Lack of association between air pollutant exposure and short-term risk of ischaemic stroke in Lyon, France.
BACKGROUND
Some observational and experimental studies have suggested a short-term relationship between air pollutants and ischaemic stroke; however, the results conflict.


OBJECTIVE
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.
Hôpital Pierre Wertheimer, Stroke Center, Hospices Civils de Lyon, Bron-Lyon, France. laura.mechtouff@chu-lyon.fr
Laura
L
Mechtouff
Florence
F
Canoui-Poitrine
Anne-Marie
AM
Schott
Norbert
N
Nighoghossian
Paul
P
Trouillas
Anne
A
Termoz
Sylvie
S
Porthault-Chatard
Jean-Stephane
JS
David
Virginie
V
Chasles
Laurent
L
Derex
D000368:Aged; D000393:Air Pollutants / Q000633:toxicity*; D018592:Cross-Over Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D052638:Particulate Matter / Q000633:toxicity*; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D014504:Urban Health
D000393:Air Pollutants; D052638:Particulate Matter