{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:31:23Z","timestamp":1774067483430,"version":"3.50.1"},"reference-count":55,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T00:00:00Z","timestamp":1729296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Environmental surroundings reduce the rate of several diseases, especially those related to stressful events. Ischemic stroke can be affected by such events, either directly or through its risk factors. Therefore, the present study evaluates the effects of green spaces and noise exposure on the risk of ischemic stroke. Methods: A case\u2013control study was carried out, including 200 ischemic stroke cases within the first 48 h of diagnosis and 200 controls, divided equally into hospitalized and non-hospitalized participants. Controls were matched to cases based on age and gender. Socio-demographic characteristics were assessed, in addition to environmental surroundings and noise exposure at home and at workplaces. Results: Living in a house, having a house garden, and taking care of the garden were associated with a lower risk of suffering an ischemic stroke (p &lt; 0.001, p &lt; 0.001, and p = 0.009, respectively). However, having buildings as the view from home led to a higher stroke rate (p &lt; 0.001). Working in an urban area, the workplace being surrounded by buildings, and the workplace not being surrounded by green spaces were also associated with a higher risk of suffering an ischemic stroke (p = 0.002, p = 0.001, and p = 0.03, respectively). As for noise exposure, being exposed to traffic noise, human noise, and other types of noise was significantly associated with a higher risk of ischemic stroke, while being exposed to higher levels of natural noise was significantly associated with a lower risk of ischemic stroke. Higher levels of noise were also associated with higher risks of ischemic stroke in homes and workplaces (p &lt; 0.001 and p = 0.008, respectively). Conclusions: Environmental surroundings and noise exposure were found to affect the risk of ischemic stroke. Greater green spaces and lower noise exposure play a protective role against ischemic stroke, suggesting a possible prevention strategy through environmental modifications at home and workplaces.<\/jats:p>","DOI":"10.3390\/ijerph21101382","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T03:57:09Z","timestamp":1729483029000},"page":"1382","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Effects of Green Spaces and Noise Exposure on the Risk of Ischemic Stroke: A Case\u2013Control Study in Lebanon"],"prefix":"10.3390","volume":"21","author":[{"given":"Jad","family":"El Masri","sequence":"first","affiliation":[{"name":"INSERM U955-E01, Institut Mondor de Recherche Biom\u00e9dicale, Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"\u00c9cole Doctorale Sciences de la Vie et de la Sant\u00e9, Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"},{"name":"INSPECT-LB (Institut National de Sant e Publique, d\u2019\u00c9pidemiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Finge","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-0499","authenticated-orcid":false,"given":"Ahmad","family":"Afyouni","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarek","family":"Baroud","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8203-9746","authenticated-orcid":false,"given":"Najla","family":"Ajaj","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos 1102, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diala","family":"El Masri","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Balamand, Koura 1100, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Younes","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-0772","authenticated-orcid":false,"given":"Pascale","family":"Salameh","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Lebanese University, Beirut 1533, Lebanon"},{"name":"INSPECT-LB (Institut National de Sant e Publique, d\u2019\u00c9pidemiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon"},{"name":"School of Medicine, Lebanese American University, Byblos 1102, Lebanon"},{"name":"Faculty of Pharmacy, Lebanese University, Beirut 1533, Lebanon"},{"name":"Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Hosseini","sequence":"additional","affiliation":[{"name":"INSERM U955-E01, Institut Mondor de Recherche Biom\u00e9dicale, Universit\u00e9 Paris-Est Cr\u00e9teil, 94010 Cr\u00e9teil, France"},{"name":"Department of Neurology, Henri Mondor Hospital, AP-HP, 94010 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1161\/01.str.0000437068.30550.cf","article-title":"Factors Influencing the Decline in Stroke Mortality: A Statement from the American Heart Association\/American Stroke Association","volume":"45","author":"Lackland","year":"2014","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Khalid, W., Rozi, S., Ali, T.S., Azam, I., Mullen, M.T., Illyas, S., Un-Nisa, Q., Soomro, N., and Kamal, A.K. 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