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The role of weather conditions and normal level of air pollution in appearance of stroke in the region of Southeast Europe

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Abstract

We investigated correlation between the normal level of air pollution, weather conditions and stroke occurrence in the region of Southeast Europe with a humid continental climate. This retrospective study included 1963 patients, 1712 (87.2%) with ischemic (IS) and 251 (12.8%) with hemorrhagic stroke (HS) admitted to emergency department. The number of patients, values of weather condition (meteorological parameters) [air temperature (°C), atmospheric pressure (kPa), relative humidity (%)] and concentrations of air pollutants [particulate matter (PM10), nitrogen dioxide (NO2), ozone (O3)], were recorded and evaluated for each season (spring, summer, autumn, winter) during 2 years (July 2008–June 2010). The highest rate of IS was observed during spring (28.9%) (p = 0.0002) and HS in winter (33.9%) (p = 0.0006). We have found negative Spearman’s correlations (after Bonferroni adjustment for the multiple correlations) of the number of males with values of relative humidity (%) (day 0, rho = − 0.15), the total number of strokes (day 2, rho = − 0.12), females (day 2, rho = − 0.12) and IS (day 2, rho = − 0.13) with concentrations of PM10 (µg/m3), as well as negative correlations of the number of females (day 2, rho = − 0.12) and IS (day 2, rho = − 0.12) with concentrations of NO2 (µg/m3) (for all p < 0.002). In winter, the number of HS (day 0, rho = 0.25, p = 0.001) positively correlated with concentrations of O3 (µg/m3). The appearance of stroke has seasonal variations, with the highest rates during spring and winter. Positive correlation between the number of HS and values of O3 requires an additional reduction of the legally permitted pollutants concentrations.

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References

  1. Thorvaldsen P, Asplund K, Kuulasmaa K et al (1995) Stroke incidence, case-fatality, and mortality in the WHO MONICA Project. Stroke 26:361–367

    Article  PubMed  CAS  Google Scholar 

  2. Turin TC, Kita Y, Murakami Y et al (2008) Higher stroke incidence in the spring season regardless of conventional risk factors: Takashima Stroke Registry, Japan, 1988-2001. Stroke 39:745–752

    Article  PubMed  Google Scholar 

  3. McArthur K, Dawson J, Walters M (2010) What is it with the weather and stroke? Expert Rev Neurother 10:243–249

    Article  PubMed  Google Scholar 

  4. Hong Y, Rha J, Lee J et al (2003) Ischemic stroke associated with decrease in temperature. Epidemiology 14:473–478

    PubMed  Google Scholar 

  5. Feigin V, Nikitin YP, Bots ML et al (2000) A population-based study of the associations of stroke occurrence with weather parameters in Siberia, Russia (1982-92). Eur J Neurol 7:171–178

    Article  PubMed  CAS  Google Scholar 

  6. Berginer VM, Goldsmith J, Batz U et al (1989) Clustering of strokes in association with meteorologic factors in the Negev desert of Israel: 1981–1983. Stroke 20:65–69

    Article  PubMed  CAS  Google Scholar 

  7. Jehle D, Moscati R, Frye J et al (1994) The incidence of spontaneous subarachnoid hemorrhage with change in barometric pressure. Am J Emerg Med 12:90–91

    Article  PubMed  CAS  Google Scholar 

  8. Matsumoto M, Ishikawa S, Kajii E (2010) Cumulative effects of weather on stroke incidence: a multi-community cohort study in Japan. J Epidemiol 20:136–142

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bittel J, Henane R (1975) Comparison of thermal exchanges in men and women under neutral and hot conditions. J Physiol 250:475–489

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Sato F, Matsushita S, Hyodo K et al (2008) Sex difference in peripheral arterial response to cold exposure. Circ J 72:1367–1372

    Article  PubMed  Google Scholar 

  11. Brunekreef B, Holgate ST (2002) Air pollution and health. Lancet 360:1233–1242

    Article  PubMed  CAS  Google Scholar 

  12. Kraft M, Eikmann T, Kappos A et al (2005) The German view: effects of nitrogen dioxide on human health–derivation of health-related short-term and long-term values. Int J Hyg Environ Health 208:305–318

    Article  PubMed  CAS  Google Scholar 

  13. Samoli E, Aga E, Touloumi G et al (2006) Short-term effects of nitrogen dioxide on mortality: an analysis within the APHEA project. Eur Respir J 27:1129–1138

    Article  PubMed  CAS  Google Scholar 

  14. Wong CM, Ma S, Hedley AJ et al (1999) Does ozone have any effect on daily hospital admissions for circulatory diseases? J Epidemiol Community Health 53:580–581

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Villeneuve PJ, Chen L, Stieb D et al (2006) Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, Canada. Eur J Epidemiol 21:689–700

    Article  PubMed  Google Scholar 

  16. Han M-H, Yi H-J, Ko Y et al (2016) Association between hemorrhagic stroke occurrence and meteorological factors and pollutants. BMC Neurol 16:59

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. City of Zagreb (2014) Zagreb in brief. The official City of Zagreb website, http://www.zagreb.hr/default.aspx?id=1125 (accessed 2014)

  18. Sheth T, Nair C, Muller J et al (1999) Increased winter mortality from acute myocardial infarction and stroke: the effect of age. J Am Coll Cardiol 33:1916–1919

    Article  PubMed  CAS  Google Scholar 

  19. Nocera R, Petrucelli P, Park J et al (2014) Meteorological variables associated with stroke. Int Sch Res Notices 2014:597106

    PubMed  PubMed Central  Google Scholar 

  20. Dawson J, Weir C, Wright F et al (2008) Associations between meteorological variables and acute stroke hospital admissions in the west of Scotland. Acta Neurol Scand 117:85–89

    PubMed  CAS  Google Scholar 

  21. Chang CL, Shipley M, Marmot M et al (2004) Lower ambient temperature was associated with an increased risk of hospitalization for stroke and acute myocardial infarction in young women. J Clin Epidemiol 57:749–757

    Article  PubMed  Google Scholar 

  22. Ohwaki K, Yano E, Murakami H et al (2004) Meteorological factors and the onset of hypertensive intracerebral hemorrhage. Int J Biometeorol 49:86–90

    Article  PubMed  Google Scholar 

  23. Jimenez-Conde J, Ois A, Gomis M et al (2008) Weather as a trigger of stroke. Daily meteorological factors and incidence of stroke subtypes. Cerebrovasc Dis 26:348–354

    Article  PubMed  CAS  Google Scholar 

  24. Hori A, Hashizume M, Tsuda Y et al (2012) Effects of weather variability and air pollutants on emergency admissions for cardiovascular and cerebrovascular diseases. Int J Environ Health Res 22:416–430

    Article  PubMed  CAS  Google Scholar 

  25. Houck PD, Lethen JE, Riggs MW et al (2005) Relation of atmospheric pressure changes and the occurrences of acute myocardial infarction and stroke. Am J Cardiol 96:45–51

    Article  PubMed  Google Scholar 

  26. Lejeune JP, Vinchon M, Amouyel P et al (1994) Association of occurrence of aneurysmal bleeding with meteorologic variations in the north of France. Stroke 25:338–341

    Article  PubMed  CAS  Google Scholar 

  27. Magalhães R, Silva MC, Correia M et al (2011) Are stroke occurrence and outcome related to weather parameters? Results from a population-based study in northern Portugal. Cerebrovasc Dis 32:542–551

    Article  PubMed  Google Scholar 

  28. Lee HC, Hu CJ, Chen CS et al (2008) Seasonal variation in ischemic stroke incidence and association with climate: a six-year population-based study. Chronobiol Int 25:938–949

    Article  PubMed  Google Scholar 

  29. Goggins WB, Woo J, Ho S et al (2012) Weather, season, and daily stroke admissions in Hong Kong. Int J Biometeorol 56:865–872

    Article  PubMed  Google Scholar 

  30. Scheers H, Jacobs L, Casas L et al (2015) Long-term exposure to particulate matter air pollution is a risk factor for stroke: meta-analytical evidence. Stroke 46:3058–3066

    Article  PubMed  CAS  Google Scholar 

  31. Chan CC, Chuang KJ, Chien LC et al (2006) Urban air pollution and emergency admissions for cerebrovascular diseases in Taipei, Taiwan. Eur Heart J 27:1238–1244

    Article  PubMed  CAS  Google Scholar 

  32. Corea F, Silvestrelli G, Baccarelli A et al (2012) Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions. Neurol Int 4:e11

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. Tsai SS, Goggins WB, Chiu HF et al (2003) Evidence for an association between air pollution and daily stroke admissions in Kaohsiung, Taiwan. Stroke 34:2612–2616

    Article  PubMed  CAS  Google Scholar 

  34. Wellenius GA, Schwartz J, Mittleman MA (2005) Air pollution and hospital admissions for ischemic and hemorrhagic stroke among medicare beneficiaries. Stroke 36:2549–2553

    Article  PubMed  CAS  Google Scholar 

  35. Ballester F, Tenias JM, Perez-Hoyos S (2001) Air pollution and emergency hospital admissions for cardiovascular diseases in Valencia, Spain. J Epidemiol Community Health 55:57–65

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  36. Villeneuve PJ, Johnson JY, Pasichnyk D et al (2012) Short-term effects of ambient air pollution on stroke: who is most vulnerable? Sci Total Environ 430:193–201

    Article  PubMed  CAS  Google Scholar 

  37. Wellenius GA, Burger MR, Coull BA et al (2012) Ambient air pollution and the risk of acute ischemic stroke. Arch Intern Med 172:229–234

    Article  PubMed  PubMed Central  Google Scholar 

  38. Xu X, Sun Y, Ha S et al (2013) Association between ozone exposure and onset of stroke in Allegheny county, Pennsylvania, USA, 1994–2000. Neuroepidemiology 41:2–6

    Article  PubMed  CAS  Google Scholar 

  39. Henrotin JB, Besancenot JP, Bejot Y et al (2007) Short-term effects of ozone air pollution on ischaemic stroke occurrence: a case-crossover analysis from a 10-year population-based study in Dijon, France. Occup Environ Med 64:439–445

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  40. Henrotin JB, Zeller M, Lorgis L et al (2010) Evidence of the role of short-term exposure to ozone on ischaemic cerebral and cardiac events: the dijon vascular project (diva). Heart 96:1990–1996

    Article  PubMed  Google Scholar 

  41. Turin TC, Kita Y, Rumana N et al (2012) Short-term exposure to air pollution and incidence of stroke and acute myocardial infarction in a Japanese population. Neuroepidemiology 38:84–92

    Article  PubMed  Google Scholar 

  42. Villeneuve PJ, Chen L, Stieb D et al (2006) Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, Canada. Eur J Epidemiol 21:689–700

    Article  PubMed  Google Scholar 

  43. Yang CY, Chen YS, Chiu HF et al (2005) Effects of asian dust storm events on daily stroke admissions in taipei, taiwan. Environ Res 99:79–84

    Article  PubMed  CAS  Google Scholar 

  44. Yamazaki S, Nitta H, Ono M et al (2007) Intracerebral haemorrhage associated with hourly concentration of ambient particulate matter: case-crossover analysis. Occup Environ Med 64:17–24

    Article  PubMed  CAS  Google Scholar 

  45. Bedada GB, Smith CJ, Tyrrell PJ et al (2012) Short-term effects of ambient particulates and gaseous pollutants on the incidence of transient ischaemic attack and minor stroke: a case crossover study. Environ Health 11:77

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  46. Shah AS, Lee KK, McAllister DA et al (2015) Short term exposure to air pollution and stroke: systematic review and meta-analysis. BMJ 350:h1295

    Article  PubMed  PubMed Central  Google Scholar 

  47. Butland BK, Atkinson RW, Crichton S et al (2017) Air pollution and the incidence of ischaemic and haemorrhagic stroke in the South London Stroke Register: a case-cross-over analysis. J Epidemiol Community Health 71:707–712

    Article  PubMed  PubMed Central  CAS  Google Scholar 

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Correspondence to Marko Mornar Jelavic.

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All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study has approval of the appropriate institutional Ethics committee.

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Knezovic, M., Pintaric, S., Jelavic, M.M. et al. The role of weather conditions and normal level of air pollution in appearance of stroke in the region of Southeast Europe. Acta Neurol Belg 118, 267–275 (2018). https://doi.org/10.1007/s13760-018-0885-0

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  • DOI: https://doi.org/10.1007/s13760-018-0885-0

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