Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study

Yijia Zhang; Qi Yan; Meghan Angley; Liping Lu; Eliza C. Miller; Suzanne Judd; R. William Field; Ka Kahe

doi:10.1161/STROKEAHA.123.043648

Back

Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study

Journal article

Open access

Peer reviewed

Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study

Yijia Zhang, Qi Yan, Meghan Angley, Liping Lu, Eliza C. Miller, Suzanne Judd, R. William Field and Ka Kahe

Stroke (1970), Vol.54(11), pp.2737-2744

11/2023

DOI: 10.1161/STROKEAHA.123.043648

PMCID: PMC10615728

PMID: 37846562

Files and links (1)

url

https://pmc.ncbi.nlm.nih.gov/articles/PMC10615728/pdf/nihms-1932880.pdfView

Open Access

Abstract

BACKGROUND: Exposure to radon has been linked to lung cancer and other lung diseases. Although biologically plausible, research of residential radon exposure in relation to stroke risk is scarce. METHODS: Study participants were from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort (n=30 239), which consisted of male and female non-Hispanic Black and White adults aged 45 and older. After excluding participants with baseline stroke and transient ischemic attack, and missing information on exposure and outcome of interest, the final sample size was 26 950. The primary outcome was time to the first ischemic stroke through September 30, 2020. County-level radon measures from Lawrence Berkeley National Laboratory were linked to each participant based on their geocoded residential history. We used Cox proportional hazards regression models with a time-dependent exposure to estimate hazard ratios and 95% CIs for the association. RESULTS: After controlling for potential confounding factors including demographic, lifestyle, clinical variables, and PM 2.5 , radon exposure was significantly associated with incident ischemic stroke among never-smokers (hazard ratio, 1.39 [95% CI, 1.01–1.90]) but not ever-smokers. The results were generally consistent in the sensitivity analysis when using radon measures from state/Environmental Protection Agency residential radon survey. CONCLUSIONS: Findings from this study suggest that the association between residential radon exposure and incidence of ischemic stroke varies by smoking status and may be prominent in never-smokers. Further studies incorporating indoor-radon measures are needed to confirm these findings.

Details

Title: Subtitle: Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study
Creators: Yijia Zhang - Columbia University
Qi Yan - Columbia University
Meghan Angley - Columbia University
Liping Lu - Columbia University
Eliza C. Miller - Columbia University
Suzanne Judd - University of Alabama at Birmingham
R. William Field - University of Iowa
Ka Kahe - Columbia University
Resource Type: Journal article
Publication Details: Stroke (1970), Vol.54(11), pp.2737-2744
DOI: 10.1161/STROKEAHA.123.043648
PMID: 37846562
PMCID: PMC10615728
NLM abbreviation: Stroke
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Electronic publication date: 10/17/2023
Date published: 11/2023
Academic Unit: Occupational and Environmental Health; Epidemiology
Record Identifier: 9984479261002771

Metrics

47 Record Views

6 Times Cited - Web of Science