Fine particulate matter constituents and cardiopulmonary mortality in a heavily polluted Chinese city

Background: Although ambient fine particulate matter (PM_2.5; particulate matter ≤ 2.5 µm in aerodynamic diameter) has been linked to adverse human health effects, the chemical constituents that cause harm are unknown. To our knowledge, the health effects of PM_2.5 constituents have not been reported for a developing country.Objectives: We examined the short-term association between PM_2.5 constituents and daily mortality in Xi’an, a heavily polluted Chinese city.Methods: We obtained daily mortality data and daily concentrations of PM_2.5, organic carbon (OC), elemental carbon (EC), and 10 water-soluble ions for 1 January 2004 through 31 December 2008. We also measured concentrations of fifteen elements 1 January 2006 through 31 December 2008. We analyzed the data using over-dispersed generalized linear Poisson models.Results: During the study period, the mean daily average concentration of PM_2.5 in Xi’an was 182.2 µg/m³. Major contributors to PM_2.5 mass included OC, EC, sulfate, nitrate, and ammonium. After adjustment for PM_2.5 mass, we found significant positive associations of total, cardiovascular, or respiratory mortality with OC, EC, ammonium, nitrate, chlorine ion, chlorine, and nickel for at least 1 lag day. Nitrate demonstrated stronger associations with total and cardiovascular mortality than PM_2.5 mass. For a 1-day lag, interquartile range increases in PM_2.5 mass and nitrate (114.9 and 15.4 µg/m³, respectively) were associated with 1.8% [95% confidence interval (CI): 0.8%, 2.8%] and 3.8% (95% CI: 1.7%, 5.9%) increases in total mortality.Conclusions: Our findings suggest that PM_2.5 constituents from the combustion of fossil fuel may have an appreciable influence on the health effects attributable to PM_2.5 in Xi’an.     

Short-term impact of particulate matter (PM(2.5)) on respiratory mortality in Madrid

Objectives: This paper sought to quantify the particulate matter (PM_2.5) pollutant's impact on short-term daily respiratory-cause mortality in the city of Madrid.

Methods: As our dependent variable, we took daily mortality registered in Madrid from 1 January 2003 to 31 December 2005, attributed to all diseases of the respiratory system as classified under heads J00–J99 of the ICD 10 and broken down as follows: J12–J18, pneumonia; J40–J44, chronic diseases of the respiratory system except asthma; J45–J46, asthma; and J96, respiratory failure.

Results: The relative risk (RR) for daily overall respiratory mortality was RR 1.0281 (1.0043–1.0520), with a proportional attributable risk (PAR) of 2.74%. This effect occurred in lag 1; respiratory failure, RR 1.0816 (1.0119–1.1512) and PAR 7.54% at lag 5; and pneumonia, RR 1.0438 (1.0001–1.0875) and PAR 4.19% at lag 6.

Conclusions: Our results reflect the association that exists between PM_2.5 concentrations and daily respiratory-cause mortality.     

Income inequality and infant mortality in New York City

A series of studies have demonstrated that people who live in regions where there are disparities in income have poorer average health status than people who live in more economically homogeneous regions. To test whether such disparities might explain health variations within urban areas, we examined the possible association between income inequality and infant mortality for zip code regions within New York City using data from the 1990 census and the New York City Department of Health. Both infant mortality and income inequality (percentage of income received by the poorest 50% of households) varied widely across these regions (range in infant mortality: 0.6–29.6/1,000 live births: range in income inequality: 12.7–27.3). An increase of one standard deviation in income inequality was associated with an increase of 0.80 deaths/1,000 live births (P<.001), controlling for other socioeconomic factors. This finding has important implications for public health practice and social epidemiological research in large urban areas, which face significant disparities both in health and in social and economic conditions. Data collection and initial analyses for this project were supported in part by an Investigator Award in Health Policy Research from The Robert Wood Johnson Foundation. The views expressed are those of the authors and do not imply endorsement by The Robert Wood Johnson Foundation.     

Association between ambient particulate matter and daily cause-specific mortality in Tanggu,Tianjin Binhai New Area,China

The aim of the study was to determine whether the area of Tanggu, Tianjin Binhai New Economic Developing Area, China, is subject to similar effects of ambient particulate matter less than 10 micrometres in aerodynamic diameter (PM10) similar to other areas of China. This study was designed to investigate cause-specific mortality risks associated with air pollution in this geographical region. The present study used a time-series analysis to explore the relationship between PM10 and the cause-specific mortalities for non-accidental, cardiovascular, and cardiopulmonary mortality from 1 January 2006 to 31 December 2010. A 10 μg/m³ increment of PM10 was associated with a 1.02% (95% confidence interval (CI): 0.48, 1.56) increase in cardiovascular mortality, and a 0.88% (95% CI: 0.36, 1.39) increase in cardiopulmonary mortality. In addition, the effects from PM10 appear to be consistent with multi-pollutant models. The results show that there are strong associations between daily cardiovascular and cardiopulmonary mortality and ambient PM10 exposure.     

Saharan dust and associations between particulate matter and daily mortality in Rome, Italy

Background: Outbreaks of Saharan-Sahel dust over Euro-Mediterranean areas frequently induce exceedances of the Europen Union''s 24-hr standard of 50 μg/m³ for particulate matter (PM) with aerodynamic diameter ≤ than 10 μm (PM₁₀).Objectives: We evaluated the effect of Saharan dust on the association between different PM fractions and daily mortality in Rome, Italy.Methods: In a study of 80,423 adult residents who died in Rome between 2001 and 2004, we performed a time-series analysis to explore the effects of PM_2.5, PM_2.5–10, and PM₁₀ on natural, cardiac, cerebrovascular, and respiratory mortality. We defined Saharan dust days by combining light detection and ranging (LIDAR) observations and analyses from operational models. We tested a Saharan dust–PM interaction term to evaluate the hypothesis that the effects of PM, especially coarse PM (PM_2.5–10), on mortality would be enhanced on dust days.Results: Interquartile range increases in PM_2.5–10 (10.8 μg/m³) and PM₁₀ (19.8 μg/m³) were associated with increased mortality due to natural, cardiac, cerebrovascular, and respiratory causes, with estimated effects ranging from 2.64% to 12.65% [95% confidence interval (CI), 1.18–25.42%] for the association between PM_2.5–10 and respiratory mortality (0- to 5-day lag). Associations of PM_2.5–10 with cardiac mortality were stronger on Saharan dust days (9.73%; 95% CI, 4.25–15.49%) than on dust-free days (0.86%; 95% CI, –2.47% to 4.31%; p = 0.005). Saharan dust days also modified associations between PM₁₀ and cardiac mortality (9.55% increase; 95% CI, 3.81–15.61%; vs. dust-free days: 2.09%; 95% CI, –0.76% to 5.02%; p = 0.02).Conclusions: We found evidence of effects of PM_2.5–10 and PM₁₀ on natural and cause-specific mortality, with stronger estimated effects on cardiac mortality during Saharan dust outbreaks. Toxicological and biological effects of particles from desert sources need to be further investigated and taken into account in air quality standards.     

Particulate matter exposures, mortality, and cardiovascular disease in the health professionals follow-up study

Background: The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes.Objectives: In this study we explored these associations in the all-male Health Professionals Follow-Up Study prospective cohort.Methods: The same spatiotemporal exposure estimation models, similar outcomes, and biennially updated covariates were used as those previously applied in the female Nurses’ Health Study cohort.Results: Among 17,545 men residing in the northeastern and midwestern United States, there were 2,813 deaths, including 746 cases of fatal coronary heart disease (CHD). An interquartile range change (4 µg/m³) in average exposure to PM ≤ 2.5 µm in diameter in the 12 previous months was not associated with all-cause mortality [hazard ratio (HR) = 0.94; 95% confidence interval (CI), 0.87–1.00] or fatal CHD (HR = 0.99; 95% CI, 0.87–1.13) in fully adjusted models. Findings were similar for separate models of exposure to PM ≤ 10 µm in diameter and PM between 2.5 and 10 µm in diameter and for copollutant models.Conclusions: Among this cohort of men with high socioeconomic status living in the midwestern and northeastern United States, the results did not support an association of chronic PM exposures with all-cause mortality and cardiovascular outcomes in models with time-varying covariates. Whether these findings suggest sex differences in susceptibility or the protective impact of healthier lifestyles and higher socioeconomic status requires additional investigation.     

北京市大气可吸入性颗粒物污染对居民死亡影响的时间序列分析

目的评估宁波市大气可吸入颗粒物(PM₁₀)短期暴露造成人群死亡的归因风险。方法收集宁波市2011—2015年人群死亡、空气污染和气象资料,利用时间序列研究方法和分布滞后非线性模型,分析PM₁₀短期暴露造成人群死亡的超额危险度、归因死亡人数和人群归因分值。结果PM₁₀短期浓度升高与人群死亡数增加相关,效应存在明显的滞后性和持续性,日均浓度每升高10 μg/m³,总死亡累积4 d(Lag0~3)的超额危险度为0.35%(95%CI:0.16%~0.53%)。宁波市2011—2015年归因于PM₁₀短期暴露的总死亡人数为3 972例(95%CI：1 877~6 032),人群归因分值为2.15%(95%CI：1.02%~3.27%)。呼吸系统疾病对PM₁₀更为敏感,其归因死亡人数和人群归因分值分别为1 323例(95%CI：619~1 990)和4.68%(95%CI：2.19%~7.03%);女性和高年龄组人群的归因风险分别高于男性和低年龄组。如果将PM₁₀日均浓度控制在150 μg/m³和100 μg/m³限值以内,人群归因风险将分别下降25.45%和53.07%。结论PM₁₀浓度变化对健康有较大的影响,应立即采用有效的控制措施。     

Altered heart rate variability in spontaneously hypertensive rats is associated with specific particulate matter components in Detroit, Michigan

Background

Exposure to fine particulate matter [aerodynamic diameter ≤ 2.5 μm (PM_2.5)] is linked to adverse cardiopulmonary health effects; however, the responsible constituents are not well defined.

Objective

We used a rat model to investigate linkages between cardiac effects of concentrated ambient particle (CAP) constituents and source factors using a unique, highly time-resolved data set.

Methods

Spontaneously hypertensive rats inhaled Detroit Michigan, CAPs during summer or winter (2005–2006) for 13 consecutive days. Electrocardiogram data were recorded continuously, and heart rate (HR) and heart rate variability (HRV) metrics were derived. Extensive CAP characterization, including use of a Semicontinuous Elements in Aerosol Sampler (SEAS), was performed, and positive matrix factorization was applied to investigate source factors.

Results

Mean CAP exposure concentrations were 518 μg/m³ and 357 μg/m³ in the summer and winter, respectively. Significant reductions in the standard deviation of the normal-to-normal intervals (SDNN) in the summer were strongly associated with cement/lime, iron/steel, and gasoline/diesel factors, whereas associations with the sludge factor and components were less consistent. In winter, increases in HR were associated with a refinery factor and its components. CAP-associated HR decreases in winter were linked to sludge incineration, cement/lime, and coal/secondary sulfate factors and most of their associated components. Specific relationships for increased root mean square of the standard deviation of successive normal-to-normal intervals (RMSSD) in winter were difficult to determine because of lack of consistency between factors and associated constituents.

Conclusions

Our results indicate that specific modulation of cardiac function in Detroit was most strongly linked to local industrial sources. Findings also highlight the need to consider both factor analytical results and component-specific results when interpreting findings.     

Myocardial infarction deaths after high level exposure to particulate matter

STUDY OBJECTIVE: To examine the short term effects of raised concentrations of air pollutants on myocardial infarction deaths, the authors measured if incidence rate ratios increased after the concentration of suspended particulate matter (SPM) reached various critical values and were sustained for various periods of time. DESIGN: Retrospective analysis of a database, which contained hourly SPM concentrations and myocardial infarction deaths. METHODS: The rate of death (events/1000 hours) attributable to myocardial infarction was compared among SPM categories. SPM categories were classified by five different critical values that measured high SPM levels, and by the hours of exposure (exposure window) after reaching the critical SPM level. MAIN OUTCOME MEASURES: The adjusted incidence rate ratios in the various SPM categories were compared with the reference category (0-99 microg/m(3)) to determine the incidence rate ratio. SETTING: Tokyo Metropolitan area, Japan. Patients/ PARTICIPANTS: 14,950 people who died of myocardial infarction in the Tokyo Metropolitan area from 1990 to 1994. MAIN RESULTS: When the exposure window was one hour, the adjusted incidence rate ratio in each category were 1.13 (95% CI: 1.07 to 1.20) in the 100-149 microg/m(3) category, 1.17-1.24 in the intermediate categories, and 1.40 (1.00 to 1.97) in the highest (300 microg/m(3) over) category. When the exposure window was one to six hours, increased rate ratios were seen in the highest category (1.17 (four hours) to 1.40 (one hour)). Gradual increases in the incidence rate ratio were seen as the SPM category increased when the exposure window was less than six hours. CONCLUSION: An increased rate ratio of myocardial infarction deaths was seen within a few hours after reaching a high concentration of SPM. When the exposure window was less than six hours, there was a gradual increase in the incidence rate ratio as the SPM concentration increased.     

Impact of personal and ambient-level exposures to nitrogen dioxide and particulate matter on cardiovascular function

This work explored the association between nitrogen dioxide (NO₂) and PM_2.5 components with changes in cardiovascular function in an adult non-smoking cohort. The cohort consisted of 65 volunteers participating in the US EPA's Detroit Exposure and Aerosol Research Study (DEARS) and a University of Michigan cardiovascular sub-study. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), brachial artery diameter (BAD), brachial artery flow-mediated dilatation (FMD) and nitroglycerin-mediated arterial dilatation (NMD) were collected by in-home examinations. A maximum of 336 daily environmental and health effect observations were obtained. Daily potassium air concentrations were associated with significant decreases in DBP (?0.0447 mmHg/ng/m³ ± 0.0132, p = 0.0016, lag day 0) among participants compliant with the personal monitoring protocol. Personal NO₂ exposures resulted in significant changes in BAD (e.g., 0.0041 mm/ppb ± 0.0019, p = 0.0353, lag day 1) and FMD (0.0612 ± 0.0235, p = 0.0103, lag day 0) among other findings.     

石家庄市空气PM2.5浓度与儿童呼吸系统疾病门诊量的关系

目的 分析石家庄市PM_2.5浓度与儿童呼吸系统疾病日门诊量的关系。方法 收集石家庄市2014-2016年气象、污染物及河北省儿童医院内科门诊呼吸系统门诊量数据,采用Poisson广义相加模型分析PM_2.5与儿童呼吸系统疾病日门诊量的关系。根据暴露-反应关系曲线进行分段危险度评估。结果 石家庄市2014-2016年PM_2.5年均值为104.93 μg/m³,该医院儿童呼吸系统疾病日门诊量均值为690例。PM_2.5与日门诊量的暴露-反应关系为非线性,且在低剂量范围时影响较大,在滞后1 d时效应最强,日均浓度每升高10 μg/m³,其儿童呼吸系统疾病日门诊量增加0.26%（95%CI：0.14%~0.38%）。分析PM_2.5累积滞后效应时发现,PM_2.5对儿童呼吸系统日门诊量有累积滞后效应,在累积滞后7 d时效应最强。多污染物分析显示：PM_2.5在只引入SO₂时对呼吸系统疾病日门诊量的效应下降,且差异具有统计学意义。引入其他污染物时,差异均无统计学意义（均有P>0.05）。结论 石家庄市空气PM_2.5会导致儿童呼吸系统疾病门诊量增加。     

The control of mosquito-borne diseases in New York City

Mosquito control began in New York City in 1901. Large-scale efforts to drain marshlands occurred through the 1930s, and aerial application of pesticide occurred as early as 1956. Components of early mosquito-borne disease control were reimplemented in 1999–2000 in response to an outbreak of West Nile virus, and included promoting public and health professional awareness regarding disease causation and prevention, providing free government laboratory testing, case reporting, mapping of mosquito breeding sites and their elimination or application of larvicide to them, and adult mosquito control. Because a potential for various mosquito-borne diseases in New York City persists, continued efforts are warranted to limit mosquito breeding, to monitor adult mosquito populations for the presence of human pathogens, and to establish protocols and capacity for adult mosquito control.     

Socioeconomic status, particulate air pollution, and daily mortality: differential exposure or differential susceptibility

BACKGROUND: Short-term increases in particulate air pollution are linked with increased daily mortality and morbidity. Socioeconomic status (SES) is a determinant of overall health. We investigated whether social class is an effect modifier of the PM(10) (particulate matter with diameter <10 micron)-daily mortality association, and possible mechanisms for this effect modification. METHODS: Area-based traffic emissions, income, and SES were available for each resident in Rome. All natural deaths (83,253 subjects) occurring in Rome among city residents (aged 35+ years) during the period 1998-2001 were identified. For each deceased individual, all the previous hospitalizations within 2 years before death were available via a record linkage procedure. PM(10) daily data were available from two urban monitoring sites. A case-crossover analysis was utilized in which control days were selected according to the time stratified approach (same day of the week during the same month). Conditional logistic regression was used. RESULTS: Due to the social class distribution in the city, exposure to traffic emissions was higher among those with higher area-based income and SES. Meanwhile, people of lower social class had suffered to a larger extent from chronic diseases before death than more affluent residents, especially diabetes mellitus, hypertension, heart failure, and chronic obstructive pulmonary diseases. Overall, PM(10) (lag 0-1) was strongly associated with mortality (1.1% increase, 95%CI = 0.7-1.6%, per 10 microg/m(3)). The effect was more pronounced among persons with lower income and SES (1.9% and 1.4% per 10 microg/m(3), respectively) compared to those in the upper income and SES levels (0.0% and 0.1%, respectively). CONCLUSIONS: The results confirm previous suggestions of a stronger effect of particulate air pollution among people in low social class. Given the uneven geographical distributions of social deprivation and traffic emissions in Rome, the most likely explanation is a differential burden of chronic health conditions conferring a greater susceptibility to less advantaged people.     

Ambient carbon monoxide and fine particulate matter in relation to preeclampsia and preterm delivery in western Washington State

Background

Preterm delivery and preeclampsia are common adverse pregnancy outcomes that have been inconsistently associated with ambient air pollutant exposures.

Objectives

We aimed to prospectively examine relations between exposures to ambient carbon monoxide (CO) and fine particulate matter [≤ 2.5 μm in aerodynamic diameter (PM_2.5)] and risks of preeclampsia and preterm delivery.

Methods

We used data from 3,509 western Washington women who delivered infants between 1996 and 2006. We predicted ambient CO and PM_2.5 exposures using regression models based on regional air pollutant monitoring data. Models contained predictor terms for year, month, weather, and land use characteristics. We evaluated several exposure windows, including prepregnancy, early pregnancy, the first two trimesters, the last month, and the last 3 months of pregnancy. Outcomes were identified using abstracted maternal medical record data. Covariate information was obtained from maternal interviews.

Results

Predicted periconceptional CO exposure was significantly associated with preeclampsia after adjustment for maternal characteristics and season of conception [adjusted odds ratio (OR) per 0.1 ppm = 1.07; 95% confidence interval (CI), 1.02–1.13]. However, further adjustment for year of conception essentially nullified the association (adjusted OR = 0.98; 95% CI, 0.91–1.06). Associations between PM_2.5 and preeclampsia were nonsignificant and weaker than associations estimated for CO, and neither air pollutant was strongly associated with preterm delivery. Patterns were similar across all exposure windows.

Conclusions

Because both CO concentrations and preeclampsia incidence declined during the study period, secular changes in another preeclampsia risk factor may explain the association observed here. We saw little evidence of other associations with preeclampsia or preterm delivery in this setting.     

Associations between recent exposure to ambient fine particulate matter and blood pressure in the Multi-ethnic Study of Atherosclerosis (MESA)

BACKGROUND: Blood pressure (BP) may be implicated in associations observed between ambient particulate matter and cardiovascular morbidity and mortality. This study examined cross-sectional associations between short-term ambient fine particles (particulate matter 相似文献   

The New York City fire epidemic as a toxic phenomenon

Summary Reductions in the fire service in New York City from 1972 to 1976 appear to have caused a disproportionate increase in fire-fighter work load through several unexpected mechanisms of fire contagion. In turn, the work load increase has itself had a disproportionate physiologic impact: A classic dose-response relation has been observed between a composite measure of per capita structural fire work load and the percentage of the fire-fighting work force retiring under conditions of disability. After 1974, the increase in work load seems to have caused entry to the linear portion of the dose-response curve.Implications of this synergism are explored for both New York City and other American urban areas now suffering fiscal crises or planning fire service reductions.     

Residential Segregation and Latino, Black and White Mortality in New York City

Although racial segregation is associated with health status, few studies have examined this relationship among Latinos. We examined the effect of race/ethnic group concentration of Latinos, blacks and whites on all-cause mortality rates within a highly segregated metropolitan area, New York City (NYC). We linked NYC mortality records from 1999 and 2000 with the 2000 U.S. Census data by zip code area. Age-adjusted mortality rates by race/ethnic concentration were calculated. Linear regression was used to determine the association between population characteristics and mortality. Blacks living in predominantly black areas had lower all-cause mortality rates than blacks living in other areas regardless of gender (1616/100,000 vs. 2014/100,000 for men; 1032/100,000 vs. 1362/100,000 for women). Amongst whites, those living in predominantly white areas had the lowest mortality rates. Latinos living in predominantly Latino areas had lower mortality rates than those in predominantly black areas (1187/100,000 vs.1950/100,000 for men; 760/100,000 vs. 779/100,000 for women). After adjustment for socioeconomic conditions, whites, older blacks, and young Latino men experienced decreasing mortality rates when living in areas with increasing similar race/ethnic concentrations. Increasing residential concentration of blacks is independently associated with lower mortality in older blacks; similarly, increasing residential concentration of Latinos and whites is associated with lower mortality in young Latino men and whites, respectively.Inagami and Asch are with the Veterans Affairs, VA Greater Los Angeles Health Care System, Division of General Internal Medicine (111G), 11301 Wilshire Blvd, Los Angeles, CA 90073, USA; Borrell is with the Columbia University, Mailman School of Public Health, 600 West 168th Street, PH 18-331, New York, NY 10032, USA; Wong, Shapiro, and Asch are with the Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA; Fang is with the Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control and Prevention, 4770 Buford Hwy. NE, MS K-47, Atlanta, GA 30341-3717, USA; Asch is with the RAND Health, Division of General Internal Medicine (111G), 11301 Wilshire Blvd, Los Angeles, CA 90073, USA.     

Prevalence of Hepatitis C Infection in New York City, 2004

Hepatitis C virus (HCV) is the leading cause of chronic liver disease in the United States. Accurate hepatitis C prevalence estimates are important to guide local public health programs but are usually unavailable to local health jurisdictions. National surveys may not reflect local variation, a particular challenge for urban settings with disproportionately large numbers of residents in high-risk population groups. In 2004, the New York City Department of Health and Mental Hygiene conducted the NYC Health and Nutrition Examination Survey, a population-based household survey of non-institutionalized NYC residents ages 20 and older. Study participants were interviewed and blood specimens were tested for antibody to HCV (anti-HCV); positive participants were re-contacted to ascertain awareness of infection and to provide service referrals. Of 1,786 participants with valid anti-HCV results, 35 were positive for anti-HCV, for a weighted prevalence of 2.2% (95% confidence interval [CI] 1.5% to 3.3%). Anti-HCV prevalence was high among participants with a lifetime history of injection drug use (64.5%, 95% CI 39.2% to 83.7%) or a lifetime history of incarceration as an adult (8.4%, 95% CI 4.3% to 15.7%). There was a strong correlation with age; among participants born between 1945 and 1954, the anti-HCV prevalence was 5.8% (95% CI 3.3% to 10.0%). Of anti-HCV positive participants contacted (51%), 28% (n = 5) first learned of their HCV status from this survey. Continued efforts to prevent new infections in known risk behavior groups are essential, along with expansion of HCV screening and activities to prevent disease progression in people with chronic HCV.     

武汉市江岸区大气污染与脑卒中死亡关系的时间序列分析

大气污染是近年来社会日益关注的环境问题。脑卒中是主要发生于老年人的脑血管疾病,具有极高的致死性和致残性。目前已经有很多研究证实了脑卒中发病与死亡和空气污染之间存在相关性。本文对近年来关于脑卒中发病与死亡和空气污染的关系部分研究进行综述。