The
effects of air pollution on the lungs and heart are now widely
appreciated, with expanding evidence for an important role in cardiac
disease.1 The Global Burden of Disease Study identified fine particulate matter (PM2.5)
in outdoor air and household air pollution from use of solid fuels as
the ninth and fourth leading risk factors, respectively, for disease
worldwide,2 and the World Health Organization attributes one in every eight deaths to air pollution.3
The effects of air pollution are not limited to cardiopulmonary
diseases. Recent evidence suggests a role in diverse outcomes, including
diabetes,4 low birth weight, and preterm birth.5
This research stems from improved understanding of the role of air
pollution in initiating systemic inflammation, a response that may
affect multiple organ systems. Two linked studies (doi:10.1136/bmj.h1295, doi:10.1136/bmj.h1111) add to growing evidence that air pollution is an important risk factor for an increasing number of common diseases.6 7
effects of air pollution on the lungs and heart are now widely
appreciated, with expanding evidence for an important role in cardiac
disease.1 The Global Burden of Disease Study identified fine particulate matter (PM2.5)
in outdoor air and household air pollution from use of solid fuels as
the ninth and fourth leading risk factors, respectively, for disease
worldwide,2 and the World Health Organization attributes one in every eight deaths to air pollution.3
The effects of air pollution are not limited to cardiopulmonary
diseases. Recent evidence suggests a role in diverse outcomes, including
diabetes,4 low birth weight, and preterm birth.5
This research stems from improved understanding of the role of air
pollution in initiating systemic inflammation, a response that may
affect multiple organ systems. Two linked studies (doi:10.1136/bmj.h1295, doi:10.1136/bmj.h1111) add to growing evidence that air pollution is an important risk factor for an increasing number of common diseases.6 7
In the first of the two papers, Shah and colleagues6
systematically reviewed and meta-analysed 103 studies conducted in 28
countries and including 6.2 million events to assess the role of short
term fluctuations in air pollution as a trigger for stroke. Although
evidence from several cohort studies of long term exposure to
particulate matter indicates associations with stroke mortality, such
findings are not universal.8
systematically reviewed and meta-analysed 103 studies conducted in 28
countries and including 6.2 million events to assess the role of short
term fluctuations in air pollution as a trigger for stroke. Although
evidence from several cohort studies of long term exposure to
particulate matter indicates associations with stroke mortality, such
findings are not universal.8
The
role of air pollution as a possible trigger for stroke has important
implications for disease burden, especially in China where air pollution
and the incidence of (especially haemorrhagic) stroke are high. In
their analysis, Shah and colleagues found that increases in each of the
common gaseous and particulate air pollutants were significantly
associated with admission to hospital for stroke or stroke related
mortality, with associations strongest for strokes on the same day as
exposure; increased ozone was only weakly associated with
cerebrovascular events.
role of air pollution as a possible trigger for stroke has important
implications for disease burden, especially in China where air pollution
and the incidence of (especially haemorrhagic) stroke are high. In
their analysis, Shah and colleagues found that increases in each of the
common gaseous and particulate air pollutants were significantly
associated with admission to hospital for stroke or stroke related
mortality, with associations strongest for strokes on the same day as
exposure; increased ozone was only weakly associated with
cerebrovascular events.
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