Environmental pollution and deaths due to stroke in a city with low levels of air pollution

ecological time series study

Authors

  • Camila Trolez Amancio Universidade de Taubaté
  • Luiz Fernando Nascimento Universidade de Taubaté

Keywords:

Stroke, Air pollutants, Particulate matter, Mortality, Sulfur dioxide

Abstract

CONTEXT AND OBJECTIVE: Little has been discussed about the increased risk of stroke after exposure to air pollutants, particularly in Brazil. The mechanisms through which air pollution can influence occurrences of vascular events such as stroke are still poorly understood. The aim of this study was to estimate the association between exposure to some air pollutants and risk of death due to stroke. DESIGN AND SETTING: Ecological time series study with data from São José dos Campos, Brazil. METHODS: Data on deaths due to stroke among individuals of all ages living in São José dos Campos and on particulate matter, sulfur dioxide and ozone were used. Statistical analysis was performed using a generalized additive model of Poisson regression with the Statistica software, in unipollutant and multipollutant models. The percentage increase in the risk of increased interquartile difference was calculated. RESULTS: There were 1,032 deaths due to stroke, ranging from 0 to 5 per day. The statistical significance of the exposure to particulate matter was ascertained in the unipollutant model and the importance of particulate matter and sulfur dioxide, in the multipollutant model. The increases in risk were 10% and 7%, for particulate matter and sulfur dioxide, respectively. CONCLUSION: It was possible to identify exposure to air pollutants as a risk factor for death due to stroke, even in a city with low levels of air pollution.

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Author Biographies

Camila Trolez Amancio, Universidade de Taubaté

Medical Student. Department of Medicine, Universidade de Taubaté (Unitau), Taubaté, São Paulo, Brazil.

Luiz Fernando Nascimento, Universidade de Taubaté

PhD. Assistant Professor, Department of Medicine, Universidade de Taubaté (Unitau), Taubaté, São Paulo, Brazil.

References

Arbex MA, Saldiva PH, Pereira LA, Braga AL. Impact of outdoor biomass air pollution on hypertension hospital admissions. J Epidemiol Community Health. 2010;64(7):573-9.

Maheswaran R, Haining RP, Brindley P, et al. Outdoor air pollution, mortality, and hospital admissions from coronary heart disease in Sheffield, UK: a small-area level ecological study. Eur Heart J. 2005;26(23):2543-9.

Nascimento LF, Pereira LA, Braga AL, Módolo MC, Carvalho JA. Efeitos da poluição atmosférica na saúde infantil em São José dos Campos, SP. [Effects of air pollution on children’s health in a city in Southeastern Brazil]. Rev Saude Publica. 2006;40(1):77-82.

Amancio CT, Nascimento LF. Association of sulfur dioxide exposure with circulatory system deaths in a medium-size city in Brazil. Braz J Med Biol Res. 2012;45(11):1080-5.

Vidale S, Bonanomi A, Guidotti M, Arnaboldi M, Sterzi R. Air pollution positively correlates with daily stroke admission and in hospital mortality: a study in the urban area of Como, Italy. Neurol Sci. 2010;31(2):179-82.

Kettunen J, Lanki T, Tiittanen P, et al. Associations of fine and ultrafine particulate air pollution with stroke mortality in an area of low air pollution levels. Stroke. 2007;38(3):918-22.

Tsai S, Goggins WB, Chiu HF, Yang CY. Evidence for an association between air pollution and daily stroke admissions in Kaohsiung, Taiwan. Stroke. 2003;34(11):2612-6.

Nascimento LF, Francisco JB, Patto MB, Antunes AM. Environmental pollutants and stroke-related hospital admissions. Cad Saude Publica. 2012;28(7):1319-24.

Lisabeth LD, Escobar JD, Dvonch JT, et al. Ambient air pollution and risk for ischemic stroke and transient ischemic attack. Ann Neurol. 2008;64(1):53-9.

Brasil. Ministério da Saúde. Portal da Saúde. Saúde lança consulta pública para o aprimoramento da assistência a pacientes com AVC. Available from: http://portal.saude.gov.br/portal/aplicacoes/ noticias/default.cfm?pg=dspDetalheNoticia&id_area=124&CO_ NOTICIA=11825. Accessed in 2013 (Oct 18).

Brasil. Ministério da Saúde. DATASUS. Informações de Saúde. Epidemiológicas e morbidade. Morbidade hospitalar do SUS – por local de residência - SP. Available from: http://tabnet.datasus.gov.br/ cgi/tabcgi.exe?sih/cnv/nrsp.def. Accessed in 2013 (Oct 18).

Cançado JE, Braga A, Pereira LA, et al. Repercussões clínicas da exposição à poluição atmosférica [Clinical repercussions of exposure to atmospheric pollution]. J Bras Pneumol. 2006;32 Suppl 2:S5-11.

Pope CA 3rd, Burnett RT, Thurston GD, et al. Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation. 2004;109(1):71-7.

Companhia Ambiental do Estado de São Paulo. Qualidade do ar. Available from: http://www.cetesb.sp.gov.br/ar/qualidade-do-ar/31- publicacoes-e-relatorios. Accessed in 2013 (Nov 18).

Wellenius GA, Schwartz J, Mittleman MA. Air pollution and hospital admissions for ischemic and hemorrhagic stroke among Medicare beneficiaries. Stroke. 2005;36(12):2549-53.

Hong YC, Lee JT, Kim H, et al. Effects of air pollutants on acute stroke mortality. Environ Health Perspect. 2002;110(2):187-91.

Conceição GMS, Saldiva PHN, Singer JM. Modelos MLG e MAG para análise da associação entre poluição atmosférica e marcadores de morbi-mortalidade: uma introduçäo baseada em dados da cidade de São Paulo [GLM and GAM model for analyzing the association between atmospheric pollution and morbidity-mortality markers: an introduction based on data from the city of São Paulo. Rev Bras Epidemiol. 2001;4(3):206-19.

Blasko I, Stampfer-Kountchev M, Robatscher P, et al. How chronic inflammation can affect the brain and support the development of Alzheimer’s disease in old age: the role of microglia and astrocytes. Aging Cell. 2004; 3(4):169-76.

Calderón-Garcidueñas L, Solt AC, Henríquez-Roldán C, et al. Long- term air pollution exposure is associated with neuroinflammation, an altered innate immune response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of amyloid beta-42 and alpha-synuclein in children and young adults. Toxicol Pathol. 2008;36(2):289-310.

Tamagawa E, van Eeden SF. Impaired lung function and risk for stroke: role of the systemic inflammation response? Chest. 2006;130(6):1631-3.

D’Mello C, Le T, Swain MG. Cerebral microglia recruit monocytes into the brain in response to tumor necrosis factoralpha signaling during peripheral organ inflammation. J Neurosci. 2009;29(7):2089-102.

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Published

2014-12-12

How to Cite

1.
Amancio CT, Nascimento LF. Environmental pollution and deaths due to stroke in a city with low levels of air pollution: ecological time series study. Sao Paulo Med J [Internet]. 2014 Dec. 12 [cited 2025 Oct. 13];132(6):349-54. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/1248

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Original Article