The association between wind-related variables and stroke symptom onset: A case-crossover study on Jeju Island

Association between synoptic types in Beijing and acute myocardial infarction hospitalizations: A comprehensive analysis of environmental factors

BACKGROUND

Environmental factors like air pollution and temperature can trigger acute myocardial infarction (AMI). However, the link between large-scale weather patterns (synoptic types) and AMI admissions has not been extensively studied. This research aimed to identify the different synoptic air types in Beijing and investigate their association with AMI occurrences.

METHODS

We analyzed data from Beijing between 2013 and 2019, encompassing 2556 days and 149,632 AMI cases. Using principal component analysis and hierarchical clustering, classification into distinct synoptic types was conducted based on weather and pollution measurements. To assess the impact of each type on AMI risk over 14 days, we employed a distributed lag non-linear model (DLNM), with the reference being the lowest risk type (Type 2).

RESULTS

Four synoptic types were identified: Type 1 with warm, humid weather; Type 2 with warm temperatures, low humidity, and long sunshine duration; Type 3 with cold weather and heavy air pollution; and Type 4 with cold temperatures, dryness, and high wind speed. Type 4 exhibited the greatest cumulative relative risk (CRR) of 1.241 (95%CI: 1.150, 1.339) over 14 days. Significant effects of Types 1, 3, and 4 on AMI events were observed at varying lags: 4-12 days for Type 1, 1-6 days for Type 3, and 1-11 days for Type 4. Females were more susceptible to Types 1 and 3, while individuals younger than 65 years old showed increased vulnerability to Types 3 and 4.

CONCLUSION

Among the four synoptic types identified in Beijing from 2013 to 2019, Type 4 (cold, dry, and windy) presented the highest risk for AMI hospitalizations. This risk was particularly pronounced for males and people under 65. Our findings collectively highlight the need for improved methods to identify synoptic types. Additionally, developing a warning system based on these synoptic conditions could be crucial for prevention.

The Influence of Selected Meteorological Factors on the Prevalence and Course of Stroke

Background: The objective of this study was to evaluate the impact of weather factors on stroke parameters. Methods: This retrospective study analyzed the records of stroke patients concerning the influence of meteorological conditions and moon phases on stroke parameters. Results: The study group consisted of 402 patients aged between 20 and 102; women constituted 49.8% of the subjects. Ischaemic stroke was diagnosed in 90.5% of patients and hemorrhagic stroke was diagnosed in 9.5% of patients. The highest number of hospitalizations due to stroke was observed in January (48 events); the lowest number was observed in July (23 events). There was no statistically significant correlation between the meteorological parameters on the day of onset and the preceding day of stroke and the neurological status (NIHSS) of patients. Mean air temperature on the day of stroke and the day preceding stroke was significantly lower in the group of patients discharged with a very good functional status (≤2 points in modified Rankin scale (mRS)) compared to the patients with a bad functional status (>2 points in mRS); respectively: 7.98 ± 8.01 vs. 9.63 ± 7.78; p = 0.041 and 8.13 ± 7.72 vs. 9.70 ± 7.50; p = 0.048). Humidity above 75% on the day of stroke was found to be a factor for excellent functional state (RR 1.61; p = 0.016). The total anterior circulation infarcts (in comparison with stroke in the other localization) were more frequent (70%) during a third quarter moon (p = 0.011). The following parameters had a significant influence on the number of stroke cases in relation to autumn having the lowest number of onsets: mean temperature (OR 1.019 95% CI 1.014–1.024, p < 0.000), humidity (OR 1.028, CI 1.023–1.034, p < 0.0001), wind speed (OR 0.923, 95% CI 0.909–0.937, p < 0.0001), insolation (OR 0.885, 95% CI 0.869–0.902, p < 0.0001), precipitation (OR 0.914, 95% CI 0.884–0.946, p < 0.0001). Conclusion: Air humidity and air temperature on the day of stroke onset as well as air temperature on the day preceding stroke are important for the functional status of patients in the acute disease period. A combination of the following meteorological parameters: lowered mean temperature and low sunshine, high humidity and high wind speed all increase the risk of stroke during the winter period. High humidity combined with high precipitation, low wind speed and low sunshine in the autumn period are associated with the lowest stroke incidence risk. A possible relationship between phases of the moon and the incidence requires further investigation.

Relationship between built environments and risks of ischemic stroke based on meteorological factors: A case study of Wuhan's main urban area

Ischemic stroke is one of the most common causes of death worldwide, and uncomfortable meteorological and built environments may increase its risk. Residents in different built environments are exposed to different risks of ischemic stroke in cold and hot weather. By using the data from 3547 patients hospitalized, a distributed lag non-linear model was established to compare the differences in the risk of ischemic stroke in urban areas with respect to different Building Height, Building Density, Normalized Differential Vegetation Index, and Distance to Water under the meteorological condition. The results showed that lower Building Height is related to the negative cold effects in winter, and higher Building Height is related to increased risks at high temperatures. Built environments with Building Heights of 10-15 m in hot weather and above 15 m in cold weather have low risks. Higher Building Density was found to be associated with reduced negative cold effects; however, the negative hot effects increased in summer. Built environments with a Building Density of more than 0.3 showed low risks, regardless of the weather conditions. Increasing NDVI seemed to mitigate negative effects in uncomfortable weather, and built environments with higher NDVI were found to be associated with lower risks of ischemic stroke. Built environments with shorter Distance to Water seemed to pose higher risks in summer, and longer Distance to Water was correlated with higher risks in winter. Built environments with Distance to Water in the range of 0.65-2.30 km showed low risks. The research results could have some implications for urban planners to form reasonable built environments under certain meteorological factors which can be beneficial for the mitigation of incidence of ischemic stroke.

Impact of Foehn Wind and Related Environmental Variables on the Incidence of Cardiac Events

In Poland there is no data related to the impact of halny wind and the related environmental variables on the incidence of cardiac events. We decided to investigate the relationship between this weather phenomenon, as well as the related environmental variables, and the incidence of cardiac events in the population of southern Poland, a region affected by this type of wind. We also decided to determine whether the environmental changes coincide with or predate the event examined. We analysed data related to 465 patients admitted to the cardiology ward in a large regional hospital during twelve months of 2011 due to acute myocardial infarction. All the patients in the study group lived in areas affected by halny wind and at the time of the event were staying in those areas. The frequency of admissions on halny days did not differ significantly from the admissions on the remaining days of the year (p = 0.496). No statistically significant differences were found between the number of admissions on halny days and on the remaining days during halny months (p = 0.084). We have identified a difference in the number of admissions between days with no halny and days immediately preceding onset of halny (p = 0.001). However, no effects of the related environmental variables have been observed in the incidence of cardiac events (p = 0.866, F = 0.37). On the days with halny wind, incidence of cardiac events is similar to that on the remaining days of the year.

A time series analysis of the relationship between apparent temperature, air pollutants and ischemic stroke in Madrid, Spain

The understanding of the role of environment on the pathogenesis of stroke is gaining importance in the context of climate change. This study analyzes the temporal pattern of ischemic stroke (IS) in Madrid, Spain, during a 13-year period (2001-2013), and the relationship between ischemic stroke (admissions and deaths) incidence and environmental factors on a daily scale by using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of air pollutants and Apparent Temperature (AT), a biometeorological index which represents human thermal comfort on IS, a lag non-linear model was fitted in a generalized additive model. The mortality rate followed a downward trend over the studied period, however admission rates progressively increased. Our results show that both increases and decreases in AT had a marked relationship with IS deaths, while hospital admissions were only associated with low AT. When analyzing the cumulative effects (for lag 0-14 days), with an AT of 1.7 °C (percentile 5%) a RR of 1.20 (95% CI, 1.05-1.37) for IS mortality and a RR of 1.09 (95% CI, 0.91-1.29) for morbidity is estimated. Concerning gender differences, men show higher risks of mortality in low temperatures and women in high temperatures. No significant relationship was found between air pollutant concentrations and IS morbi-mortality, but this result must be interpreted with caution, since there are strong spatial fluctuations of the former between nearby geographical areas that make it difficult to perform correlation analyses.

A new approach to modeling temperature-related mortality: Non-linear autoregressive models with exogenous input

Temperature-mortality relationships are nonlinear, time-lagged, and can vary depending on the time of year and geographic location, all of which limits the applicability of simple regression models in describing these associations. This research demonstrates the utility of an alternative method for modeling such complex relationships that has gained recent traction in other environmental fields: nonlinear autoregressive models with exogenous input (NARX models). All-cause mortality data and multiple temperature-based data sets were gathered from 41 different US cities, for the period 1975-2010, and subjected to ensemble NARX modeling. Models generally performed better in larger cities and during the winter season. Across the US, median absolute percentage errors were 10% (ranging from 4% to 15% in various cities), the average improvement in the r-squared over that of a simple persistence model was 17% (6-24%), and the hit rate for modeling spike days in mortality (>80th percentile) was 54% (34-71%). Mortality responded acutely to hot summer days, peaking at 0-2 days of lag before dropping precipitously, and there was an extended mortality response to cold winter days, peaking at 2-4 days of lag and dropping slowly and continuing for multiple weeks. Spring and autumn showed both of the aforementioned temperature-mortality relationships, but generally to a lesser magnitude than what was seen in summer or winter. When compared to distributed lag nonlinear models, NARX model output was nearly identical. These results highlight the applicability of NARX models for use in modeling complex and time-dependent relationships for various applications in epidemiology and environmental sciences.

The association of ambient temperature with incidence of cardiac arrhythmias in a short timescale

The body response time and an association between the exposure to outdoor temperature and cardiac arrhythmia were not fully understood. Hence, we further investigated the association between ambient temperature and the exacerbations of arrhythmia symptoms on a short timescale using the emergency department (ED) visit data. We used a total of 17,088 arrhythmia-related ED visits in Seoul, from 2008 to 2011 and fitted the model adjusting for other meteorological variables and air pollutants under the case-crossover analysis with the same year-month time stratification. The association was presented as an odds ratio (OR) with a 95% confidence interval (CI) by a 5 °C decrease in the ambient temperature. The delay time (h) between exposure and the onset of arrhythmia exacerbation was considered with time blocks for every 3 h as 1-3 h, up to 118-120 h; and daily lags (1 day), from 25-48 h to 97-120 h, as a multi-time average of exposures. The overall association was increased at lag 4-6 h and the increased association was statistically significant at lag 40-42 h (OR 1.027, 95% CI 1.003-1.051) and the adverse association continued at 97-120 h (OR 1.053, 95% CI 1.027-1.080). However, the delay of several days between ambient temperature and body response should be further investigated considering the modification according to varied demographic characteristics or different environmental circumstances.