A time series analysis of atmospheric nitrogen dioxide and acute onset of stroke in Yangzhou,China
Objective To investigate the influence of atmospheric nitrogen dioxide(NO2)exposure on the acute onset of stroke in Yangzhou,China,and to provide a scientific basis for formulating propaganda policies for the prevention and treatment of stroke and strengthening disease prevention.Methods The Chronic Disease Management Information Platform of Jiangsu Province was used to collect the data on the acute onset of stroke in Yangzhou City from January 1,2020 to December 31,2022,and meanwhile,air pollu-tion data(PM2.5,PM10,SO2,NO2,CO,O3)and meteorological data(mean daily temperature and relative humidity)were obtained from Yangzhou Ecological Environment Bureau and Yangzhou Meteorological Bureau,respectively.A time series analysis was per-formed to investigate the influence of NO2 on the onset of stroke.Results The median of daily concentration of NO2 was 25.1 μg/m3 in Yangzhou in 2020-2022.In the single-pollutant model,the risk of stroke among residents was increased by 1.91％(95％confi-dence interval[CI]:0.50％-3.32％)for every 10 μg/m3 increase in NO2 concentration(lag02 d),and in the dual-pollutant model,the positive association between NO2 and the acute onset of stroke remained stable after control of the confounding effects of other pollu-tants.The subgroup analysis showed that NO2 had statistically significant effects on stroke risk in people with different gender and edu-cation levels,among which the effect was more significant in female and people with primary school education or below.For every 10 μg/m3 increase in NO2 concentration(lag02 d),the risk of stroke was increased by 2.20％(95％CI:0.47％-3.93％)in female,and the risk of stroke was increased by 5.84％(95％CI:2.31％-9.38％)in people with primary school education or below.NO2 had a statistically significant effect on stroke risk in patients ≥65 years old.For every 10 μg/m3 increase in NO2,the risk of stroke in pa-tients ≥65 years old increased by 2.34％(95％CI:0.83％-3.85％).The effect of NO2 on the risk of cerebral infarction was statisti-cally significant,and the risk of cerebral infarction increased by 2.31％for every 10 μg/m3 increase in NO2(95％CI:0.76％-3.86％).Conclusion NO2 in Yangzhou may increase the risk of acute stroke,especially cerebral infarction.Female,people ≥ 65 years of age,and people with primary school education and below are more susceptible to acute stroke caused by increased NO2 levels.
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