Abstract: Introduction: The objectives of the present research were to examine the associations of gaseous air pollutants and climate change (humidity and temperature) with occurrence of stroke (incidence), whether the associations differ in season, sex, and age (elderly vs young) in order to capture subpopulations and association with stroke subtypes (ischemic and hemorrhagic and ischemic subtypes). Method: This is a case-crossover design. All strokes within 2 weeks from onset and within 1 year of event were screened and recruited. After a general neurological examination, the following gaseous pollutants were measured: NO2, SO2, and CO along with PM 2.5 and respirable suspended particulate matter PM10 diameter in areas of Delhi in using the help of New Delhi’s Central Pollution Control Board at onset of stroke (24 h interval), 15 days of enrolment and 3 months. The other covariates measured were physical activity, cooking fuel, domestic ventilation, location of house, and socioeconomic status. A smile drive air quality meter was used to measure the indoor pollution. Results: A total of 280 patients were screened, and 110 stroke patients were recruited in the study. The mean age for all patients was 52.3 ± 11.2 years with a mean NIHSS of 5.86 ± 1.3 and mean mRS of 1.04 ± 0.07. N =77 were ischemic, and n = 32 were hemorrhagic; 44.5% were stroke in young, and 70% of the total sample were hypertensive with 63.3% having positive smoking history (n = 70). One-way ANOVA between PM2.5 and PM10 levels at different time points was different (F = 2.9, P = 0.16; F = 1.9, P = 0.43, respectively). The cold season observed the highest number of patients (n = 54); mild cold observed a total of n = 29 patients. Multivariate regression analysis keeping age and type of stroke as constants showed that covariables like type of fuel used and in-house CO followed by PM2.5 showed strong association toward occurrence of stroke (R2 = 0.119, F = 3.92, P = 0.057). Conclusion: The present study indicates that there is some association of occurrence of stroke with air pollution and climatic changes affect the incidence of stroke. PM 2.5 and PM 10 levels through Delhi were different at all time points (F = 1.9, P = 0.043). A quantifiable database will be generated, which can be used to control pollution and consequently in stroke guidelines.
Bhasin et al. (Thu,) studied this question.