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No associations between environmental exposures and stroke severity in a low pollution area in Sweden
Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg; Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg; Dep of Rehabilitation Medicine, Sahlgrenska University Hospital, Gothenburg.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
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2025 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 15, no 1, article id 20218Article in journal (Refereed) Published
Sustainable development
SDG 3: Good health and well-being, SDG 11: Sustainable cities and communities
Abstract [en]

Mounting evidence supports associations between air pollution and noise exposure and cardiovascular events; however, the relationships at low exposure levels and for stroke outcomes remain uncertain. The aim was to investigate the associations between environmental exposures over 1-year and 10-year periods and both stroke severity and stroke type in a registry-based cohort including people with stroke residing in a low-pollution area of Sweden. Patients with stroke admitted to the Sahlgrenska University Hospital from 2014 to 2019 were included. Stroke severity was assessed with the National Institutes of Health Stroke Scale and stroke types were ischemic and hemorrhagic. Annual residential environmental exposures (road traffic noise (LAeq,24h), inhalable particulate matter (PM10), and nitrogen oxides (NOx)) were assigned from high-resolution dispersion models to participants one year and for ten years prior to stroke, respectively. Of 4066 patients, 1965 (48.3%) were women. The mean (± SD) age was 73.6 (14.0) years. A total of 1563 (28%) had moderate to severe stroke, and 3603 (88.6%) had ischemic stroke. We did not find significant associations between environmental exposures (LAeq,24h, NOx, PM10) and stroke severity nor stroke type. The generally low levels of exposure and low variance of these environmental factors might explain the lack of observed associations.

Place, publisher, year, edition, pages
2025. Vol. 15, no 1, article id 20218
Keywords [en]
Air pollution, Cerebrovascular stroke, Epidemiology, Hemorrhagic stroke, Ischemic stroke, Noise, Planetary health, Risk factors
National Category
Occupational Health and Environmental Health Neurology Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:du-50783DOI: 10.1038/s41598-025-06639-wISI: 001512788900013PubMedID: 40542178Scopus ID: 2-s2.0-105008713121OAI: oai:DiVA.org:du-50783DiVA, id: diva2:1977607
Available from: 2025-06-26 Created: 2025-06-26 Last updated: 2025-10-09Bibliographically approved

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Palstam, Annie

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