Ambient air pollution has been linked to stroke, but few studies have examined in detail stroke subtypes and confounding by road traffic noise, which was recently associated with stroke. Here we examined the association between long-term exposure to air pollution and incidence of stroke (overall, ischemic, hemorrhagic), adjusting for road traffic noise. In a nationwide Danish Nurse Cohort consisting of 23,423 nurses, recruited in 1993 or 1999, we identified 1,078 incident cases of stroke (944 ischemic and 134 hemorrhagic) up to December 31, 2014, defined as first-ever hospital contact. The full residential address histories since 1970 were obtained for each participant and the annual means of air pollutants (particulate matter with diameter < 2.5 µm and < 10 µm (PM_2.5 and PM₁₀), nitrogen dioxide (NO₂), nitrogen oxides (NOx)) and road traffic noise were determined using validated models. Time-varying Cox regression models were used to estimate hazard ratios (HR) (95% confidence intervals (CI)) for the associations of one-, three, and 23-year running mean of air pollutants with stroke adjusting for potential confounders and noise. In fully adjusted models, the HRs (95% CI) per interquartile range increase in one-year running mean of PM_2.5 and overall, ischemic, and hemorrhagic stroke were 1.12 (1.01–1.25), 1.13 (1.01–1.26), and 1.07 (0.80–1.44), respectively, and remained unchanged after adjustment for noise. Long-term exposure to ambient PM_2.5 was associated with the risk of stroke independent of road traffic noise.

环境空气污染已与中风相关，但很少有研究详细研究中风亚型和道路交通噪音（最近与中风有关）的混淆。在这里，我们检查了长期暴露于空气污染与中风发生率（整体，局部缺血，大出血）之间的关系，并针对道路交通噪声进行了调整。在1993年或1999年招募的由23,423名护士组成的全国性丹麦护士队列中，我们确定了截至2014年12月31日的1078例中风事件（944例缺血和134例出血），这是有史以来第一次住院。获得了每个参与者的自1970年以来的完整住所地址历史记录和年度空气污染物平均值（直径<2.5 µm和<10 µm的颗粒物（PM _2.5和PM ₁₀），二氧化氮（NO ₂），氮氧化物（NOx））和道路交通噪音均使用经过验证的模型确定。使用随时间变化的Cox回归模型来估算危险性（HR）（95％置信区间（CI）），以估算空气污染物的一年，三年和23年平均值与通过冲程调整的潜在混杂因素和噪声的关联。在完全调整的模型中，PM _2.5和整体，缺血性和出血性卒中的一年运行平均值使每个四分位间距的HR（95％CI）分别为1.12（1.01–1.25），1.13（1.01–1.26）和1.07 （0.80–1.44），并且在调整噪声后保持不变。长期暴露于环境PM _2.5与中风风险相关，而与道路交通噪声无关。