Annals of Indian Academy of Neurology
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Air pollution and cerebrovascular disorders with special reference to asia: An overview

1 Department of Medicine, Aga Khan University, Karachi, Pakistan
2 Department of Neurology, VMMC and Safdarjung Hospital, New Delhi, India
3 Department of Neurology, Janakpuri Super specialty Hospital, New Delhi, India
4 Department of Neurology, BLK Hospital, New Delhi, India

Correspondence Address:
Mohammad Wasay,
Department of Medicine, Aga Khan University, Karachi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.aian_491_22

Background: Among the primary environmental issues affecting global health, air pollution is considered the leading cause of concern. Globally, around 800,000 deaths were attributed to air pollution according to WHO. Evidence suggests that there has been a strong association of air pollution with stroke. Approximately, 25% of stroke mortality was due to air pollution according to a study in 2013. Objective: The aim of this review was to analyze the association between stroke, intracerebral hemorrhage, and subarachnoid hemorrhage and air pollution and its burden globally with a special focus on South Asia along with its association with the COVID-19 pandemic. Results: There is growing research data linking air pollution to cardiovascular disorders including stroke. Short-term and long-term air pollution exposures have been shown to increase stroke incidence in epidemiological data. Air pollution, both gaseous and particle, show a strong and tight temporal relationship with stroke hospitalizations and death. The link between ICH and SAH to air pollution is less strong and less well studied as compared to ischemic stroke. Stroke and air pollution both are highly prevalent in South Asia. It is possible that the high prevalence of stroke in south Asia may be linked to the high frequency of air pollution in addition to other conventional risk factors. Decreased stroke admissions and mortality and reduced cardiovascular mortality reported during coronavirus disease 2019 (COVID) lockdown may be attributable to decreased levels of air pollution. Conclusion: Even though air pollution poses a significant threat to human health, a great number of countries still fail to achieve internationally agreed air quality standards. Air pollution should be recognized among the most significant controllable risk factors for cardiovascular and cerebrovascular disease prevention and treatment.

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