OBJECTIVETo assess the association between heat wave and stroke mortality in Jiang'an District of Wuhan, China during 2003 to 2010.

METHODSDaily data of stroke mortality, meteorological factor and ambient pollution were collected from June to September during 2003 to 2010 in Jiang'an District of Wuhan.Quasi-Poisson regression in generalized additive model was applied to evaluate the impact of heat wave on stroke mortality on different lag days.

RESULTSDuring the study period, a total of 38 heat wave events and 191 heat wave days were registered. The total stroke death was 2 455 (1 182 women and 1 998 people aged 65 years old and over). Quasi-Poisson regression in generalized additive model showed that after controlling for long-term trend and seasonal trend, weekday, holiday, and relative humidity, heat wave was associated with stroke mortality on current day with relative risk of 1.15 (95%CI 1.01-1.30). Heat wave was not significantly associated with stroke mortality on current day among men (RR= 0.98, 95%CI 0.82-1.18, P=0.848) and people aged below 65 years old (RR=0.90, 95%CI 0.67-1.22, P=0.500), but relative risk increased to 1.34 (95%CI 1.12-1.62, P=0.002) and 1.20 (95%CI 1.04-1.39, P=0.002) for women and elderly (≥65 years old) people, respectively. When ambient pollutants (PM(10), sulfur dioxide and nitrogen dioxide) were involved into the models, the impacts of heat wave on stroke mortality almost remained unchanged. Lagged effects were found in the association between heat wave and stroke mortality, relative risks reached the highest on lag of 2 days and the effects of heat wave usually lasted for 3 to 5 days. Moreover, lagged patterns of the effects of heat wave on stroke mortality were different between female and male and people of different age groups.significantly increased relative risks were found on current day in the elderly (≥65 years old) people and women, while significant associations occurred on lag of 2 days for men and people aged below 65 years old.

CONCLUSIONSHeat wave increased the risk of stroke mortality in Jiang'an District of Wuhan. The effect of heat wave lasted for several days and lagged patterns of the effects of heat wave on stroke mortality were different between females and males and people of different age groups.

Aged ; Air Pollution ; China ; Female ; Hot Temperature ; Humans ; Male ; Stroke ; mortality

OBJECTIVEUsing time-series analyses to determine the association between ambient air pollution and stroke mortality in Jiang'an District of Wuhan, China from 2003 to 2010.

METHODSData on daily stroke mortality for the period 2003 January 1 to 2010 December 31 was obtained from Jiang'an District Center for Disease Control and Prevention, Wuhan and data on relevant air pollution and meteorological factors from the local municipal environmental monitoring center and meteorology bureau of Wuhan, respectively. Application of a time-series analysis in generalized additive model was applied to evaluate the association between air pollution and stroke mortality.

RESULTSAnnual average concentrations of PM10, SO(2) and NO(2) during the study period were (115.0 ± 60.0), (50.2 ± 33.7), and (57.6 ± 25.3) µg/m³ respectively. The total stroke death was 9 204, including 4 495 women, and 7 628 people aged over 65-years old. In single-pollutant model, a 10 µg/m³ increase in previous day (lag 1 d) ambient pollutants was associated with 0.67% (95% CI: 0.25%-1.10%) excess risk in stroke mortality for PM10, 0.87% (95% CI: 0.13%-1.63%) excess risk for SO(2) and 2.07% (95% CI: 1.08%-3.07%) excess risk for NO(2), respectively. When co-pollutants were involved into the models, only NO(2) remained strongly associated with stroke mortality (β = 2.07, 95% CI: 1.08-3.07, P < 0.001). A 10 µg/m³, increase of NO(2) in lag 1 d was associated with 1.77% (95% CI: 0.54%-3.01%), 2.27% (95% CI: 0.98%-3.57%) and 2.00% (95% CI: 0.59%-3.43%) excess risk in stroke mortality, respectively, after adjusting for PM10, SO(2)th PM10 and SO(2) e-specific and gender-specific analyses showed that the association between ambient air pollution and stroke mortality was stronger in the elderly (≥ 65 years old) people and women. A 10 µg/m, increase of PM10, SO(2) NO(2) in lag 1 d was associated with excess stroke mortality of 0.97% (95% CI: 0.37%-1.57%), 1.73% (95% CI: 0.69%-2.78%) and 2.98% (95% CI: 1.59%-4.39%) for women, respectively and 0.94% (95% CI: 0.47%-1.42%), 1.06% (95% CI: 0.23%-1.90%) and 2.50% (95% CI: 1.40%-3.62%) for the elderly people (> 65 years old), respectively.

CONCLUSIONPM10 and gaseous pollutants (SO(2), NO(2)) were significant risk factors for acute stroke death, and people aged over 65-years old and women were more susceptible to the effect of ambient pollutants on stroke mortality.

Aged ; Air Pollutants ; Air Pollution ; China ; Environmental Monitoring ; Female ; Humans ; Models, Theoretical ; Mortality ; Nitrogen Dioxide ; Particulate Matter ; Risk ; Risk Factors ; Stroke ; Sulfur Dioxide

Objective: To investigate the prevalence and risk factors of diabetic peripheral neuropathy in type 2 diabetic patients under community management programs. Methods: A cross-sectional study was conducted on T2DM patients in eight communities in Wuhan and Changshu cities. Data would included questionnaire, body measurement, blood testing and clinical examination. The criterion of diabetic peripheral neuropathy was under the combination of symptoms with five physical examinations. Binary logistic regression model was used to analyze the influential factors. Results: The overall prevalence of peripheral neuropathy was 71.2% among the diabetic patients who were managed in primary care health services in the two cities. The binary logistic regression method identified older age (≥60 years, OR=2.39, 95%CI:1.95-2.94), longer diabetic duration (≥10 years, OR=1.25, 95%CI: 1.02-1.54), and worse postprandial glucose control (2 h postprandial plasma glucose >10.0 mmol/L: OR=1.65, 95%CI:1.33-2.04) (all P<0.05) as risk factors for the presence of diabetic peripheral neuropathy, while higher education level was protective factor (compared to patients with education levels of primary school or below, OR=0.52, 95%CI: 0.41-0.66; OR=0.59, 95%CI: 0.44-0.79; OR=0.64, 95%CI: 0.44-0.94 for those with education levels of junior high school, senior high school, and college, respectively). Conclusions High rates of diabetic peripheral neuropathy among T2DM patients suggested the urgent need for early screening and standardized management at the community levels. It is necessary to promote appropriate screening techniques and methods to identify the peripheral neuropathy, in the primary health service institutions.