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Airborne pollutants and lacunar stroke: a case cross-over analysis on stroke unit admissions

Francesco Corea, Giorgio Silvestrelli, Andrea Baccarelli, Alessandra Giua, Paolo Previdi, Giorgio SIliprandi, Nicola Murgia
  • Francesco Corea
    Brain Injury Unit, San Giovanni Battista Hospital, Foligno, Italy |
  • Giorgio Silvestrelli
    Stroke Unit, Carlo Poma Hospital, Mantova, Italy
  • Andrea Baccarelli
    Department of Environmental and Occupational Health, IRCCS Maggiore Policlinico Hospital, Mangiagalli and Regina Elena Foundation and University of Milano, Italy
  • Alessandra Giua
    Clinica Neurologica, Università di Sassari, Italy
  • Paolo Previdi
    Stroke Unit, Division of Neurology, Carlo Poma Hospital, Mantua, Italy
  • Giorgio SIliprandi
    Regional Environmental Protection Agency, Mantua, Italy
  • Nicola Murgia
    Section of Occupational Medicine, Respiratory Diseases and Toxicology. University of Perugia, Italy


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 mm (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.


stroke, air pollution

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Submitted: 2012-01-22 15:34:32
Published: 2012-08-24 14:37:05
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Copyright (c) 2012 Francesco Corea, Giorgio Silvestrelli, Andrea Baccarelli, Alessandra Giua, Paolo Previdi, Giorgio SIliprandi, Nicola Murgia

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