Search

To examine whether high ambient temperature and diurnal temperature range during the summer are associated with risk of stroke/transient ischemic attack (TIA). A time-stratified case-crossover study design was conducted. The study sample comprised all individuals aged ≥50 years who had a stroke/TIA reported to the Israeli National Stroke Registry between 2014 and 2016 during the summer season. Daily temperature data were retrieved from the Israel Meteorological Service. Conditional logistic regression models were used with relative humidity and air pollution as covariates. The sample included 15,123 individuals who had a stroke/TIA during the summer season (mean age 73 ± 12 years; 54% males). High ambient temperature was associated with stroke/TIA risk starting from the day before the stroke event, and increasing in strength over a six-day lag (OR = 1.10 95%CI 1.09–1.12). Moreover, a larger diurnal temperature range prior to stroke/TIA occurrence was associated with decreased stroke/TIA risk (OR = 0.96 95%CI 0.95–0.97 for a six-day lag). High ambient temperature may be linked to increased risk of cerebrovascular events in subsequent days. However, relief from the heat during the night may attenuate this risk. • Weather conditions are emerging as novel risk factors for stroke. • High temperatures were associated with increased stroke risk. • A lag period of 1–6 days existed between the day of exposure and the stroke event. • Larger diurnal temperature ranges were linked with reduced stroke risk. [ABSTRACT FROM AUTHOR]

A growing body of literature reports associations between exposure to particulate matter with diameter ≤2.5 μm (PM 2.5) during pregnancy and birth outcomes. However, findings are inconsistent across studies. To assess the association between PM 2.5 and birth outcomes of fetal growth in a cohort with high prevalence of siblings by multilevel models accounting for geographical- and mother-level correlations. In Israel, we used Maccabi Healthcare Services data to establish a population-based cohort of 381,265 singleton births reaching 24–42 weeks' gestation and birth weight of 500–5000 g (2004–2015). Daily PM 2.5 predictions from a satellite-based spatiotemporal model were linked to the date of birth and maternal residence. We generated mean PM 2.5 values for the entire pregnancy and for exposure periods during pregnancy. Associations between exposure and birth outcomes were modeled by using multilevel logistic regression with random effects for maternal locality of residence, administrative census area (ACA) and mother. In fully adjusted models with a mother-level random intercept only, a 10-μg/m3 increase in PM 2.5 over the entire pregnancy was positively associated with term low birth weight (TLBW) (Odds ratio, OR = 1.25, 95% confidence interval, CI: 1.09,1.43) and small for gestational age (SGA) (OR = 1.15, 95% CI: 1.06,1.26). Locality- and ACA-level effects accounted for <0.4% of the variance while mother-level effects explained ∼50% of the variability. Associations varied by exposure period, infants' sex, birth order, and maternal pre-pregnancy BMI. Consideration of mother-level variability in a region with high fertility rates provides new insights on the strength of associations between PM 2.5 and birth outcomes. • New evidence from the Middle East – a region with scarce data. • Maternal exposure to PM2.5 was associated with fetal growth outcomes. • Associations were clearer when mother-level clustering in the data was accounted for. • Associations were modified by infant's sex, birth order and maternal pre-pregnancy BMI. • Associations were highest for low socio-economic status and for third trimester of pregnancy. [ABSTRACT FROM AUTHOR]