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Association of residential air pollution, noise, and greenspace with initial ischemic stroke severity

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dc.contributor.author Vivanco Hidalgo, Rosa María
dc.contributor.author Avellaneda Gómez, Carla
dc.contributor.author Dadvand, Payam
dc.contributor.author Cirach, Marta
dc.contributor.author Ois Santiago, Angel Javier
dc.contributor.author Gómez González, Alejandra
dc.contributor.author Rodríguez-Campello, Ana
dc.contributor.author Ceballos, Pablo de
dc.contributor.author Basagaña Flores, Xavier
dc.contributor.author Zabalza, Ana
dc.contributor.author Cuadrado-Godia, Elisa
dc.contributor.author Sunyer Deu, Jordi
dc.contributor.author Roquer, Jaume
dc.contributor.author Wellenius, Gregory A.
dc.date.accessioned 2019-12-13T08:31:36Z
dc.date.issued 2019
dc.identifier.citation Vivanco-Hidalgo RM, Avellaneda-Gómez C, Dadvand P, Cirach M, Ois Á, Gómez González A et al. Association of residential air pollution, noise, and greenspace with initial ischemic stroke severity. Environ Res. 2019;179(Pt A):108725. DOI: 10.1016/j.envres.2019.108725
dc.identifier.issn 0013-9351
dc.identifier.uri http://hdl.handle.net/10230/43156
dc.description.abstract BACKGROUND AND PURPOSE: A number of environmental risk factors of acute ischemic stroke have been identified, but few studies have evaluated the influence of the outdoor environment on stroke severity. We assessed the association of residential ambient fine particulate matter air pollution (PM2.5), noise, and surrounding greenspace with initial stroke severity. METHODS: We obtained data on patients hospitalized with acute ischemic stroke from a hospital-based prospective stroke register (2005-2014) in Barcelona. We estimated residential PM2.5 based on an established land use regression model, greenspace as the average satellite-based Normalized Difference Vegetation Index (NDVI) within a 300 m buffer of the residence, and daily (Lday), evening (Levening), night (Lnight) and average noise (Lden) level at the street nearest to the residential address using municipal noise models. Stroke severity was assessed at the time of hospital presentation using the National Institute of Health Stroke Scale (NIHSS).We used logistic regression and binomial models to evaluate the associations of PM2.5, greenspace, and noise with initial stroke severity adjusting for potential confounders. RESULTS: Among 2761 patients, higher residential surrounding greenspace was associated with lower risk of severe stroke (OR for NIHSS>5, 0.75; 95% CI: 0.60-0.95), while, living in areas with higher Lden was associated with a higher risk of severe stroke (OR, 1.30; 95% CI: 1.02-1.65). PM2.5 was not associated with initial stroke severity. CONCLUSIONS: In an urban setting, surrounding greenspace and traffic noise at home are associated with initial stroke severity, suggesting an important influence of the built environment on the global burden of ischemic stroke.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof Environmental Research. 2019;179(Pt A):108725
dc.rights © Elsevier http://dx.doi.org/10.1016/j.envres.2019.108725
dc.title Association of residential air pollution, noise, and greenspace with initial ischemic stroke severity
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1016/j.envres.2019.108725
dc.subject.keyword Air pollution
dc.subject.keyword Greenspace
dc.subject.keyword Ischemic
dc.subject.keyword Noise
dc.subject.keyword Stroke
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion


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