Global burden of stroke attributable to air pollution (1990-2021): An analysis of GBD 2021 data

This study aims to quantify the global burden of stroke attributable to air pollution and assess associated health disparities by region, gender, and socio-demographic index using 2021 Global Burden of Disease data. We conducted a systematic analysis of the 2021 Global Burden of Disease database, employing Joinpoint regression, decomposition analysis, and health inequality analysis to evaluate air pollution's impact on stroke mortality and disability-adjusted life years. Analyses were stratified by nationality, region, gender, and socio-demographic index to identify health disparities. The study findings demonstrate a substantial increase in the global absolute burden of stroke attributable to air pollution from 1991 to 2021, with stroke-related mortality reaching 44,962,167 cases (95% uncertainty interval: 35,020,339-55,467,024) and disability-adjusted life years amounting to 44,962,167 person-years (95% uncertainty interval: 35,020,339-55,467,024). Notably, regional disparities in stroke burden have become increasingly pronounced. Furthermore, the disease burden was significantly higher among male patients compared to females, highlighting the critical role of gender disparities in the health impacts of stroke. Based on these findings, we recommend enhancing air pollution monitoring and control, strengthening health system resilience, and promoting targeted public health interventions. This study provides a scientific foundation for formulating prevention strategies against air pollution-related stroke and calls for strengthened global cooperation to address this critical public health challenge.