{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:12:42Z","timestamp":1789135962566,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82373534"],"award-info":[{"award-number":["82373534"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Air pollution exposure has been linked to ischaemic stroke (IS), yet the sensitive life stages for pollution-related IS risk and the interplay of genetic susceptibility remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analysed 404\u2009234 IS-free participants from a large UK prospective cohort. Exposures to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , SO\n                      <jats:sub>2<\/jats:sub>\n                      and O\n                      <jats:sub>3<\/jats:sub>\n                      were estimated across five life stages (toddlerhood, childhood, adolescence, youth and middle-aged to older adulthood) and cumulatively from birth. Bayesian life-course models identified sensitive exposure windows and quantile g-computation estimated mixture effects. Gene\u2013environment interactions with polygenic risk scores (PRSs) were evaluated using relative excess risk due to interaction (RERI), attributable proportion (AP) and synergy index (S).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow-up of 13.6 years, 8130 IS cases occurred. Associations between air pollutants and IS varied by life stage, with stronger associations observed in middle-aged to older adulthood (HRs: 1.586 (95% CI 1.554 to 1.618) for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , 1.180 (1.167\u20131.193) for SO\n                      <jats:sub>2<\/jats:sub>\n                      , 1.588 (1.552\u20131.624) for O\n                      <jats:sub>3<\/jats:sub>\n                      ). For cumulative exposures, elevated risks were seen from toddlerhood to older adulthood (HRs: 1.139\u20131.313). Mixture effects were most pronounced in toddlerhood (HR=2.829, 95% CI 2.623 to 3.052), largely driven by SO\n                      <jats:sub>2<\/jats:sub>\n                      (weight=0.500). Bayesian life-course models suggested PM\n                      <jats:sub>2.5<\/jats:sub>\n                      (25.2%) and O\n                      <jats:sub>3<\/jats:sub>\n                      (24.5%) had greater relative contributions in childhood and adolescence whereas SO\n                      <jats:sub>2<\/jats:sub>\n                      (45.9%) contributed more in later life. Higher pollutant exposure and elevated PRS were associated with higher IS risk (RERI&gt;0, AP&gt;0 and S&gt;1).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Air pollution associations with IS risk vary across life stages and may be influenced by genetic susceptibility, supporting a life-course prevention approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2026-226064","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:20:33Z","timestamp":1781198433000},"page":"770-776","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Sensitive life-stage periods and genetic susceptibility in the association between air pollution and ischaemic stroke risk: a Bayesian life-course 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9934-2478","authenticated-orcid":false,"given":"Fei","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dashan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Ran","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianru","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinzhou","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Key Laboratory of Mitochondrial Medicine and Rare Diseases, Research Institute of Neuromuscular and Neurodegenerative Diseases, Qilu Hospital of Shandong University, Jinan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3643-9408","authenticated-orcid":false,"given":"Hualiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"2026091107001839000_80.10.770.1","first-page":"S6","article-title":"Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions","volume":"97","author":"Saini","year":"2021","journal-title":"Neurology (ECronicon)"},{"key":"2026091107001839000_80.10.770.2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00228-0"},{"key":"2026091107001839000_80.10.770.3","doi-asserted-by":"crossref","first-page":"e542","DOI":"10.1016\/S2542-5196(21)00145-5","article-title":"Ambient air pollution and the risk of ischaemic and 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