2020

Author(s): Ruan Z, Qi J, Yin P, Qian ZM, Liu J, Liu Y, Yang Y, Li H, Zhang S, Howard SW, Lin H, Wang L

This time-series study collects data on stroke-related mortality, years of life lost (YLL), air pollution, and meteorological conditions in 96 Chinese cities from 2013 to 2016 and proposes a three-stage strategy to generate the national and regional estimations of avoidable YLL, gains in life expectancy and stroke-related population attributable fraction by postulating that the daily fine particulate matter (PM(2.5)) has been kept under certain standards. A total of 1 318 911 stroke deaths are analyzed. Each 10 µg m(-3) increment in PM(2.5) at lag(03) is associated with a city-mean increase of 0.31 (95% CI: 0.19, 0.44) years of life lost from stroke. A number of 914.11 (95% CI: 538.28, 1288.94) years of city-mean life lost from stoke could be avoided by attaining the WHO's Air Quality Guidelines (AQG) (25 µg m(-3)). Moreover, by applying the AQG standard, 0.11 (0.08, 0.15) years of life lost might be prevented for each death, and about 0.91% (95% CI: 0.62%, 1.19%) of the total years of life lost from stroke might be explained by the daily excess PM(2.5) exposure. This study indicates that stroke patients can have a longer life expectancy if stricter PM(2.5) standards are put in place, especially ischemic stroke patients.

DOI: https://dx.doi.org/10.1002/gch2.202000048