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Extensive evidence suggests that ambient air pollution contributes to a higher risk of hospital admissions for cerebrovascular diseases; however, its association with admissions for sequelae of stroke remains unclear. A time‐stratified case‐crossover study was conducted among 31,810 older adults who were admitted to hospital for sequelae of stroke in Guangzhou, China during 2016–2019. For each subject, daily residential exposure to fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) was extracted from a validated grid data set. Conditional logistic regression models were used for exposure‐response analyses. In single‐pollutant models, each interquartile range (IQR) increase of lag 04‐day exposure to CO (IQR: 0.25 mg/m3) and lag 3‐day exposure to O3 (69.6 μg/m3) was significantly associated with a 4.53% (95% confidence interval: 1.67%, 7.47%) and 5.63% (1.92%, 9.48%) increase in odds of hospital admissions for sequelae of stroke, respectively. These associations did not significantly vary across age or sex. With further adjustment for each of the other pollutants in 2‐pollutant models, the association for CO did not change significantly, while the association for O3 disappeared. We estimated that 7.72% of the hospital admissions were attributable to CO exposures. No significant or consistent association was observed for exposure to PM2.5, PM10, SO2, or NO2. In conclusion, short‐term exposure to ambient CO, even at levels below the WHO air quality guideline, was significantly associated with an increased odds of hospital admissions for sequelae of stroke, which may lead to considerable excess hospital admissions. Plain Language Summary: Stroke continues to be the global leading cause of death and adult disability. Despite obvious improvements in the treatment of stroke, about one‐third of stroke survivors experience significantly physical and neuropsychological sequelae. Sequelae of stroke is always disabling and prolonged, which may impose substantially direct and indirect economic burden for individuals, family, and the society. Thus, identifying risk factors for sequelae of stroke is critical to prevent hospital admissions and reduce its burden of disease. As an ongoing public health concern worldwide, ambient air pollution has been linked to a variety of cerebrovascular diseases; however, the adverse effects of ambient air pollution on sequelae of stroke are yet to be evaluated. In this study, we used a case‐crossover design to investigate the effects of ambient air pollution on hospital admissions for sequelae of stroke. We found that short‐term exposure to ambient carbon monoxide (CO) was significantly associated with an increased odds of hospital admissions for sequelae of stroke and posed considerable excess hospital admissions even at CO levels lower than the WHO air quality guideline. Our findings provide new evidence that reducing ambient CO exposures may be an effective approach to prevent hospital admissions for sequelae of stroke. Key Points: Short‐term exposure to ambient carbon monoxide (CO) was significantly associated with an increased odds of hospital admissions for sequelae of strokeAmbient CO exposure may contribute to considerable excess hospital admissions for sequelae of strokeOur findings provide useful clues for the public to help prevent hospital admissions for sequelae of stroke by considering the effect of CO exposure [ABSTRACT FROM AUTHOR]

The acute effects of ambient air pollution on recurrence of ischemic cerebrovascular events (ICEs) remains largely unknown. We therefore conducted a time-stratified case-crossover study of 43,896 patients who were 60 years or older and were admitted to hospital for recurrent ICEs including ischemic stroke and transient ischemic attack in Guangzhou, China during 2016-2019. Based on each patient's home address and pollutant data from its neighboring air quality monitoring stations, we used an inverse distance weighting method to assess exposures to particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). Conditional logistic regression models were used to quantify exposure-response associations. During the study period, there were 43,896 case days and 149,131 control days. In single-pollutant models, each 10 μg/m3 increase in exposure to PM10, NO2 and CO (mean exposure on date of admission and 1 day prior) was significantly associated with a 0.74% (95% confidence interval [CI]: 0.13-1.36%), 2.15% (1.38-2.93%) and 0.14% (0.07-0.21%) increase in odds of hospital admissions for recurrent ICEs, respectively, and no significant departures from linearity were detected. The association for NO2 exposure remained consistent in 2-pollutant models, while the associations for PM10 and CO disappeared or changed materially with adjustment for other pollutants. Stronger association for NO2 exposure was observed in cool season than that in warm season. We found that short-term exposure to ambient air pollutants, especially NO2, was associated with increased risk of hospital admissions for recurrent ICEs in older adults. [ABSTRACT FROM AUTHOR]

Ambient air pollution has been linked to an increased risk of various acute cardiovascular outcomes; however, its effects on hospital admissions for angina are yet to be evaluated. We conducted a time-stratified case-crossover study with conditional logistic regression models among 46,687 adults 60 years or older who were admitted to hospital for angina in Guangzhou, China during 2016–2019 to investigate the association of exposure to ambient particulate matter with an aerodynamic diameter ≤2.5 μm (PM 2.5), particulate matter with an aerodynamic diameter ≤10 μm (PM 10), sulfur dioxide (SO 2), nitrogen dioxide (NO 2), carbon monoxide (CO), and ozone (O 3) with hospital admissions for angina. Daily residential air pollutant exposures were extracted from a grid dataset. Each 10 μg/m3 increase of lag 0-day exposure to PM 10 , SO 2 , NO 2 , CO, and O 3 was significantly associated with a 0.80% (95% confidential interval: 0.32%, 1.28%), 4.04% (0.34%, 7.89%), 2.47% (1.81%, 3.12%), 0.13% (0.07%, 0.19%), and −0.38% (−0.74%, −0.01%) increase in odds of admission, respectively. The association for NO 2 exposure remained stable, while the associations for PM 10 , SO 2 , CO, and O 3 became insignificant with adjustment for other air pollutants. The association for NO 2 exposure was stronger in cool season. We estimated that up to 9.12% of angina admissions were attributable to NO 2 exposure. Our findings suggest that ambient NO 2 may trigger hospital admissions for angina in Chinese older adults, which highlights the importance to prevent angina by reducing individual NO 2 exposures. • Short-term exposure to ambient NO 2 was associated with an increased odds of angina admissions in older adults. • The association for NO 2 was stronger in cool season. • Reducing traffic-related air pollution may be helpful in preventing angina admissions. [ABSTRACT FROM AUTHOR]