Ambient air pollution and risk for ischemic stroke and transient ischemic attack

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Abstract
Objective: Data on the association between air pollution and cerebrovascular disease in the United States are limited. The objective of this study was to investigate the association between short‐term exposure to ambient air pollution and risk for ischemic cerebrovascular events in a US community.Methods: Daily counts of ischemic strokes/transient ischemic attacks (TIAs) (2001–2005) were obtained from the population‐based Brain Attack Surveillance in Corpus Christi (BASIC) Project. Daily particulate matter less than 2.5μm in diameter (PM2.5), ozone (O3), and meteorological data were obtained from Texas Commission on Environmental Quality. To examine the association between PM2.5and stroke/TIA risk, we used Poisson regression. Separate models included same‐day PM2.5, PM2.5lagged 1 to 5 days, and an averaged lag effect. All models were adjusted for temperature, day of week, and temporal trends in stroke/TIA. The effects of O3were also investigated.Results: Median PM2.5was 7.0μg/m3(interquartile range, 4.8–10.0μg/m3). There were borderline significant associations between same‐day (relative risk [RR], 1.03; 95% confidence interval [CI], 0.99–1.07 for an interquartile range increase in PM2.5) and previous‐day (RR, 1.03; 95% CI, 1.00–1.07) PM2.5and stroke/TIA risk. These associations were independent of O3, which demonstrated similar associations with stroke/TIA risk (same‐day RR, 1.02; 95% CI, 0.97–1.08; previous‐day RR, 1.04; 95% CI, 0.99–1.09).Interpretation: We observed associations between recent PM2.5and O3exposure and ischemic stroke/TIA risk even in this community with relatively low pollutant levels. This study provides data on environmental exposures and stroke risk in the United States, and suggests future research on ambient air pollution and stroke is warranted. Ann Neurol 2008