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Louis S, Carlson AK, Suresh A, Rim J, Mays M, Ontaneda D, Dhawan A. Impacts of Climate Change and Air Pollution on Neurologic Health, Disease, and Practice: A Scoping Review. Neurology 2023; 100:474-483. [PMID: 36384657 PMCID: PMC9990849 DOI: 10.1212/wnl.0000000000201630] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although the international community collectively seeks to reduce global temperature rise to less than 1.5°C before 2100, irreversible environmental changes have already occurred, and as the planet warms, these changes will continue to occur. As we witness the effects of a warming planet on human health, it is imperative that neurologists anticipate how the epidemiology and incidence of neurologic disease may change. In this review, we organized our analysis around 3 key themes related to climate change and neurologic health: extreme weather events and temperature fluctuations, emerging neuroinfectious diseases, and pollutant impacts. Across each of these themes, we appraised and reviewed recent literature relevant to neurologic disease and practice. METHODS Studies were identified using search terms relating to climate change, pollutants, and neurologic disease in PubMed, OVID MEDLINE, EMBASE, PsycInfo, and gray literature. Studies published between 1990 and 2022 were included if they pertained to human incidence or prevalence of disease, were in English, and were relevant to neurologic disease. RESULTS We identified a total of 364 articles, grouped into the 3 key themes of our study: extreme weather events and temperature fluctuations (38 studies), emerging neuroinfectious diseases (37 studies), and pollutant impacts (289 studies). The included studies highlighted the relationships between neurologic symptom exacerbation and temperature variability, tick-borne infections and warming climates, and airborne pollutants and cerebrovascular disease incidence and severity. DISCUSSION Temperature extremes and variability both associated with stroke incidence and severity, migraine headaches, hospitalization in patients with dementia, and multiple sclerosis exacerbations. Exposure to airborne pollutants, especially PM2.5 and nitrates, associated with stroke incidence and severity, headaches, dementia risk, Parkinson disease, and MS exacerbation. Climate change has demonstrably expanded favorable conditions for zoonotic diseases beyond traditional borders and poses the risk of disease in new, susceptible populations. Articles were biased toward resource-rich regions, suggesting a discordance between where research occurs and where changes are most acute. As such, 3 key priorities emerged for further study: neuroinfectious disease risk mitigation, understanding the pathophysiology of airborne pollutants on the nervous system, and methods to improve delivery of neurologic care in the face of climate-related disruptions.
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Affiliation(s)
- Shreya Louis
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH
| | - Alise K Carlson
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH
| | - Abhilash Suresh
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH
| | - Joshua Rim
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH
| | - MaryAnn Mays
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH
| | - Daniel Ontaneda
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH
| | - Andrew Dhawan
- From the Lerner College of Medicine (S.L.), Cleveland Clinic, OH; and Neurological Institute (A.K.C., A.S., J.R., M.M., D.O., A.D.), Cleveland Clinic, OH.
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Association between extreme ambient temperature and onset of ischemic stroke: Time series study in Wuhan and Yichang, China. eNeurologicalSci 2021. [DOI: 10.1016/j.ensci.2021.100372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Khan K, Tanaka-Mizuno S, Turin TC, Takashima N, Kadota A, Ueshima H, Miura K, Kita Y. Relationship of Ambient Temperature Parameters to Stroke Incidence in a Japanese Population - Takashima Stroke Registry, Japan, 1988-2010. Circ J 2021; 85:2215-2221. [PMID: 34321376 DOI: 10.1253/circj.cj-21-0325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Using a population-based stroke registry system, we evaluated the relationship between ambient temperature parameters and stroke incidence in a Japanese population.Methods and Results:We analyzed data from the Takashima Stroke Registry, which records all stroke occurrences in Takashima City, Japan. The study period of 8,401 days was divided into quintiles of daily weather parameters, and the middle quintile was used as the reference category. Incidence rates (IR per 100,000 person-years) were calculated across the quintiles. Poisson regression analysis was used to calculate the effect of temperature parameters on stroke incidence. There were 2,405 first-ever strokes (1,294 men), including 1,625 ischemic, 545 cerebral hemorrhages, 213 subarachnoid hemorrhages, and 22 unclassified strokes. The stroke IR was higher in the middle quintile of average temperature, 357.3 (328.4-388.8), and for other parameters. After adjustment for age and sex, for all stroke, the incidence rate ratio (IRR) in the highest (Q5: IRR 0.81, 95% confidence interval (CI) 0.71-0.92) and the second-highest (Q4: IRR 0.80, 95% CI 0.71-0.91) quintile was lower than that in the middle quintile (Q3: Reference). Analogous results were observed for the minimum, maximum, and lag-days temperatures, also in the subtypes and across ≥65 years of age, also in females. CONCLUSIONS Higher temperatures, irrespective of the parameter (average, minimum, or maximum), had a protective effect against stroke occurrence in Japan.
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Affiliation(s)
- Kawser Khan
- Department of Public Health, Shiga University of Medical Science.,National Heart Foundation Hospital and Research Institute
| | - Sachiko Tanaka-Mizuno
- Department of Medical Statistics, Shiga University of Medical Science.,Department of Digital Health and Epidemiology, Kyoto University
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science.,Department of Public Health, Kindai University, Faculty of Medicine
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science.,NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science.,NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science.,NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Yoshikuni Kita
- Department of Public Health, Shiga University of Medical Science.,Tsuruga Nursing University
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Yang X, Zhang L, Chen X, Liu F, Shan A, Liang F, Li X, Wu H, Yan M, Ma Z, Dong G, Liu Y, Chen J, Wang T, Zhao B, Liu Y, Gu D, Tang N. Long-term exposure to ambient PM 2.5 and stroke mortality among urban residents in northern China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 213:112063. [PMID: 33636465 PMCID: PMC8150861 DOI: 10.1016/j.ecoenv.2021.112063] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/01/2021] [Accepted: 02/11/2021] [Indexed: 05/09/2023]
Abstract
Evidence is still limited for the role of long-term PM2.5 exposure in cerebrovascular diseases among residents in high pollution regions. The study is aimed to investigate the long-term effects of PM2.5 exposure on stroke mortality, and further explore the effect modification of temperature variation on the PM2.5-mortality association in northern China. Based on a cohort data with an average follow-up of 9.8 years among 38,435 urban adults, high-resolution estimates of PM2.5 derived from a satellite-based model were assigned to each participant. A Cox regression model with time-varying exposures and strata of geographic regions was employed to assess the risks of stroke mortality associated with PM2.5, after adjusting for individual risk factors. The cross-product term of PM2.5 exposure and annual temperature range was further added into the regression model to test whether the long-term temperature variation would modify the association of PM2.5 with stroke mortality. Among the study participants, the annual mean level of PM2.5 concentration was 66.3 μg/m3 ranging from 39.0 μg/m3 to 100.6 μg/m3. For each 10 μg/m3 increment in PM2.5, the hazard ratio (HR) was 1.31 (95% CI: 1.04-1.65) for stroke mortality after multivariable adjustment. In addition, the HRs of PM2.5 decreased gradually as the increase of annual temperature range with the HRs of 1.95 (95% CI: 1.36-2.81), 1.53 (95% CI: 1.06-2.22), and 1.11 (95% CI: 0.75-1.63) in the low, middle, and high group of annual temperature range, respectively. The findings provided further evidence of long-term PM2.5 exposure on stroke mortality in high-exposure settings such as northern China, and also highlighted the view that assessing the adverse health effects of air pollution might not ignore the role of temperature variations in the context of climate change.
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Affiliation(s)
- Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Liwen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Fengchao Liang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xuejun Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Hui Wu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Mengfan Yan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Zhao Ma
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yamin Liu
- School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Jie Chen
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tong Wang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Baoxin Zhao
- Taiyuan Center for Disease Control and Prevention, Taiyuan 030001, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China.
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Lavados PM, Olavarría VV, Hoffmeister L. Ambient Temperature and Stroke Risk. Stroke 2018; 49:255-261. [DOI: 10.1161/strokeaha.117.017838] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/30/2017] [Accepted: 11/09/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Pablo M. Lavados
- From the Departamento de Neurología y Psiquiatría (P.M.L., V.V.O.) y Departamento de Paciente Crítico (V.V.O.), Unidad de Neurología Vascular, Servicio de Neurología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Chile; Departamento de Ciencias Neurológicas, Universidad de Chile, Santiago (P.M.L.); and Escuela de Salud Pública, Facultad de Ciencias, Universidad Mayor, Santiago, Chile (L.H.)
| | - Verónica V. Olavarría
- From the Departamento de Neurología y Psiquiatría (P.M.L., V.V.O.) y Departamento de Paciente Crítico (V.V.O.), Unidad de Neurología Vascular, Servicio de Neurología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Chile; Departamento de Ciencias Neurológicas, Universidad de Chile, Santiago (P.M.L.); and Escuela de Salud Pública, Facultad de Ciencias, Universidad Mayor, Santiago, Chile (L.H.)
| | - Lorena Hoffmeister
- From the Departamento de Neurología y Psiquiatría (P.M.L., V.V.O.) y Departamento de Paciente Crítico (V.V.O.), Unidad de Neurología Vascular, Servicio de Neurología, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Chile; Departamento de Ciencias Neurológicas, Universidad de Chile, Santiago (P.M.L.); and Escuela de Salud Pública, Facultad de Ciencias, Universidad Mayor, Santiago, Chile (L.H.)
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Li JM, Zhang C. Value of serum OPN levels in patients with acute cerebral hemorrhage for assessment of nerve function impairment. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2016.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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