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Volume 12, Issue 2 (4-2026)
jhehp 2026, 12(2): 127-133 |
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Asadi F, Masaebi F, Maqboli M, Farhoudi M, Mehrasbi M R. Air Pollution and Risk of Stroke: A Multi-Year Analysis of PM2.5 and Other Pollutants in Tabriz, Iran. jhehp 2026; 12 (2) :127-133
URL: http://jhehp.zums.ac.ir/article-1-734-en.html
URL: http://jhehp.zums.ac.ir/article-1-734-en.html
1- Department of Environmental Health, Faculty of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
2- Health and Environment Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
3- Department of Neurology, Medical Faculty, Zanjan University of Medical Sciences, Zanjan, Iran.
4- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
2- Health and Environment Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
3- Department of Neurology, Medical Faculty, Zanjan University of Medical Sciences, Zanjan, Iran.
4- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract: (251 Views)
Background: This study examined the relationship between urban air pollution indices and daily stroke.
Methods: This study was conducted between 2020 and 2023 at Imam Reza Hospital in Tabriz. Data on stroke patients were collected from the Tabriz Stroke Registry, and daily air pollutant data were obtained from the Environmental Protection Agency website. Descriptive statistical analyses, along with Poisson and negative binomial regression models, were used to assess the association between air pollutant exposure and stroke incidence.
Results: PM2.5 was identified as the primary pollutant during 89.30% of the study period. The mean daily stroke incidence was 1.35 (SD: 1.17), with the highest incidence observed on days dominated by SO2 (1.91, SD: 0.83) and the lowest on days dominated by O3 (1.21, SD: 1.27). SO2 had the highest mean Air Quality Index (AQI) value (mean: 84, SD: 36), whereas O3 showed the lowest (mean: 42, SD: 13). PM2.5 showed a significant positive association with stroke incidence (IRR: 1.003, 95% CI: 1.001-1.005, P < 0.001), corresponding to a 0.3% increase in stroke incidence per unit rise in PM2.5-related AQI. No statistically significant associations were observed for the other air pollutants.
Conclusion: Elevated PM2.5 levels were associated with increased stroke incidence, while other air pollutants showed no significant correlations. These findings underscore the importance of effective management of particulate matter sources and the strengthening of air quality monitoring systems to mitigate stroke risk.
Methods: This study was conducted between 2020 and 2023 at Imam Reza Hospital in Tabriz. Data on stroke patients were collected from the Tabriz Stroke Registry, and daily air pollutant data were obtained from the Environmental Protection Agency website. Descriptive statistical analyses, along with Poisson and negative binomial regression models, were used to assess the association between air pollutant exposure and stroke incidence.
Results: PM2.5 was identified as the primary pollutant during 89.30% of the study period. The mean daily stroke incidence was 1.35 (SD: 1.17), with the highest incidence observed on days dominated by SO2 (1.91, SD: 0.83) and the lowest on days dominated by O3 (1.21, SD: 1.27). SO2 had the highest mean Air Quality Index (AQI) value (mean: 84, SD: 36), whereas O3 showed the lowest (mean: 42, SD: 13). PM2.5 showed a significant positive association with stroke incidence (IRR: 1.003, 95% CI: 1.001-1.005, P < 0.001), corresponding to a 0.3% increase in stroke incidence per unit rise in PM2.5-related AQI. No statistically significant associations were observed for the other air pollutants.
Conclusion: Elevated PM2.5 levels were associated with increased stroke incidence, while other air pollutants showed no significant correlations. These findings underscore the importance of effective management of particulate matter sources and the strengthening of air quality monitoring systems to mitigate stroke risk.
Type of Study: Original Article |
Subject:
Environmental Health, Sciences, and Engineering
Received: 2025/12/29 | Accepted: 2026/03/19 | Published: 2026/04/1
Received: 2025/12/29 | Accepted: 2026/03/19 | Published: 2026/04/1
References
1. Alavian, F. (2019). Hypothermia and stroke: Pros and cons. The Neuroscience Journal of Shefaye Khatam, 7(2), 83-98. [Crossref]
2. Alimohammadi, H., Fakhri, S., Derakhshanfar, H., Hosseini-Zijoud, S. M., Safari, S., & Hatamabadi, H. R. (2016). The effects of air pollution on ischemic stroke admission rate. Chonnam Medical Journal, 52(1), 53-58. [Crossref]
3. Amini, H., Dehlendorff, C., Lim, Y. H., Mehta, A., Jørgensen, J. T., Mortensen, L. H., . . . & Andersen, Z. J. (2020). Long-term exposure to air pollution and stroke incidence: A danish nurse cohort study. Environment International, 142, 105891. [Crossref]
4. Asakereh H, A. L. (2019). Studying the relationship between Tabriz air types and air pollution. Physical Geography Research, 52(3), 375-394.
5. Chen, G., Wang, A., Li, S., Zhao, X., Wang, Y., Li, H., . . . & Guo, Y. (2019). Long-term exposure to air pollution and survival after ischemic stroke. Journal of Stroke, 50(3), 563-570. [Crossref]
6. Fan, Y. X., Zhang, W., Li, W., Ma, Y. J., & Zhang, H. Q. (2024). Global, regional, and national impact of air pollution on stroke burden: Changing landscape from 1990 to 2021. BMC Public Health, 24(1), 2786. [Crossref]
7. Fiouji, H. N. S., Jam Barsang, S., & Erfani, M. (2020). Epidemiologic study of the main risk factors for one year ischemic stroke and surivial in patients admitted to the neurology department of Ghayim Hospital in Mashhad. Tolooebehdasht Journal, 19(2), 34-42. [Crossref]
8. Gholampour, A., Hassanvand, M., Nabizadeh, R., Alizadeh, Z., & Mahvi, A. (2016). Ionic content and sources identification of particulate matter in the ambient air of Tabriz During 2013 to 2014. Iranian Journal of Health and Environment, 9(3), 319-330.
9. Gholizadeh, M. H. F., & Darand, M. (2009). The Correlation between air pollution and human mortality in Tehran. Hakim Research Journal, 12(2), 65-71.
10. Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators. (2025). Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990-2023. Journal of the American College of Cardiology, 86(22), 2167-2243. [Crossref]
11. Gorbani, R. H. D., & Shorkri Firoozjah, P. (2012). The study Tabriz City air pollution condition on the basis of principal component analysis (PCA). Department of Geography and Urban Planning, University of Tabriz, 16(39), 89-108.
12. Han, M. H., Yi, H. J., Kim, Y. S., & Kim, Y. S. (2015). Effect of seasonal and monthly variation in weather and air pollution factors on stroke incidence in Seoul, Korea. Journal of Stroke, 46(4), 927-935. [Crossref]
13. Huang, K., Liang, F., Yang, X., Liu, F., Li, J., Xiao, Q., . . . & Gu, D. (2019). Long term exposure to ambient fine particulate matter and incidence of stroke: Prospective cohort study from the China-PAR project. BMJ Journal, 367, l6720. [Crossref]
14. Khorshiddoust, A. M., Mohammadi, G. H., Aghlmand, F., & Sadr, A. H. (2018). Descriptive-statistical analysis of the relationship between atmospheric conditions and urban pollution in Tabriz. Journal of Environmental Hazard Management, 5(2), 217-230.
15. Kulick, E. R., Kaufman, J. D., & Sack, C. (2023). Ambient air pollution and stroke: An updated review. Journal of Stroke, 54(3), 882-893. [Crossref]
16. Lee, K. K., Miller, M. R., & Shah, A. S. V. (2018). Air pollution and stroke. Journal of Stroke, 20(1), 2-11. [Crossref]
17. Ljungman, P. L., & Mittleman, M. A. (2014). Ambient air pollution and stroke. Journal of Stroke, 45(12), 3734-3741. [Crossref]
18. Niknam Azodi, M., Ostvar, F., Amjadipour, A., Besharat, S., Taziki, B., Abdollahi, F., & Sajedi, S. A. (2022). The impact of meteorological factors and geomagnetic activity on occurrence of stroke in Northeast of Iran. Journal of Gorgan University of Medical Sciences, 24(3), 86-92.
19. Safavy, S., Mousavi, M., Dehghanzadeh Reihani, R., & Shakeri, M. (2016). Seasonal and spatial zoning of air quality index and ambient air pollutants by Arc-GIS for Tabriz City and assessment of the current executive problem. Journal of Health and Hygiene, 7(2), 158-177.
20. Shah, A. S., Lee, K. K., McAllister, D. A., Hunter, A., Nair, H., Whiteley, W. L., . . . & Mills, N. L. (2015). Short term exposure to air pollution and stroke: Systematic review and meta-analysis. BMJ Journal, 350, h1295. [Crossref]
21. Sun, S., Stewart, J. D., Eliot, M. N., Yanosky, J. D., Liao, D., Tinker, L. F., . . . & Wellenius, G. A. (2019). Short-term exposure to air pollution and incidence of stroke in the women's health initiative. Environment International, 132, 105065. [Crossref]
22. Taimuri, B., Lakhani, S., Javed, M., Garg, D., Aggarwal, V., Mehndiratta, M. M., & Wasay, M. (2022). Air pollution and cerebrovascular disorders with special reference to Asia: An overview. Annals of Indian Academy of Neurology, 25(Suppl 1), S3-S8. [Crossref]
23. Verhoeven, J. I., Allach, Y., Vaartjes, I. C. H., Klijn, C. J. M., & de Leeuw, F. E. (2021). Ambient air pollution and the risk of ischaemic and haemorrhagic stroke. Lancet Planet Health, 5(8), e542-e552. [Crossref]
24. Villeneuve, P. J., Chen, L., Stieb, D., & Rowe, B. H. (2006). Associations between outdoor air pollution and emergency department visits for stroke in Edmonton, Canada. European Journal of Epidemiology, 21(9), 689-700. [Crossref]
25. Wellenius, G. A., Burger, M. R., Coull, B. A., Schwartz, J., Suh, H. H., Koutrakis, P., . . . & Mittleman, M. A. (2012). Ambient air pollution and the risk of acute ischemic stroke. Archives of Internal Medicine, 172(3), 229-234. [Crossref]
26. Wolf, K., Hoffmann, B., Andersen, Z. J., Atkinson, R. W., Bauwelinck, M., Bellander, T., . . . & Ljungman, P. L. S. (2021). Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease: A pooled analysis of six European cohorts within the elapse project. Lancet Planet Health, 5(9), e620-e632. [Crossref]
27. Wu, H., Lu, Z., Wei, J., Zhang, B., Liu, X., Zhao, M., . . . & Xi, B. (2022). Effects of the COVID-19 lockdown on air pollutant levels and associated reductions in ischemic stroke incidence in Shandong Province, China. Front Public Health, 10, 876615. [Crossref]
28. Zhou, M., Wang, H., Zeng, X., Yin, P., Zhu, J., Chen, W., . . . & Liang, X. (2019). Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 394(10204), 1145-1158. [Crossref]
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