Cardiovascular

Time-series analysis of the impact of short-term exposure to atmospheric pollutants on stroke risk among residents in Guiyang City, 2016-2021.

Zhang L, Su M, et al. • Frontiers in public health • 2026

PubMed 42964290 DOI 10.3389/fpubh.2026.1777772
TL;DR

Even under low pollution levels in Guiyang City, short-term exposure to PM2.5, PM10, SO2, NO2, O3 and CO is significantly associated with increased stroke risk with a lag effect, particularly among women and older adults.

Key Findings

Results

The study identified 11,517 stroke cases among Guiyang residents from 2016 to 2021, averaging 5.25 cases per day.

  • Daily data on stroke incidence, air pollutants, and meteorological conditions for permanent residents were collected for 2016-2021.
  • Guiyang is described as a low-pollution karst city in Southwest China, a setting where research on air pollution and stroke has been limited.
Results

Short-term exposure to all six studied pollutants was positively associated with stroke risk.

  • Pollutants were PM2.5, PM10, SO2, NO2, O3 (per 10 μg/m3 increase) and CO (per 1 mg/m3 increase).
  • A generalized additive model with a quasi-Poisson distribution was used, controlling for long-term trends, meteorological factors, day-of-week effects, and holiday effects.
  • Both single-day and cumulative lag models were used to examine lag effects.
Results

At maximum lag, relative risks for stroke were elevated for each pollutant, with the largest effect for CO.

  • PM2.5 RR 1.026 (95% CI 1.005-1.048); PM10 RR 1.015 (1.001-1.030).
  • SO2 RR 1.075 (1.016-1.137); NO2 RR 1.057 (1.017-1.098).
  • O3 RR 1.013 (1.003-1.023); CO RR 1.346 (1.072-1.691) per 1 mg/m3.
Results

Women were more sensitive than men to all six pollutants, especially CO.

  • For CO, the lag0 RR in women was 1.548 (95% CI 1.116-2.147).
  • Analyses were stratified by gender.
Results

Older adults (≥65 years) showed increased stroke risk across all pollutants, whereas in those <65 years only NO2 and PM10 had statistically significant effects.

  • Analyses were stratified by age (<65 vs ≥65 years).
  • Significant effects in the younger group were limited to NO2 and PM10.
Conclusions

The association between air pollutants and stroke persisted at low pollution levels and showed lag effects.

  • The authors conclude short-term exposure is significantly associated with increased stroke risk with a lag effect even under low pollution levels.
  • They recommend strengthening air quality management and protecting high-risk populations to potentially reduce stroke burden.

What This Means

This study looked at whether short-term increases in air pollution were linked to more strokes in Guiyang, a relatively low-pollution city in Southwest China. Researchers analyzed daily records of 11,517 strokes (about 5 per day) between 2016 and 2021, alongside daily air quality and weather data, using statistical methods that account for long-term trends, weather, day of the week, and holidays. They found that higher levels of all six pollutants examined (fine and coarse particles, sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide) were associated with a modestly higher risk of stroke, with effects appearing over several days. Women appeared more sensitive than men, and adults aged 65 and older were more affected than younger people, for whom only nitrogen dioxide and larger particles showed clear links. This research suggests that air pollution may be linked to stroke risk even where pollution levels are relatively low, and that older adults and women may be particularly vulnerable. As an observational time-series study, it shows association rather than proof of cause, but the authors suggest improved air quality management and protection of high-risk groups could help reduce stroke burden.

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Citation

Zhang L, Su M, Zhai S, Jiang M, Chen X, Liu R, et al.. (2026). Time-series analysis of the impact of short-term exposure to atmospheric pollutants on stroke risk among residents in Guiyang City, 2016-2021.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1777772