Objective To investigate the risk of fatal stroke mortality associated with short-term exposure to air pollution， and to determine the susceptible population. Methods In this study， daily stroke mortalities of adults between 2012 and 2014 in Songjiang District， Shanghai were collected. Time-stratified case-crossover approach was used to assess the association between daily concentrations of air pollutants and fatal stroke mortalities. Results This study included 514 patients who died from acute strokes. The average concentrations during the study period were 77.45 μg·m^-3 for PM_2.5， 21.22 μg·m^-3 for SO₂， and 57.59 μg·m^-3 for NO₂. The fatal stroke mortality of adults under the age of 65 was found to be significantly associated with NO₂. At the time of a Lag of 2 d and 03 d， a significantly higher risk of fatal stroke mortality in relation to NO₂ exposure was observed， and the OR values of ischemic stroke mortality for people were 3.86 （1.53-9.75） and 5.83 （1.40-24.34） respectively. People over the age of 65 were more sensitive to increased PM_2.5 concentrations， at the time of a Lag of 03 d， fatal strokes increased by 28% when PM_2.5 levels increased. A significantly higher risk of fatal stroke mortality in relation to increase of NO₂ concentration was observed among people who were overweight or obese. Conclusion A significantly higher risk of fatal stroke mortality is associated with the increase of PM_2.5 and NO₂. The results also suggest that the susceptible population should take additional precautions to avoid or reduce the risk of fatal strokes.

OBJECTIVE: Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM (particles ≤ 2.5 μm in aerodynamic diameter) exposure. METHODS: Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM and fatal ICH incidence in Shanghai, China. RESULTS: A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM was 77.45 μg/m. The incidence of fatal ICH was significantly associated with PM concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09-1.46) versus 1.05 (0.98-1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking. CONCLUSIONS Fatal ICH incidence was associated with PM exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM.
Air Pollutants ; analysis ; Cause of Death ; Cerebral Hemorrhage ; mortality ; China ; epidemiology ; Diabetes Mellitus ; mortality ; Environmental Exposure ; statistics & numerical data ; Female ; Humans ; Incidence ; Male ; Particle Size ; Particulate Matter ; analysis ; Stroke ; mortality