Association of greenness exposure and particulate matter exposure with ischemic stroke patients mortality in a cohort study

LIU Chengrong; LIU Chao; ZHANG Yingying; ZHAO Ke; ZHANG Peiyao; ZHANG Bingyin; LU Zilong; GUO Xiaolei; XUE Fuzhong; JIA Xianjie

doi:10.16462/j.cnki.zhjbkz.2024.05.009

Volume 28 Issue 5

May 2024

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Article Navigation > CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION > 2024 > 28(5): 547-553

LIU Chengrong, LIU Chao, ZHANG Yingying, ZHAO Ke, ZHANG Peiyao, ZHANG Bingyin, LU Zilong, GUO Xiaolei, XUE Fuzhong, JIA Xianjie. Association of greenness exposure and particulate matter exposure with ischemic stroke patients mortality in a cohort study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 547-553. doi: 10.16462/j.cnki.zhjbkz.2024.05.009

Citation:

LIU Chengrong, LIU Chao, ZHANG Yingying, ZHAO Ke, ZHANG Peiyao, ZHANG Bingyin, LU Zilong, GUO Xiaolei, XUE Fuzhong, JIA Xianjie. Association of greenness exposure and particulate matter exposure with ischemic stroke patients mortality in a cohort study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 547-553. doi: 10.16462/j.cnki.zhjbkz.2024.05.009

Citation:

LIU Chengrong, LIU Chao, ZHANG Yingying, ZHAO Ke, ZHANG Peiyao, ZHANG Bingyin, LU Zilong, GUO Xiaolei, XUE Fuzhong, JIA Xianjie. Association of greenness exposure and particulate matter exposure with ischemic stroke patients mortality in a cohort study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(5): 547-553. doi: 10.16462/j.cnki.zhjbkz.2024.05.009

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Association of greenness exposure and particulate matter exposure with ischemic stroke patients mortality in a cohort study

doi: 10.16462/j.cnki.zhjbkz.2024.05.009

1.
Department of Epidemiology and Health Statistics, School of Public Health, Bengbu Medical University, Bengbu 233030, China
2.
Institute of Chronic Non-Communicable Disease Prevention and Control, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
3.
Department of Biostatistics, School of Public Health, Qilu Medical College, Shandong University, Jinan 250012, China
4.
National Institute of Health Care Big Data, Jinan 250003, China

Funds:

Bengbu Medical College 512 Talent Cultivation Program by51201202

Natural Science Research Program for Colleges and Universities in Anhui Province 2023AH040288

More Information

Corresponding author: JIA Xianjie, E-mail: jiaxianjie@bbmc.edu.cn
Received Date: 2023-07-11
Rev Recd Date: 2023-10-23

Available Online: 2024-06-05

Publish Date: 2024-05-10

Abstract

Abstract

Objective The interaction between greenness exposure and mortality from ischemic stroke (IS) was assessed based on satellite remote sensing data (NDVI). Methods Individual cases suffering from IS from 2013-2019 were collected in five counties in Shandong to construct a cohort of IS patients. NDVI summer exposure values and annual average exposure concentrations of PM_2.5 and PM₁₀ were matched according to the residential address of each patient. Cox proportional risk models were used to explore the association between long-term greenfield exposure and combined exposure to PM_2.5 and PM₁₀ and their interactions with ischemic stroke death, and the analyses were stratified by sex, age, and residence. Restricted cubic spline functions were used to assess the dose-response relationship between greenfield exposure, PM_2.5 and PM₁₀ and the risk of death in IS patients, respectively. Results The cohort included 59 084 individuals and 4 726 (8.00%) deaths due to IS. The results of the model′s analysis showed that NDVI was negatively associated with the risk of death in patients with IS when assessing the combined exposure of NDVI with PM_2.5 and PM₁₀. The interaction results showed that the IS mortality hazard ratio (HR) for each 0.1-unit increase in NDVI was 0.74 (95% CI: 0.67-0.82), each 10 μg/m³ increase in PM_2.5 was 0.94 (95% CI: 0.88-1.00), and the interaction term was 1.04 (95% CI: 1.02-1.07). Age, sex, and residence were effect modifiers influencing the association of combined exposure to NDVI with PM_2.5 and PM₁₀ and its interaction with death in IS patients. NDVI was nonlinearly associated with IS death, and PM_2.5 and PM₁₀ were associated with IS death in a "U" and "J" pattern, respectively. Conclusions Greenness exposure may reduce the risk of death from IS, while the risk of death from the disease may be further reduced by practicing good greenness planning and by reducing exposure concentrations of PM_2.5 and PM₁₀.
- Ischemic stroke,
- Greenness exposure,
- Fine particulate matter,
- Inhaled particulate matter,
- Retrospective cohort study

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References(20)

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