globalchange  > 气候变化与战略
DOI: 10.1016/j.envres.2020.109327
Stroke burden and mortality attributable to ambient fine particulate matter pollution in 195 countries and territories and trend analysis from 1990 to 2017
Author: Jiang Y.; Lu H.; Man Q.; Liu Z.; Wang L.; Wang Y.; Suo C.; Zhang T.; Jin L.; Dong Q.; Cui M.; Chen X.
Source Publication: Environmental Research
ISSN: 139351
Publishing Year: 2020
Volume: 184
Language: 英语
Keyword: Disability-adjusted life years (DALYs) ; Fine particulate matter (PM2.5) ; Global burden of disease ; Mortality ; Stroke
English Abstract: Background: Fine particulate matter (PM2.5) exposure is associated with stroke incidence and mortality. However, the global distribution and trends of stroke burden and mortality attributable to PM2.5 are rarely studied. We estimated the spatial patterns and temporal trends of PM2.5-attributable stroke burden in 195 countries and territories from 1990 to 2017. Methods: Detailed data on stroke burden attributable to PM2.5 were extracted from the Global Burden of Disease Study (GBD) 2017. The numbers and age-standardized rates of stroke disability-adjusted life years (DALYs) and mortality (ASDR and ASMR) were estimated by age, sex, subtype, region, and country. Temporal trends in ASDR and ASMR were analyzed using estimated annual percentage change (EAPC). Results: Globally, in 2017, 10.5 million DALYs and 0.4 million deaths related to stroke were attributable to PM2.5. The corresponding ASDR and ASMR increased with age, were highest in males and for intracerebral hemorrhage, and varied greatly across countries, with the largest burden in high-middle sociodemographic index (SDI) regions and East Asia. The global ASDR and ASMR decreased by 7.2% and 12.2% from 1990 to 2017, with EAPCs of −0.42 (95% confidence interval [CI]: -0.55, −0.28) and −0.57 (95% CI: -0.72, −0.42), respectively. Age-specific stroke burden rates declined significantly, except in the middle-aged population. The decrease was more pronounced in women and for subarachnoid hemorrhage, while proportions of ischemic stroke burden increased globally and in all SDI regions. Most geographic regions achieved significant declines in ASDR and ASMR since 1990; however, Asia and approximately 30% of countries and territories, especially in low-income countries, showed undesirable increasing trends. Conclusions: The patterns and trends were heterogeneous across countries. Strengthened and tailored approaches for stroke prevention and air pollution management are still needed to reduce the disease burden associated with PM2.5, particularly in males, middle-age populations, and low-income countries and for ischemic stroke. © 2020 Elsevier Inc.
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Document Type: 期刊论文
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Affiliation: State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, 200438, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu 225312, China; Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China; Department of Clinical Laboratory, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to School of Medicine, Tongji University, Shanghai, 200081, China; Department of Internal Medicine, Air Force Medical Center, Chinese PLA, Beijing, 100089, China; Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China

Recommended Citation:
Jiang Y.,Lu H.,Man Q.,et al. Stroke burden and mortality attributable to ambient fine particulate matter pollution in 195 countries and territories and trend analysis from 1990 to 2017[J]. Environmental Research,2020-01-01,184
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