PMID- 30641259 OWN - NLM STAT- MEDLINE DCOM- 20190710 LR - 20240319 IS - 1873-6750 (Electronic) IS - 0160-4120 (Print) IS - 0160-4120 (Linking) VI - 124 DP - 2019 Mar TI - Case-crossover analysis of short-term particulate matter exposures and stroke in the health professionals follow-up study. PG - 153-160 LID - S0160-4120(18)31394-1 [pii] LID - 10.1016/j.envint.2018.12.044 [doi] AB - BACKGROUND: Stroke is a leading cause of morbidity and mortality in the United States. Associations between short-term exposures to particulate matter (PM) air pollution and stroke are inconsistent. Many prior studies have used administrative and hospitalization databases where misclassification of the type and timing of the stroke event may be problematic. METHODS: In this case-crossover study, we used a nationwide kriging model to examine short-term ambient exposure to PM(10) and PM(2.5) and risk of ischemic and hemorrhagic stroke among men enrolled in the Health Professionals Follow-up Study. Conditional logistic regression models were used to obtain estimates of odds ratios (OR) and 95% confidence intervals (CI) associated with an interquartile range (IQR) increase in PM(2.5) or PM(10). Lag periods up to 3 days prior to the stroke event were considered in addition to a 4-day average. Stratified models were used to examine effect modification by patient characteristics. RESULTS: Of the 727 strokes that occurred between 1999 and 2010, 539 were ischemic and 122 were hemorrhagic. We observed positive statistically significant associations between PM(10) and ischemic stroke (OR(lag0-3) = 1.26; 95% CI: 1.03-1.55 per IQR increase [14.46 mug/m(3)]), and associations were elevated for nonsmokers, aspirin nonusers, and those without a history of high cholesterol. However, we observed no evidence of a positive association between short-term exposure to PM and hemorrhagic stroke or between PM(2.5) and ischemic stroke in this cohort. CONCLUSIONS: Our study provides evidence that ambient PM(10) may be associated with higher risk of ischemic stroke and highlights that ischemic and hemorrhagic strokes are heterogeneous outcomes that should be treated as such in analyses related to air pollution. CI - Copyright (c) 2018 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Fisher, Jared A AU - Fisher JA AD - Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. Electronic address: jared.fisher@nih.gov. FAU - Puett, Robin C AU - Puett RC AD - Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. FAU - Laden, Francine AU - Laden F AD - Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. FAU - Wellenius, Gregory A AU - Wellenius GA AD - Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. FAU - Sapkota, Amir AU - Sapkota A AD - Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. FAU - Liao, Duanping AU - Liao D AD - Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA. FAU - Yanosky, Jeff D AU - Yanosky JD AD - Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA. FAU - Carter-Pokras, Olivia AU - Carter-Pokras O AD - Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA. FAU - He, Xin AU - He X AD - Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA. FAU - Hart, Jaime E AU - Hart JE AD - Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. LA - eng GR - R01 ES017017/ES/NIEHS NIH HHS/United States GR - F32 HL083648/HL/NHLBI NIH HHS/United States GR - P30 ES000002/ES/NIEHS NIH HHS/United States GR - R01 ES020871/ES/NIEHS NIH HHS/United States GR - T32 ES007069/ES/NIEHS NIH HHS/United States GR - R03 ES016619/ES/NIEHS NIH HHS/United States GR - UM1 CA167552/CA/NCI NIH HHS/United States GR - R01 HL035464/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20190112 PL - Netherlands TA - Environ Int JT - Environment international JID - 7807270 RN - 0 (Air Pollutants) RN - 0 (Particulate Matter) SB - IM MH - Adult MH - Aged MH - Air Pollutants/analysis/*toxicity MH - Cohort Studies MH - Cross-Over Studies MH - Follow-Up Studies MH - *Health Personnel MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Particulate Matter/analysis/*toxicity MH - Risk Assessment MH - Spatial Analysis MH - Stroke/*chemically induced PMC - PMC6692897 MID - NIHMS1044649 OTO - NOTNLM OT - Air pollution OT - Case-crossover OT - Particulate matter OT - Stroke COIS- The authors declare they have no actual or potential competing financial interests. EDAT- 2019/01/15 06:00 MHDA- 2019/07/11 06:00 PMCR- 2019/08/14 CRDT- 2019/01/15 06:00 PHST- 2018/07/02 00:00 [received] PHST- 2018/12/16 00:00 [revised] PHST- 2018/12/19 00:00 [accepted] PHST- 2019/01/15 06:00 [pubmed] PHST- 2019/07/11 06:00 [medline] PHST- 2019/01/15 06:00 [entrez] PHST- 2019/08/14 00:00 [pmc-release] AID - S0160-4120(18)31394-1 [pii] AID - 10.1016/j.envint.2018.12.044 [doi] PST - ppublish SO - Environ Int. 2019 Mar;124:153-160. doi: 10.1016/j.envint.2018.12.044. Epub 2019 Jan 12.