Clustering of Environmental Parameters and the Risk of Acute Ischaemic Stroke.
Geraldine P Y KooHuili ZhengJoel C L AikBenjamin Yong Qiang TanVijay Kumar SharmaChing Hui SiaMarcus Eng-Hock OngAndrew Fu-Wah HoPublished in: International journal of environmental research and public health (2023)
Acute ischaemic stroke (AIS) risk on days with similar environmental profiles remains unknown. We investigated the association between clusters of days with similar environmental parameters and AIS incidence in Singapore. We grouped calendar days from 2010 to 2015 with similar rainfall, temperature, wind speed, and Pollutant Standards Index (PSI) using k-means clustering. Three distinct clusters were formed 'Cluster 1' containing high wind speed, 'Cluster 2' having high rainfall, and 'Cluster 3' having high temperatures and PSI. We aggregated the number of AIS episodes over the same period with the clusters and analysed their association using a conditional Poisson regression in a time-stratified case-crossover design. Comparing the three clusters, Cluster 3 had the highest AIS occurrence (IRR 1.09; 95% confidence interval (CI) 1.05-1.13), with no significant difference between Clusters 1 and 2. Subgroup analyses in Cluster 3 showed that AIS risk was amplified in the elderly (≥65 years old), non-smokers, and those without a history of ischaemic heart disease/atrial fibrillation/vascular heart disease/peripheral vascular disease. In conclusion, we found that AIS incidence may be higher on days with higher temperatures and PSI. These findings have important public health implications for AIS prevention and health services delivery during at-risk days, such as during the seasonal transboundary haze.
Keyphrases
- public health
- atrial fibrillation
- liver failure
- risk factors
- human health
- respiratory failure
- risk assessment
- pulmonary hypertension
- heart failure
- life cycle
- smoking cessation
- randomized controlled trial
- clinical trial
- acute coronary syndrome
- mitral valve
- middle aged
- intensive care unit
- mass spectrometry
- open label
- percutaneous coronary intervention
- climate change
- high speed