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Study: Even Low Levels of Air Pollution May Pose Stroke Risk, Current Standards May Be Insufficient

31 May 2008

Short-term exposure to low levels of particulate air pollution may increase the risk of stroke or mini-stroke, according to findings by a University of Michigan team that suggest current exposure standards could be insufficient to protect the public. The study suggests future research on ambient air pollution and stroke is warranted.

The study examined particulate air pollution in a southeast Texas community where there is a large petroleum and petrochemical industry presence. In the study, researchers identified ischemic strokes and transient ischemic attacks (TIA)—sometimes called mini-strokes—but that often lead to a stroke later. Ischemic attacks are caused by a blockage of blood flow to the brain by a blood clot.

Researchers looked at data from the Brain Attack Surveillance in Corpus Christi Project, a population-based stroke surveillance project designed to capture all strokes in Nueces County, Texas. Ischemic stroke and TIA cases between 2001 and 2005 were identified using trained staff and later verified by neurologists. Daily historical air pollutant and meteorological data were obtained for the same time period from the Texas Commission on Environmental Quality’s Monitoring Operations database. Data on fine particulate matter and ozone were available from a centrally located monitor in Corpus Christi, Tex., located upwind of the local industrial facilities. The majority of stroke/TIA cases were also located upwind of local chemical plants and refineries.

The results showed borderline significant associations between same day and previous day fine particulate matter exposures and ischemic stroke/TIA risk. Similar associations were also seen with ozone, another type of pollution.

Specifically, median PM2.5 was 7.0 µg/m3 (interquartile range, 4.8-10.0 µg/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) PM2.5 and stroke/TIA risk. These associations were independent of O3 (ozone), 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).

Despite the fossil fuel industry in the area, fine particulate matter exposures were low relative to other regions of the country, probably because of the proximity to the coast and prevailing wind patterns.

Findings suggest that recent exposure to fine particulate matter may increase the risk of ischemic cerebrovascular events specifically. Some research has shown that particulate air pollution is associated with acute artery vasoconstriction and with increased thickening of the blood, which may enhance the potential for blood clots. However, this requires further study.

The vast majority of the public is exposed to ambient air pollution at the levels observed in this community or greater every day, suggesting a potentially large public health impact.

—Lynda Lisabeth, lead author and assistant professor in the University of Michigan School of Public Health

However, Lisabeth stressed that the association requires further study in other areas with varying climates and alternative study designs. Stroke is the third leading cause of death in the United States.

The study, “Ambient Air Pollution and Risk of Ischemic Stroke and TIA,” will be published in the July 2008 issue of Annals of Neurology, the official journal of the American Neurological Association. Co-authors are James Escobar, Joseph Dvonch, Brisa Sanchez, Jennifer Majersik, Devin Brown, Melinda Smith, and Lewis Morgenstern.

Earlier this month, the California Air Resources Board was presented with research showing long-term exposures to fine particle pollution pose a greater health threat than previously estimated.

At the request of the board in 2006, ARB researchers carefully reviewed all scientific studies on the subject and consulted with health scientists. While exposures to particulate matter have long been known as a serious health threat, new information suggests that the pollutant is even more toxic than previously thought.

Hospitalizations, emergency room visits and doctor visits for respiratory illnesses or heart disease have been associated with PM2.5 exposure. Other studies suggest that PM2.5 exposure may influence asthma symptoms and acute and chronic bronchitis. Children, the elderly and people with pre-existing chronic disease are most at risk of experiencing adverse health effects from PM2.5 exposure. Even small increases in PM2.5 exposures may increase health risks.

Resources

  • Lynda D. Lisabeth, et. al. Ambient air pollution and risk for ischemic stroke and transient ischemic attack. Annals of Neurology Published Online: 28 May DOI: 10.1002/ana.21403

May 31, 2008 in Emissions | Permalink | Comments (7) | TrackBack (0)

Comments

I think its time we ban all industrial activity.

Posted by: Israel Cohen | May 31, 2008 at 05:56 PM

@Israel Cohen

I think you are being ironic here. But if you really have this felling, there is a solution. Move to Lancaster County in Pennsylvania.. You (as well as some other disillusioned “English” on this site) can reconnect with the land and nature this way. The Old Order Amish use horses for farming and transportation, dress in a traditional manner, and forbid electricity or telephones in the home. They do permit the use of solar panels, hydropower and wind mills. IMHO, the Pennsylvania Dutch country is one of the most beautiful areas on the east coast because the land hardens back to a simpler time. Its air is fresh and there is a spiritual purity about the land.

You will never see a fat Amish. They work hard, walk everywhere and have a simple diet of home grown organic food. They are friendly to the English, but it is hard to buy land since it is handed down through the generations. They speak Enlish to the outsider but Pennsylvania Dutch among themselves. If you visit, plan to drive at the rate of a horse drawn buggy. Passing them is impossible on the narrow winding county roads.

You folks, stop complaining and do something about it.

Posted by: yoder | May 31, 2008 at 06:59 PM

Once the full medical studies appear reinforcing the preliminary heart, stroke & lung(other body parts?) damage studies of fine & nano particles, we will really know the NECESSITY of renewable energy sources. As for the Amish allowing solar, hydro & wind power sources...hey, that's just the power mix in my Northwest! We've got lots of Dutch farmers here too!

Posted by: litesong | June 01, 2008 at 12:42 PM


Paracelsus said it best in the 14th cenury "Everything is a poison, the secret is the dosage".

If evidence turns up that indicts PM 2.5 as a hazard, then we should establish revised limits for this toxicity, regualte and and monitor to reduce those emissions.

But there is a law of diminishing returns at work. As the dosages get smaller and smaller, the effects become indistiguishable from the background.

There is also an iron law of bureacracy, never admit progress, and if in danger of declaring victory, hence eliminating jobs, redefine a new problem as a raison d'etre.

I look forward to further research into a toxicity previously unmeasured, because it was unmeasureable.

Posted by: | June 01, 2008 at 02:22 PM

Anon....You don't get it. PM 2.5 is dangerous. This study says its even more dangerous than we thought. But it is smaller particles than PM 2.5, namely fine & nano particles that are preliminarily more dangerous than PM 2.5. Further studies need to come out, but it looks like fine & nano particles are much worse, & may be the causitive factors to the terrible lung, heart & stroke disease numbers that plague modern people.

Also, people have talked about 'diminishing returns' for decades as an excuse to stop improvements of internal combustion engine (ICE) emissions. That is why this study & those preliminary & full fine & nano particle studies will land like a ton of bricks, inditing our modes of internal combustion engine(ICE) travel with the death of millions. Yes, will land like a ton of bricks except on those that just don't want to care about our sick citizens.

Posted by: litesong | June 01, 2008 at 07:33 PM

@ litesong,

What terrible heart and lung diseases are you speaking of?

I certainly agree that more people die of these diseases than before. But that is simply because many of the other former killers have been cured. Much of the heart disease measured, is degenerative, simply wearing out passed the programmed plan, and many lung diseases are self-induced.

Actions have already been taken, to limit or to eliminate respiring tobacco, asbestos, and silica and other toxics. Prior damage has been done, that has not yet been reflected in the statistics. These injured people have not died off yet.

Unless you didn't look lately, the average life expectancy in the Western world is as high as it has ever been. Some would say almost three times the "normal" life expectancy.

Our caveman ancestors, those Noble Savages, so beloved of Gaian nouveaux religionists, never breathed toxic industrial emissions, nor auto exhaust, ate only organic food, got plenty of exercise, and ...

were dead before the age thirty.

When and if we ascertain that PM 2.5 and finer particularites, is truly a killer, I agree that we need to regulate such enmissions, monitor, and remove as much as is practical from the environment. We certainly know how to do that; having succeeded with even more toxic substances, and we shall.

But based on the evidence of observed life expectancy, approaching 80, that such toxicity will prove to be a relatively minor killer in the big scheme of things.

Posted by: stas peterson | June 02, 2008 at 11:39 AM

The life expectancy comments are much to the point. All of the increases of population are due to the use of improved energy resources either agriculture or fossil fuels. Starving is a quick death caused by lack of income and infants and children are highly succeptible to it and the coexisting lack of medical care and clean water. Polluted air has not caused enough deaths to keep the population low. There are many risks in life, but to be most efficient those that cause the most loss of human hours should be dealt with first. In the US, many children and adults go hungry when there is a loss of employment or less income or higher prices. Doctors are not even visited when people are hungry. Cheap energy is necessary for a functioning economy, but if pollution controls increase the cost too much jobs are lost and move to China. How many poor peoples' babies are you willing to have die so that your child can have your version of clean air. The price of your bottle of clean water will feed a child for a week or more. Every bit of money in peoples pockets is eventually derived from minerals, foods and energy taken from the earth. If it is not done in the US it will have to be done somewhere else and their babies will die instead of yours, and then yours will too from starvation...HG...

Posted by: Henry Gibson | June 11, 2008 at 07:48 PM

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