An Exposomic Approach looking at the Effect of Climate and Air Pollutant Mixtures on Stroke: a National Study Across Israel

Stroke is the second leading cause of death globally, and a major cause of long-term disability. Several studies found higher risk of stroke associated with air pollution, and temperature exposures. However, current studies have many limitations. First, most studies examine a single exposure, rather than addressing the complex correlation between different pollutants. Second, most studies did not incorporate humidity, which affects the ability to cool the body and modifies how individuals experience heat. Third, many studies are not able to capture the small-scale differences in exposures between geographic locations. This proposed research will innovatively address these limitations and be the first nationwide study to analyze stroke risk based on a combined effect of numerous highly spatiotemporally resolved air pollutants and climatic exposures. First, we will develop satellite-based daily spatiotemporal nitrogen dioxide (originates mostly from traffic) and humidity models across Israel. We will then utilize the national Israeli stroke registry (2014 – 2020), and analyze the combined effects of air pollutants, temperature, and humidity on subtypes of stroke. Additionally, we will identify populations and climate regions that are more vulnerable to the exposure-mixture effect. As climate changes, exposures to both extreme temperatures and air pollution are expected to increase. This is especially relevant in Israel, a country with a variety of climate regions, some featured with extreme heat and humidity conditions.