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Environ Res. 2018 Apr;162:160-165. doi: 10.1016/j.envres.2017.12.024. Epub 2018 Jan 5.

Short-term exposure to traffic-related air pollution and ischemic stroke onset in Barcelona, Spain.

Author information

1
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: rvivanco@imim.es.
2
Brown University School of Public Health, Providence, Rhode Island, USA. Electronic address: Gregory_Wellenius@brown.edu.
3
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Electronic address: xavier.basagana@isglobal.org.
4
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain. Electronic address: marta.cirach@isglobal.org.
5
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: Alejandra.gomez.glez@gmail.com.
6
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: pablo.ceballos4@gmail.com.
7
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: anazabalza@gmail.com.
8
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: jjimenez@imim.es.
9
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: csoriano@imim.es.
10
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: egiralt@imim.es.
11
Institute of Environmental Assessment and Water Research, IDAEA-CSIC, Barcelona, Spain. Electronic address: andres.alastuey@idaea.csic.es.
12
Institute of Environmental Assessment and Water Research, IDAEA-CSIC, Barcelona, Spain. Electronic address: xavier.querol@idaea.csic.es.
13
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Electronic address: jordi.sunyer@isglobal.org.
14
Hospital del Mar Medical Research Institute, Barcelona, Spain. Electronic address: jroquer@parcdesalutmar.cat.

Abstract

OBJECTIVE:

To assess the relationship between short-term exposure to outdoor ambient air pollutants (fine particulate matter [PM2.5] and black carbon [BC]), ischemic stroke (IS) and its different subtypes, and the potential modifying effect of neighborhood greenspace and noise.

METHODS:

This time-stratified case-crossover study was based on IS and transient ischemic attacks (TIA) recorded in a hospital-based prospective stroke register (BASICMAR 2005-2014) in Barcelona (Catalonia, Spain). Daily and hourly pollutant concentrations and meteorological data were obtained from monitoring stations in the city. Time-lags (from previous 72h to acute stroke onset) were analyzed. Greenness and noise were determined from the Normalized Difference Vegetation Index (NDVI) and daily average noise level at the street nearest to residential address, respectively.

RESULTS:

The 2742 cases with known onset date and time, living in the study area, were analyzed. After adjusting for temperature, no statistically significant association between pollutants exposure and overall stroke risk was found. In subtype analysis, an association was detected between BC exposure at 24-47h (odds ratio, 1.251; 95% confidence interval [CI], 1.001-1.552; P = 0.042) and 48-72h (1.211; 95% CI, 0.988-1.484; P = 0.065) time-lag prior to stroke onset and large-artery atherosclerosis subtype. No clear modifying effect of greenness or noise was observed.

CONCLUSIONS:

Overall, no association was found between PM2.5 and BC exposure and acute IS risk. By stroke subtype, large-artery atherosclerotic stroke could be triggered by daily increases in BC, a diesel fuel-related pollutant in the study area.

KEYWORDS:

Air pollution; Atherosclerosis; Black carbon; Ischemic stroke

PMID:
29310044
DOI:
10.1016/j.envres.2017.12.024
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