期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 187, 期 5, 页码 1001-1009出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwy007
关键词
air pollution; effect modifiers; fine particulate matter (PM2.5); first-ever stroke; particulate matter; stroke; susceptibility
资金
- National Natural Science Foundation of China [21507166, 71532014, 417222036]
- Medicine and Health Sciences and Technology Innovation Project, Chinese Academy of Medical Sciences [2017-I2M-1-004]
- Data Center of the National Center for Stroke Control and Prevention, National Health and Family Planning Commission of the People's Republic of China
Different populations may respond differently to exposure to ambient fine particulate matter, defined as particulate matter with an aerodynamic diameter less than or equal to 2.5 mu m (PM2.5); however, less is known about the distribution of susceptible individuals among the entire population. We conducted a time-stratified case-crossover study to assess associations between stroke risk and exposure to PM2.5 . During 2013-2015, 1,356 first-ever stroke events were derived from a large representative sample, the China National Stroke Screening Survey (CNSSS) database. Daily PM2.5 average exposures with a spatial resolution of 0.1 degrees were estimated using a data assimilation approach combining satellite measurements, air model simulations, and monitoring values. The distribution of susceptibility was derived according to individual-specific associations with PM2.5 modified by different combinations of individual-level characteristics and their joint frequencies among all of the CNSSS participants (n = 1,292,010). We found that first-ever stroke was statistically significantly associated with PM2.5 (per 10-mu g/m(3) increment of exposure, odds ratio = 1.049, 95% confidence interval (CI): 1.038, 1.061). This association was modified by demographic (e.g., sex), lifestyle (e.g., overweight/obesity), and medical history (e.g., diabetes) variables. The combined association with PM2.5 varied from 0.966 (95% CI: 0.920, 1.013) to 1.145 (95% CI: 1.080, 1.215) per 10-mu g/m(3) increment in different subpopulations. We found that most of the CNSSS participants were at increased risk of PM2.5-related stroke, while only a small proportion were highly susceptible.
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