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Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London stroke register: A case-cross-over analysis

Butland, BK; Atkinson, RW; Crichton, S; Barratt, B; Beevers, S; Spiridou, A; Hoang, U; ... Wolfe, CD; + view all (2017) Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London stroke register: A case-cross-over analysis. Journal of Epidemiology and Community Health , 71 (7) pp. 707-712. 10.1136/jech-2016-208025. Green open access

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Abstract

Background Few European studies investigating associations between short-term exposure to air pollution and incident stroke have considered stroke subtypes. Using information from the South London Stroke Register for 2005-2012, we investigated associations between daily concentrations of gaseous and particulate air pollutants and incident stroke subtypes in an ethnically diverse area of London, UK. Methods Modelled daily pollutant concentrations based on a combination of measurements and dispersion modelling were linked at postcode level to incident stroke events stratified by haemorrhagic and ischaemic subtypes. The data were analysed using a time-stratified case-cross-over approach. Conditional logistic regression models included natural cubic splines for daily mean temperature and daily mean relative humidity, a binary term for public holidays and a sine-cosine annual cycle. Of primary interest were same day mean concentrations of particulate matter < 2.5 and < 10 mm in diameter (PM 2.5 , PM 10 ), ozone (O 3 ), nitrogen dioxide (NO 2 ) and NO 2+ nitrogen oxide (NO X ). Results Our analysis was based on 1758 incident strokes (1311 were ischaemic and 256 were haemorrhagic). We found no evidence of an association between all stroke or ischaemic stroke and same day exposure to (PM 2.5 , PM 10 ), (O 3 ), (NO 2 ) or (NO X ). For haemorrhagic stroke, we found a negative association with PM10 suggestive of a 14.6% (95% CI 0.7% to 26.5%) fall in risk per 10 mg/m3 increase in pollutant. Conclusions Using data from the South London Stroke Register, we found no evidence of a positive association between outdoor air pollution and incident stroke or its subtypes. These results, though in contrast to recent meta-analyses, are not inconsistent with the mixed findings of other UK studies.

Type: Article
Title: Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London stroke register: A case-cross-over analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jech-2016-208025
Publisher version: https://doi.org/10.1136/jech-2016-208025
Language: English
Additional information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10038841
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