TY - JOUR
T1 - Increasing emergency room visits for stroke by elevated levels of fine particulate constituents
AU - Chen, Szu Ying
AU - Lin, Yu Lun
AU - Chang, Wei Tien
AU - Lee, Chung Te
AU - Chan, Chang Chuan
N1 - Funding Information:
We acknowledge the assistance of Prof. Jing-Shiang Hwang, Distinguished Research Fellow, Institute of Statistical Science, Academia Sinica, Taiwan. This work was supported by grants from the National Science Council of Taiwan ( NSC 97-2923-I-002-001-MY4 and NSC 100-2314-B-002-151-MY3 ).
PY - 2014/3/1
Y1 - 2014/3/1
N2 - The associations between fine particulate matter (PM2.5) and stroke remain inconsistent. We conducted a time-series study to evaluate emergency room (ER) visits for ischemic and hemorrhagic strokes in relation to PM2.5 and its constituents. Generalized additive models were used to model the counts of daily ER visits for ischemic and hemorrhagic strokes among patients admitted to the National Taiwan University Hospital from 1 January 2004 to 31 August 2008. Exposure variables included PM2.5 and the four constituents, nitrate, sulfate, organic carbon (OC), and elemental carbon (EC). 12,982 ischemic stroke and 3362 hemorrhagic stroke cases were identified during the study period. For hemorrhagic stroke, the strongest relative risks (RRs) of ER visits were 1.19 [95% confidence interval (CI), 1.07-1.32] and 1.08 (95% CI, 1.02-1.15) for an interquartile range (IQR) increase in 3-day average nitrate and EC. For ischemic stroke, increased RRs of ER visits of 1.21 (95% CI, 1.07-1.36) and 1.18 (95% CI, 1.06-1.31) were observed in the warm season for an IQR increase in 3-day average of OC and EC, respectively. PM2.5 and OC were associated with increased RRs of ER visits for ischemic stroke among patients aged 65years or older and female patients. In conclusion, PM2.5 constituents, rather than PM2.5 mass, are more closely related to ER visits for hemorrhagic stroke. Both PM2.5 mass and its chemical constituents are associated with ER visits for ischemic stroke in the warm season, among patients older than 65years, and female patients.
AB - The associations between fine particulate matter (PM2.5) and stroke remain inconsistent. We conducted a time-series study to evaluate emergency room (ER) visits for ischemic and hemorrhagic strokes in relation to PM2.5 and its constituents. Generalized additive models were used to model the counts of daily ER visits for ischemic and hemorrhagic strokes among patients admitted to the National Taiwan University Hospital from 1 January 2004 to 31 August 2008. Exposure variables included PM2.5 and the four constituents, nitrate, sulfate, organic carbon (OC), and elemental carbon (EC). 12,982 ischemic stroke and 3362 hemorrhagic stroke cases were identified during the study period. For hemorrhagic stroke, the strongest relative risks (RRs) of ER visits were 1.19 [95% confidence interval (CI), 1.07-1.32] and 1.08 (95% CI, 1.02-1.15) for an interquartile range (IQR) increase in 3-day average nitrate and EC. For ischemic stroke, increased RRs of ER visits of 1.21 (95% CI, 1.07-1.36) and 1.18 (95% CI, 1.06-1.31) were observed in the warm season for an IQR increase in 3-day average of OC and EC, respectively. PM2.5 and OC were associated with increased RRs of ER visits for ischemic stroke among patients aged 65years or older and female patients. In conclusion, PM2.5 constituents, rather than PM2.5 mass, are more closely related to ER visits for hemorrhagic stroke. Both PM2.5 mass and its chemical constituents are associated with ER visits for ischemic stroke in the warm season, among patients older than 65years, and female patients.
KW - Air pollution
KW - Emergency room visits
KW - Particulate matter
KW - Stroke
KW - Time-series study
UR - http://www.scopus.com/inward/record.url?scp=84891354247&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2013.12.035
DO - 10.1016/j.scitotenv.2013.12.035
M3 - 期刊論文
C2 - 24388822
AN - SCOPUS:84891354247
SN - 0048-9697
VL - 473-474
SP - 446
EP - 450
JO - Science of the Total Environment
JF - Science of the Total Environment
ER -