Ambient Air Pollution and Hospitalizations for Ischemic Stroke: A Time Series Analysis Using a Distributed Lag...

Short-term exposure to air pollution has been associated with ischemic stroke (IS) hospitalizations, but the evidence of its effects on IS in low- and middle-income countries is limited and inconsistent. We aimed to quantitatively estimate the association between air pollution and hospitalizations for IS in Chongqing, China. This time series study included 2,299 inpatients with IS from three hospitals in Chongqing from January 2015 to December 2016. Generalized linear regression models combined with a distributed lag nonlinear model (DLNM) were used to investigate the impact of air pollution on IS hospitalizations. Stratification analysis was further implemented by sex, age, and season. The maximum lag-specific and cumulative percentage changes of IS were 1.2% (95% CI: 0.4-2.1%, lag 3 day) and 3.6% (95% CI: 0.5-6.7%, lag 05 day) for each 10 μg/m³ increase in PM_2.5; 1.0% (95% CI: 0.3-1.7%, lag 3 day) and 2.9% (95% CI: 0.6-5.2%, lag 05 day) for each 10 μg/m³ increase in PM₁₀; 4.8% (95% CI: 0.1-9.7%, lag 4 day) for each 10 μg/m³ increase in SO₂; 2.5% (95% CI: 0.3-4.7%, lag 3 day) and 8.2% (95% CI: 0.9-16.0%, lag 05 day) for each 10 μg/m3 increase in NO₂; 0.7% (95% CI: 0.0-1.5%, lag 6 day) for each 10 μg/m³ increase in O₃. No effect modifications were detected for sex, age, and season. Our findings suggest that short-term exposure to PM_2.5, PM₁₀, SO₂, NO₂, and O₃ contributes to more IS hospitalizations, which warrant the government to take effective actions in addressing air pollution issues.