Lack of association between air pollutant exposure and short-term risk of ischaemic stroke in Lyon, France

Authors


  • Conflicts of interests: None declared.
  • Funding: This work was funded by a grant from the Fondation de France. The AVC69 study was funded by a grant from the French Ministry of Health (PHRC interregional 2007 ‘Etude d'observation des délais de prise en charge et des trajectories des accidents vasculaires cérébraux dans le Rhône’).

Correspondence: Laura Mechtouff*, Hospices Civils de Lyon, Stroke Center, Hôpital Pierre Wertheimer, 59 Boulevard Pinel, 69677 Lyon Bron cedex, France.

E-mail: laura.mechtouff@chu-lyon.fr

Abstract

Background

Some observational and experimental studies have suggested a short-term relationship between air pollutants and ischaemic stroke; however, the results conflict.

Aims

The objective of this study was to investigate the association between particulate matter less than 2·5 and 10 microns in aerodynamic diameter, nitrogen dioxide, sulphur dioxide and ozone, and short-term risk of ischaemic stroke in Lyon, France.

Methods

The AVC69 study was a multicenter cohort study in which all consecutive adult patients admitted to one of the emergency or neurological departments of the Rhône area for suspicion of stroke were included during a seven-month period. Only patients with ischaemic stroke living within the study area, composed of Lyon and 18 neighbouring communities with homogenous air pollutants exposure, formed the basis of our study. We adopted a time-stratified case-crossover design to analyse the short-term effect (up to two-days) of air pollutants on ischaemic stroke incidence. Models were adjusted for temperature, variation of atmospheric pressure, minimal relative humidity, influenza epidemics, pollen count, and holidays. Stratified analyses by gender and class age were performed. Different lag times were analysed.

Results

 376 patients were included. Mean age was 76·6 years (±13·7). 53·7% were women. No association was observed between air pollutants and short-term risk of ischaemic stroke after adjustment for main confounding factors. Results remained unchanged whatever the gender or age.

Conclusions

These results suggest a lack of association between air pollutant exposure and short-term risk of ischaemic stroke in a French urban area.

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