes or pollutants.
Conclusion: Outdoor air pollution, particularly that arising from vehicle exhausts, may increase risk of TACI but
not other stroke subtypes.

Item Type: Article
Identification Number:
3 June 2016Accepted
10 June 2016Published Online
15 October 2016Published
Uncontrolled Keywords: Stroke, Incidence, Air pollution
Subjects: CAH11 - computing > CAH11-01 - computing > CAH11-01-01 - computer science
Divisions: Faculty of Computing, Engineering and the Built Environment
Faculty of Computing, Engineering and the Built Environment > School of Computing and Digital Technology
Depositing User: Ian Mcdonald
Date Deposited: 26 Jan 2017 12:24
Last Modified: 22 Mar 2023 12:01

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