Residential exposure to petroleum refining and stroke in the southern United States
The southern United States (US) sustains a disproportionate burden of incident stroke and associated mortality, compared to other parts of the US. A large proportion of this risk remains unexplained. Petroleum production and refining (PPR) is concentrated within this region and emits multiple pollut...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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IOP Publishing
2022-01-01
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| Series: | Environmental Research Letters |
| Subjects: | |
| Online Access: | https://doi.org/10.1088/1748-9326/ac8943 |
| _version_ | 1797747287046225920 |
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| author | Honghyok Kim Natalia Festa Kate Burrows Dae Cheol Kim Thomas M Gill Michelle L Bell |
| author_facet | Honghyok Kim Natalia Festa Kate Burrows Dae Cheol Kim Thomas M Gill Michelle L Bell |
| author_sort | Honghyok Kim |
| collection | DOAJ |
| description | The southern United States (US) sustains a disproportionate burden of incident stroke and associated mortality, compared to other parts of the US. A large proportion of this risk remains unexplained. Petroleum production and refining (PPR) is concentrated within this region and emits multiple pollutants implicated in stroke pathogenesis. The relationship between residential PPR exposure and stroke has not been studied. We aimed to investigate the census tract-level association between residential PPR exposure and stroke prevalence for adults (⩾18 years) in seven southern US states in 2018. We conducted spatial distance- and generalized propensity score-matched analysis that adjusts for sociodemographic factors, health behavioral factors, and unmeasured spatial confounding. PPR was measured as inverse-distance weighted averages of petroleum production within 2.5 km or 5 km from refineries, which was strongly correlated with measured levels of sulfur dioxide, a byproduct of PPR. The prevalence of self-reported stroke ranged from 0.4% to 12.7% for all the census tracts of the seven states. People with low socioeconomic status and of Hispanic ethnicity resided closer to petroleum refineries. The non-Hispanic Black population was exposed to higher PPR, while the non-Hispanic White population was exposed to lower PPR. Residential PPR exposure was significantly associated with stroke prevalence. One standard deviation increase in PPR within 5 km from refineries was associated with 0.22 (95% confidence interval: 0.09, 0.34) percentage point increase in stroke prevalence. PPR explained 5.6% (2.4, 8.9) of stroke prevalence in the exposed areas. These values differed by states: 1.1% (0.5, 1.7) in Alabama to 11.7% (4.9, 18.6) in Mississippi, and by census tract-level: 0.08% (0.03, 0.13) to 25.3% (10.6, 40.0). PPR is associated with self-reported stroke prevalence, suggesting possible links between pollutants emitted from refineries and stroke. The increased prevalence due to PPR may differ by sociodemographic factors. |
| first_indexed | 2024-03-12T15:49:32Z |
| format | Article |
| id | doaj.art-11c4e3d3a981419eb33dac9ab314f997 |
| institution | Directory Open Access Journal |
| issn | 1748-9326 |
| language | English |
| last_indexed | 2024-03-12T15:49:32Z |
| publishDate | 2022-01-01 |
| publisher | IOP Publishing |
| record_format | Article |
| series | Environmental Research Letters |
| spelling | doaj.art-11c4e3d3a981419eb33dac9ab314f9972023-08-09T15:16:33ZengIOP PublishingEnvironmental Research Letters1748-93262022-01-0117909401810.1088/1748-9326/ac8943Residential exposure to petroleum refining and stroke in the southern United StatesHonghyok Kim0https://orcid.org/0000-0001-9636-3428Natalia Festa1Kate Burrows2https://orcid.org/0000-0002-0530-6776Dae Cheol Kim3Thomas M Gill4Michelle L Bell5https://orcid.org/0000-0002-3965-1359School of the Environment, Yale University , New Haven, CT 06511, United States of AmericaVeterans Affairs (VA) Office of Academic Affiliations through the VA/National Clinician Scholars Program and Yale University , New Haven, CT, United States of America; National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine , New Haven, CT, United States of AmericaThe Institute at Brown University for Environment and Society, Providence , RI, United States of AmericaGraduate School of Public Health, Seoul National University , Seoul, Republic of KoreaDepartment of Internal Medicine, Yale School of Medicine , New Haven, CT, United States of AmericaSchool of the Environment, Yale University , New Haven, CT 06511, United States of AmericaThe southern United States (US) sustains a disproportionate burden of incident stroke and associated mortality, compared to other parts of the US. A large proportion of this risk remains unexplained. Petroleum production and refining (PPR) is concentrated within this region and emits multiple pollutants implicated in stroke pathogenesis. The relationship between residential PPR exposure and stroke has not been studied. We aimed to investigate the census tract-level association between residential PPR exposure and stroke prevalence for adults (⩾18 years) in seven southern US states in 2018. We conducted spatial distance- and generalized propensity score-matched analysis that adjusts for sociodemographic factors, health behavioral factors, and unmeasured spatial confounding. PPR was measured as inverse-distance weighted averages of petroleum production within 2.5 km or 5 km from refineries, which was strongly correlated with measured levels of sulfur dioxide, a byproduct of PPR. The prevalence of self-reported stroke ranged from 0.4% to 12.7% for all the census tracts of the seven states. People with low socioeconomic status and of Hispanic ethnicity resided closer to petroleum refineries. The non-Hispanic Black population was exposed to higher PPR, while the non-Hispanic White population was exposed to lower PPR. Residential PPR exposure was significantly associated with stroke prevalence. One standard deviation increase in PPR within 5 km from refineries was associated with 0.22 (95% confidence interval: 0.09, 0.34) percentage point increase in stroke prevalence. PPR explained 5.6% (2.4, 8.9) of stroke prevalence in the exposed areas. These values differed by states: 1.1% (0.5, 1.7) in Alabama to 11.7% (4.9, 18.6) in Mississippi, and by census tract-level: 0.08% (0.03, 0.13) to 25.3% (10.6, 40.0). PPR is associated with self-reported stroke prevalence, suggesting possible links between pollutants emitted from refineries and stroke. The increased prevalence due to PPR may differ by sociodemographic factors.https://doi.org/10.1088/1748-9326/ac8943stroke beltoil industrypetroleum refineryenvironmental pollutionenvironmental justicesmall-area variation in stroke |
| spellingShingle | Honghyok Kim Natalia Festa Kate Burrows Dae Cheol Kim Thomas M Gill Michelle L Bell Residential exposure to petroleum refining and stroke in the southern United States Environmental Research Letters stroke belt oil industry petroleum refinery environmental pollution environmental justice small-area variation in stroke |
| title | Residential exposure to petroleum refining and stroke in the southern United States |
| title_full | Residential exposure to petroleum refining and stroke in the southern United States |
| title_fullStr | Residential exposure to petroleum refining and stroke in the southern United States |
| title_full_unstemmed | Residential exposure to petroleum refining and stroke in the southern United States |
| title_short | Residential exposure to petroleum refining and stroke in the southern United States |
| title_sort | residential exposure to petroleum refining and stroke in the southern united states |
| topic | stroke belt oil industry petroleum refinery environmental pollution environmental justice small-area variation in stroke |
| url | https://doi.org/10.1088/1748-9326/ac8943 |
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