Particulate Air Pollution Exposure and Stroke among Adults in Israel

Britney Gaines, Itai Kloog, Inbar Zucker, Gal Ifergane, Victor Novack, Carmit Libruder, Yael Hershkovitz, Perry E. Sheffield and Maayan Yitshak-Sade ()
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Britney Gaines: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Itai Kloog: Department of Geography and Environmental Development, Ben Gurion University, Beer Sheva 8410501, Israel
Inbar Zucker: Ministry of Health, Jerusalem 9446724, Israel
Gal Ifergane: Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
Victor Novack: Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
Carmit Libruder: Ministry of Health, Jerusalem 9446724, Israel
Yael Hershkovitz: Ministry of Health, Jerusalem 9446724, Israel
Perry E. Sheffield: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Maayan Yitshak-Sade: Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA

IJERPH, 2023, vol. 20, issue 2, 1-11

Abstract: Stroke is the second most common cause of death and disability in the world. Many studies have found fine particulate matter (PM 2.5 ) exposure to be associated with an increased risk of atherosclerotic cardiovascular disease, mostly focusing on ischemic heart disease and acute myocardial infarction. In a national analysis conducted in Israel—an area with unique climate conditions and high air pollution levels, we estimated the association between short-term PM 2.5 exposure and ischemic stroke, intracerebral hemorrhage (ICH), or transient ischemic attacks (TIA). Using the Israeli National Stroke Registry, we obtained information on all stroke cases across Israel in 2014–2018. We obtained daily PM 2.5 exposures from spatiotemporally resolved exposure models. We restricted the analytical data to days in which PM 2.5 levels did not exceed the Israeli 24 h standard (37.5 µg/m 3 ). We repeated the analysis with a stratification by sociodemographic characteristics and comorbidities. For all outcomes, the exposure–response curves were nonlinear. PM 2.5 exposure was associated with a higher ischemic stroke risk, with larger effect estimates at higher exposure levels. Although nonsignificant, the exposure–response curve for TIA was similar. The associations with ICH were nonsignificant throughout the PM 2.5 exposure distribution. The associations with ischemic stroke/TIA were larger among women, non-Jewish individuals, older adults, and individuals with diabetes, hypertension, and ischemic heart disease. In conclusion, short-term PM 2.5 exposure is associated with a higher risk for ischemic stroke and possibly TIA, even when PM 2.5 concentrations do not exceed the Israeli air quality guideline threshold. Vulnerability to the air pollution effects differed by age, sex, ethnicity, and comorbidities.

Keywords: air pollution; stroke; PM 2.5 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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