Evidence map›Paper›PMID 25810496›Full record

SynthesisBMJ (Clinical research ed.)2015

Short term exposure to air pollution and stroke: systematic review and meta-analysis.

Anoop S V Shah, Kuan Ken Lee, David A McAllister, Amanda Hunter, Harish Nair, William Whiteley, Jeremy P Langrish, David E Newby, Nicholas L Mills

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 350 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
350citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

350 citing papers in PubMed, 13 syntheses or guidelines pooled it.

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  13. Short-term exposure to sulphur dioxide (SOEnvironment international · 2021
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290 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Anoop S V ShahBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK anoopsshah@gmail.com.
Kuan Ken LeeBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK.
David A McAllisterCentre of Population Health Sciences, University of Edinburgh, Edinburgh, UK.
Amanda HunterBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK.
Harish NairCentre of Population Health Sciences, University of Edinburgh, Edinburgh, UK.
William WhiteleyCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Jeremy P LangrishBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK.
David E NewbyBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK.
Nicholas L MillsBHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4SB, UK.

Funding

British Heart Foundation CH/09/002British Heart Foundation FS/10/024/28266British Heart Foundation PG/11/27/28842British Heart Foundation RG/10/9/28286British Heart Foundation SS/CH/09/002Medical Research Council G0902303Wellcome Trust 103782
6 · The paper itself

Abstract

objectiveTo review the evidence for the short term association between air pollution and stroke.

designSystematic review and meta-analysis of observational studies DATA SOURCES: Medline, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science searched to January 2014 with no language restrictions. ELIGIBILITY CRITERIA: Studies investigating the short term associations (up to lag of seven days) between daily increases in gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate matter (<2.5 µm or <10 µm diameter (PM2.5 and PM10)), and admission to hospital for stroke or mortality.

main outcome measuresAdmission to hospital and mortality from stroke.

resultsFrom 2748 articles, 238 were reviewed in depth with 103 satisfying our inclusion criteria and 94 contributing to our meta-estimates. This provided a total of 6.2 million events across 28 countries. Admission to hospital for stroke or mortality from stroke was associated with an increase in concentrations of carbon monoxide (relative risk 1.015 per 1 ppm, 95% confidence interval 1.004 to 1.026), sulphur dioxide (1.019 per 10 ppb, 1.011 to 1.027), and nitrogen dioxide (1.014 per 10 ppb, 1.009 to 1.019). Increases in PM2.5 and PM10 concentration were also associated with admission and mortality (1.011 per 10 μg/m(3) (1.011 to 1.012) and 1.003 per 10 µg/m(3) (1.002 to 1.004), respectively). The weakest association was seen with ozone (1.001 per 10 ppb, 1.000 to 1.002). Strongest associations were observed on the day of exposure with more persistent effects observed for PM(2·5).

conclusionGaseous and particulate air pollutants have a marked and close temporal association with admissions to hospital for stroke or mortality from stroke. Public and environmental health policies to reduce air pollution could reduce the burden of stroke. SYSTEMATIC REVIEW REGISTRATION: PROSPERO-CRD42014009225.

Indexed as

Air PollutantsAir PollutionEnvironmental ExposureHumansParticulate MatterPatient AdmissionRisk FactorsStrokeAir PollutantsParticulate Matter

Identifiers

PMID25810496
PMCPMC4373601

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.