Stroke and Long-Term Exposure to Outdoor Air Pollution From Nitrogen Dioxide A Cohort Study

Zorana Jovanovic Andersen, Luise Cederkvist Kristiansen, Klaus K. Andersen, Tom S. Olsen, Martin Hvidberg, Steen S. Jensen, Matthias Ketzel, Steffen Loft, Mette Sørensen, Anne Tjønneland, Kim Overvad, Ole Lundsgaard Raaschou-Nielsen

    Research output: Contribution to journalJournal articleResearchpeer-review

    Abstract

    Background and Purpose-Years of exposure to tobacco smoke substantially increase the risk for stroke. Whether long-term exposure to outdoor air pollution can lead to stroke is not yet established. We examined the association between long-term exposure to traffic-related air pollution and incident and fatal stroke in a prospective cohort study.Methods-We followed 57 053 participants of the Danish Diet, Cancer and Health cohort in the Hospital Discharge Register for the first-ever hospital admission for stroke (incident stroke) between baseline (1993-1997) and 2006 and defined fatal strokes as death within 30 days of admission. We associated the estimated mean levels of nitrogen dioxide at residential addresses since 1971 to incident and fatal stroke by Cox regression analyses and examined the effects by stroke subtypes: ischemic, hemorrhagic, and nonspecified stroke.Results-Over a mean follow-up of 9.8 years of 52 215 eligible subjects, there were 1984 (3.8%) first-ever (incident) hospital admissions for stroke of whom 142 (7.2%) died within 30 days. We detected borderline significant associations between mean nitrogen dioxide levels at residence since 1971 and incident stroke (hazard ratio, 1.05; 95% CI, 0.99-1.11, per interquartile range increase) and stroke hospitalization followed by death within 30 days (1.22; 1.00-1.50). The associations were strongest for nonspecified and ischemic strokes, whereas no association was detected with hemorrhagic stroke.Conclusions-Long-term exposure to traffic-related air pollution may contribute to the development of ischemic but not hemorrhagic stroke, especially severe ischemic strokes leading to death within 30 days.
    Original languageEnglish
    JournalStroke
    Volume43
    Issue number2
    Pages (from-to)320-325
    ISSN0039-2499
    DOIs
    Publication statusPublished - 2012

    Fingerprint Dive into the research topics of 'Stroke and Long-Term Exposure to Outdoor Air Pollution From Nitrogen Dioxide A Cohort Study'. Together they form a unique fingerprint.

    Cite this