PM 2.5 and black carbon associated with acute ischaemic stroke: an ecological study

Although both particulate matter with a diameter of 2.5 μm (PM 2.5) and black carbon are associated with cardiovascular disease, data on the correlation of PM 2.5 and black carbon with acute ischaemic stroke, particularly based on ecological research, remain limited.

To evaluate the association of PM 2.5 and black carbon with cases of acute ischaemic stroke in Thailand adjusted for physical factors.

In our ecological study, we collected data from the Health Insurance Database, which covers approximately 70% of Thailand's population from 77 provinces, about numbers of patients with acute ischaemic stroke who were admitted and reimbursed. The data of PM 2.5 and black carbon were collected. The predictive model of cases of acute ischaemic stroke in relation to PM 2.5 and black carbon was computed by Poisson regression analysis adjusted for physical factors.

During the study period, 201 023 patients were diagnosed as having acute ischaemic stroke in 77 provinces in Thailand. The median of PM 2.5 and black carbon of all provinces was 29.19 (range: 18.88-34.50) and 1.17 (range: 0.43-2.29) µg/m³, respectively. PM 2.5 and black carbon were significantly associated with cases of acute ischaemic stroke with adjusted coefficients of 0.008 and 0.179, respectively (p<0.001 for both factors).

Our ecological study showed that both PM 2.5 and black carbon are associated with cases of acute ischaemic stroke in Thailand.