RESUMO
The association between fine particulate matter (PM2.5) and cardiovascular outcomes is well established. To evaluate whether source-specific PM2.5 is differentially associated with cardiovascular disease in New York City (NYC), we identified PM2.5 sources and examined the association between source-specific PM2.5 exposure and risk of hospitalization for myocardial infarction (MI). Methods: We adapted principal component pursuit (PCP), a dimensionality-reduction technique previously used in computer vision, as a novel pattern recognition method for environmental mixtures to apportion speciated PM2.5 to its sources. We used data from the NY Department of Health Statewide Planning and Research Cooperative System of daily city-wide counts of MI admissions (2007-2015). We examined associations between same-day, lag 1, and lag 2 source-specific PM2.5 exposure and MI admissions in a time-series analysis, using a quasi-Poisson regression model adjusting for potential confounders. Results: We identified four sources of PM2.5 pollution: crustal, salt, traffic, and regional and detected three single-species factors: cadmium, chromium, and barium. In adjusted models, we observed a 0.40% (95% confidence interval [CI]: -0.21, 1.01%) increase in MI admission rates per 1 µg/m3 increase in traffic PM2.5, a 0.44% (95% CI: -0.04, 0.93%) increase per 1 µg/m3 increase in crustal PM2.5, and a 1.34% (95% CI: -0.46, 3.17%) increase per 1 µg/m3 increase in chromium-related PM2.5, on average. Conclusions: In our NYC study, we identified traffic, crustal dust, and chromium PM2.5 as potentially relevant sources for cardiovascular disease. We also demonstrated the potential utility of PCP as a pattern recognition method for environmental mixtures.
RESUMO
BACKGROUND: While evidence suggests that daily ambient temperature exposure influences stroke risk, little is known about the potential triggering role of ultra short-term temperature. METHODS: We examined the association between hourly temperature and ischemic and hemorrhagic stroke, separately, and identified any relevant lags of exposure among adult New York State residents from 2000 to 2015. Cases were identified via ICD-9 codes from the New York Department of Health Statewide Planning and Reearch Cooperative System. We estimated ambient temperature up to 36 h prior to estimated stroke onset based on patient residential ZIP Code. We applied a time-stratified case-crossover study design; control periods were matched to case periods by year, month, day of week, and hour of day. Additionally, we assessed effect modification by leading stroke risk factors hypertension and atrial fibrillation. RESULTS: We observed 578,181 ischemic and 164,755 hemorrhagic strokes. Among ischemic and hemorrhagic strokes respectively, the mean (standard deviation; SD) patient age was 71.8 (14.6) and 66.8 (17.4) years, with 55% and 49% female. Temperature ranged from -29.5 °C to 39.2 °C, with mean (SD) 10.9 °C (10.3 °C). We found linear relationships for both stroke types. Higher temperature was associated with ischemic stroke over the 7 h following exposure; a 10 °C increase over 7 h was associated with 5.1% (95% Confidence Interval [CI]: 3.8, 6.4%) increase in hourly stroke rate. In contrast, temperature was negatively associated with hemorrhagic stroke over 5 h, with a 5-h cumulative association of -6.2% (95% CI: 8.6, -3.7%). We observed suggestive evidence of a larger association with hemorrhagic stroke among patients with hypertension and a smaller association with ischemic stroke among those with atrial fibrillation. CONCLUSION: Hourly temperature was positively associated with ischemic stroke and negatively associated with hemorrhagic stroke. Our results suggest that ultra short-term weather influences stroke risk and hypertension may confer vulnerability.
