Abstract
Particulate air pollution is known to be associated with cardiovascular disease. The relation of particulate air pollution with cerebrovascular disease (CVD) has not been extensively studied, particularly in relation to different subtypes of stroke. A time-series study was conducted to evaluate the association between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. We analyzed 781 CVD consecutive patients living in Mantua county admitted between 2006–08. Data on stroke types, demographic variables, risk factors were available from the Lombardia Stroke Registry. Daily mean value of particulate matter with a diameter <10 µm (PM10), carbon monoxide, nitric oxide, nitrogen dioxide, sulphur dioxide, benzene and ozone were used in the analysis. The association between CVD, ischemic strokes subtypes and pollutants was investigated with a case-crossover design, using conditional logistic regression analysis, adjusting for temperature, humidity, barometric pressure and holidays. Among the 781 subjects admitted 75.7% had ischemic stroke, 11.7% haemorrhagic stroke 12.6% transient ischemic attack. In men admission for stroke was associated with PM10 [odds ratio (OR) 1.01, 95%; confidence interval (CI) 1.00–1.02; P<0.05]. According to the clinical classification, lacunar anterior circulation syndrome stroke type was related to PM10 level registered on the day of admission for both genders (OR: 1.01, 95%; CI: 1.00–1.02; P<0.05) while for total anterior circulation syndrome stroke only in men (OR: 1.04, 95%; CI 1.01–1.07; P<0.05).In conclusion, our study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke.
Highlights
IntroductionUniversity of Milano; 4Clinica Neurologica, Università di Sassari; 5Regional Environmental Protection ly Agency, Mantua; 6Section of Occupational Medicine, Respiratory n Diseases and Toxicology, University o of Perugia, Italy use Abstract ial Particulate air pollution is known to be associated with cardiovascular disease
The impact of air pollution on ischemic levels was clear in some subtypes of Our study, differently from other experistrokes subtypes according to the TOAST and ischemic events and mostly in the male gen- ences, is not likely to be biased by the inclu
Total anterior circulation syn- demonstrated in other clinical studies and the air pollution stations taken into drome (TACI) stroke subtype was associated to the possible mechanism taken into consider- account.[1,24]
Summary
University of Milano; 4Clinica Neurologica, Università di Sassari; 5Regional Environmental Protection ly Agency, Mantua; 6Section of Occupational Medicine, Respiratory n Diseases and Toxicology, University o of Perugia, Italy use Abstract ial Particulate air pollution is known to be associated with cardiovascular disease. The rc relation of particulate air pollution with cerebrovascular disease (CVD) has not been e extensively studied, in relation to m different subtypes of stroke. A time-series study was conducted to evaluate the associam tion between daily air pollution and acute stroke unit hospitalizations in Mantua, Italy. These effects have been explained by release of soluble mediators by the lungs, inducing systemic events including inflammation, blood coagulation, and atherosclerosis, by the direct translocation of ultra fine particles into the systemic circulation, or by the alteration in autonomic cardiac control.[6,7,8,9]
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