Short-term effects of NO2 on the risk of stroke hospitalization and interaction with climatic factors: a medical record-based study

Short-term effects of NO2 on the risk of stroke hospitalization and interaction with climatic factors: a medical record-based study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Short-term effects of NO2 on the risk of stroke hospitalization and interaction with climatic factors: a medical record-based study Zhuo Liu, Xiaojuan Ma, Yuhui Geng, Mingbo Chen, Ting Pan, Hua Meng, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4291576/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Evidence for NO2 as a traffic sign pollutant on the risk of stroke in the population is deficient, and there is no clear evidence of an interaction with extreme meteorological conditions. Methods We used a generalized additive model to assess the independent effect of NO2 on stroke, plotted exposure-response curves to assess the relationship between ambient NO2 concentrations and the risk of hospitalization for stroke in the population, and stratified analyses to assess the presence of interactions between NO2 and temperature and humidity. Findings The single-day lagged and cumulative lagged effects of NO2 on the risk of HS hospitalization had the largest effect values at Lag0 (ER = 3.430, 95%CI: 1.326 ~ 5.577), Lag05 (ER = 4.643, 95%CI: 0.781 ~ 8.652), respectively; and the single-day lagged and cumulative lagged effects of NO2 on the risk of IS hospitalization had the largest effect value at The effect values were largest at Lag1 (ER = 2.076, 95%CI: 0.180 ~ 4.007) and Lag02 (ER = 3.347, 95% CI: 0.827 ~ 5.529).High temperature was synergistic with ambient NO2 on the risk of hospitalization in both HS and IS total populations (RERI = 0.083, 95%CI: 0.004 ~ 0.207), (RERI = 0.074, 95%CI: 0.009 ~ 0.168), and low RH and high RH synergistic with ambient NO2 on the risk of hospitalization in HS (RERI = 0.099, 95% CI: 0.052 to 0.142), (RERI = 0.127, 95% CI: 0.111 to 0.155). Interpretation Exposure to NO2 increases the risk of hospitalization related to hemorrhagic and ischemic strokes. NO2 and temperature or humidity interact with risk of stroke hospitalization with sex and age differences. ambient NO2 Meteorological factors Stroke Short-term effects Interaction Figures Figure 1 Figure 2 Figure 3 Figure 4 Full Text Additional Declarations No competing interests reported. Tables are available in the Supplementary Files section. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4291576","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":294369475,"identity":"4205ec0b-883e-4f18-906d-213b27ba3849","order_by":0,"name":"Zhuo Liu","email":"","orcid":"","institution":"Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhuo","middleName":"","lastName":"Liu","suffix":""},{"id":294369478,"identity":"0c951fa8-6756-4f8c-ae8e-d482113a738f","order_by":1,"name":"Xiaojuan Ma","email":"","orcid":"","institution":"Ningxia Medical 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section.\u003c/p\u003e","formattedTitle":"Short-term effects of NO2 on the risk of stroke hospitalization and interaction with climatic factors: a medical record-based study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"ambient NO2, Meteorological factors, Stroke, Short-term effects, Interaction","lastPublishedDoi":"10.21203/rs.3.rs-4291576/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4291576/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEvidence for NO2 as a traffic sign pollutant on the risk of stroke in the population is deficient, and there is no clear evidence of an interaction with extreme meteorological conditions.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe used a generalized additive model to assess the independent effect of NO2 on stroke, plotted exposure-response curves to assess the relationship between ambient NO2 concentrations and the risk of hospitalization for stroke in the population, and stratified analyses to assess the presence of interactions between NO2 and temperature and humidity.\u003c/p\u003e\u003ch2\u003eFindings\u003c/h2\u003e \u003cp\u003eThe single-day lagged and cumulative lagged effects of NO2 on the risk of HS hospitalization had the largest effect values at Lag0 (ER\u0026thinsp;=\u0026thinsp;3.430, 95%CI: 1.326\u0026thinsp;~\u0026thinsp;5.577), Lag05 (ER\u0026thinsp;=\u0026thinsp;4.643, 95%CI: 0.781\u0026thinsp;~\u0026thinsp;8.652), respectively; and the single-day lagged and cumulative lagged effects of NO2 on the risk of IS hospitalization had the largest effect value at The effect values were largest at Lag1 (ER\u0026thinsp;=\u0026thinsp;2.076, 95%CI: 0.180\u0026thinsp;~\u0026thinsp;4.007) and Lag02 (ER\u0026thinsp;=\u0026thinsp;3.347, 95% CI: 0.827\u0026thinsp;~\u0026thinsp;5.529).High temperature was synergistic with ambient NO2 on the risk of hospitalization in both HS and IS total populations (RERI\u0026thinsp;=\u0026thinsp;0.083, 95%CI: 0.004\u0026thinsp;~\u0026thinsp;0.207), (RERI\u0026thinsp;=\u0026thinsp;0.074, 95%CI: 0.009\u0026thinsp;~\u0026thinsp;0.168), and low RH and high RH synergistic with ambient NO2 on the risk of hospitalization in HS (RERI\u0026thinsp;=\u0026thinsp;0.099, 95% CI: 0.052 to 0.142), (RERI\u0026thinsp;=\u0026thinsp;0.127, 95% CI: 0.111 to 0.155).\u003c/p\u003e\u003ch2\u003eInterpretation\u003c/h2\u003e \u003cp\u003eExposure to NO2 increases the risk of hospitalization related to hemorrhagic and ischemic strokes. NO2 and temperature or humidity interact with risk of stroke hospitalization with sex and age differences.\u003c/p\u003e","manuscriptTitle":"Short-term effects of NO2 on the risk of stroke hospitalization and interaction with climatic factors: a medical record-based study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-26 20:00:14","doi":"10.21203/rs.3.rs-4291576/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"32e7c765-f44e-4417-bce0-d89b94714e50","owner":[],"postedDate":"April 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-18T12:08:26+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-26 20:00:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4291576","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4291576","identity":"rs-4291576","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}