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Leinweber ME, Meisenbacher K, Schmandra T, Karl T, Torsello G, Walensi M, Geisbuesch P, Schmitz-Rixen T, Jung G, Hofmann AG. Exploring the Effects of Local Air Pollution on Popliteal Artery Aneurysms. J Clin Med 2024; 13:3250. [PMID: 38892961 PMCID: PMC11172973 DOI: 10.3390/jcm13113250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: A growing body of evidence highlights the effects of air pollution on chronic and acute cardiovascular diseases, such as associations between PM10 and several cardiovascular events. However, evidence of the impact of fine air pollutants on the development and progression of peripheral arterial aneurysms is not available. Methods: Data were obtained from the multicenter PAA outcome registry POPART and the German Environment Agency. Means of the mean daily concentration of PM10, PM2.5, NO2, and O3 concentrations were calculated for 2, 10, and 3650 days prior to surgery for each patient. Additionally, weighted ten-year averages were analyzed. Correlation was assessed by calculating Pearson correlation coefficients, and regression analyses were conducted as multiple linear or multiple logistic regression, depending on the dependent variable. Results: For 1193 patients from the POPART registry, paired air pollution data were available. Most patients were male (95.6%) and received open surgical repair (89.9%). On a regional level, the arithmetic means of the daily means of PM10 between 2000 and 2022 were neither associated with average diameters nor runoff vessels. Negative correlations for mean PAA diameter and mean NO2, as well as a positive correlation with mean O3, were found; however, they were not statistically significant. On patient level, no evidence for an association of mean PM10 exposure over ten years prior to inclusion in the registry and PAA diameter or the number of runoff vessels was found. Weighted PM10, NO2, and O3 exposure over ten years also did not result in significant associations with aneurysm diameter or runoff vessels. Short-term air pollutant concentrations were not associated with symptomatic PAAs or with perioperative complications. Conclusions: We found no indication that long-term air pollutant concentrations are associated with PAA size or severity, neither on a regional nor individual level. Additionally, short-term air pollution showed no association with clinical presentation or treatment outcomes.
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Affiliation(s)
| | - Katrin Meisenbacher
- Department of Vascular and Endovascular Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Thomas Schmandra
- Department of Vascular Surgery, Sana Klinikum Offenbach, 63069 Offenbach, Germany
| | - Thomas Karl
- Department of Vascular and Endovascular Surgery, Klinikum am Plattenwald, SLK-Kliniken Heilbronn GmbH, 74177 Bad Friedrichshall, Germany
| | - Giovanni Torsello
- Department for Vascular Surgery, Franziskus Hospital Münster, 48145 Münster, Germany
| | - Mikolaj Walensi
- Department of Vascular Surgery and Phlebology, Contilia Heart and Vascular Center, 45138 Essen, Germany
| | - Phillip Geisbuesch
- Department of Vascular and Endovascular Surgery, Klinikum Stuttgart, 70199 Stuttgart, Germany
| | - Thomas Schmitz-Rixen
- German Society of Surgery, Langenbeck-Virchow-Haus, Luisenstraße 58/59, 10117 Berlin, Germany
| | - Georg Jung
- Department of Vascular and Endovascular Surgery, Luzerner Kantonsspital, 6000 Lucern, Switzerland
| | - Amun Georg Hofmann
- FIFOS—Forum for Integrative Research and Systems Biology, 1170 Vienna, Austria
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Lichtblau M, Reimann L, Piccari L. Pulmonary vascular disease, environmental pollution, and climate change. Pulm Circ 2024; 14:e12394. [PMID: 38933180 PMCID: PMC11205889 DOI: 10.1002/pul2.12394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024] Open
Abstract
Pollution and climate change constitute a combined, grave and pervasive threat to humans and to the life-support systems on which they depend. Evidence shows a strong association between pollution and climate change on cardiovascular and respiratory diseases, and pulmonary vascular disease (PVD) is no exception. An increasing number of studies has documented the impact of environmental pollution and extreme temperatures on pulmonary circulation and the right heart, on the severity and outcomes of patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (PH), on the incidence of pulmonary embolism, and the prevalence and severity of diseases associated with PH. Furthermore, the downstream consequences of climate change impair health care systems' accessibility, which could pose unique obstacles in the case of PVD patients, who require a complex and sophisticated network of health interventions. Patients, caretakers and health care professionals should thus be included in the design of policies aimed at adaptation to and mitigation of current challenges, and prevention of further climate change. The purpose of this review is to summarize the available evidence concerning the impact of environmental pollution and climate change on the pulmonary circulation, and to propose measures at the individual, healthcare and community levels directed at protecting patients with PVD.
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Affiliation(s)
- Mona Lichtblau
- Clinic of Pulmonology, Pulmonary Hypertension UnitUniversity Hospital ZurichZurichSwitzerland
| | - Lena Reimann
- Clinic of Pulmonology, Pulmonary Hypertension UnitUniversity Hospital ZurichZurichSwitzerland
| | - Lucilla Piccari
- Department of Pulmonary MedicineHospital del MarBarcelonaSpain
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Bumroongkit C, Liwsrisakun C, Deesomchok A, Pothirat C, Theerakittikul T, Limsukon A, Trongtrakul K, Tajarernmuang P, Niyatiwatchanchai N, Euathrongchit J, Inchai J, Chaiwong W. Correlation of Air Pollution and Prevalence of Acute Pulmonary Embolism in Northern Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12808. [PMID: 36232104 PMCID: PMC9566050 DOI: 10.3390/ijerph191912808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The relationship between the level of air pollution and acute pulmonary embolism (APE) has had inconsistent results. OBJECTIVE This study aimed to analyze the relationship between the high level of air pollution exposure and APE. METHODS A ten-year retrospective cohort, single-center study was performed on patients diagnosed with APE from October 2010 to December 2020. The association between air pollution and monthly APE case diagnosis was analyzed. RESULTS A total number of 696 patients was included. The effect of every 10 µg/m3 increment of particulate matters with an aerodynamic diameter < 10 µm (PM10) on total monthly APE cases (unprovoked PE and provoked PE) was increased significantly at lag 4, 5 and 6 months with adjusted RR (95% CI) of 1.06 (1.01, 1.12), p = 0.011, 1.07 (1.01, 1.13), p = 0.021 and 1.06 (1.01, 1.12), p = 0.030, respectively. Adjusted RR for APE was significantly increased for PM10 in the second tertile ((adjusted RR (95% CI) 1.76 (1.12, 2.77)), p = 0.014. CONCLUSIONS We conclude that PM10 is associated with an increased prevalence of APE cases. The policy for tighter control of air pollution in our country is needed to reduce the impact of air pollutants on people's health.
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Affiliation(s)
- Chaiwat Bumroongkit
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chalerm Liwsrisakun
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Athavudh Deesomchok
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chaicharn Pothirat
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Theerakorn Theerakittikul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Atikun Limsukon
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Konlawij Trongtrakul
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Pattraporn Tajarernmuang
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Nutchanok Niyatiwatchanchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juntima Euathrongchit
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Juthamas Inchai
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Warawut Chaiwong
- Division of Pulmonary, Critical Care, and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
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Li Z, Zhang Y, Yuan Y, Yan J, Mei Y, Liu X, Xu Q, Shi J. Association between exposure to air pollutants and the risk of hospitalization for pulmonary embolism in Beijing, China: A case-crossover design using a distributed lag nonlinear model. ENVIRONMENTAL RESEARCH 2022; 204:112321. [PMID: 34748777 DOI: 10.1016/j.envres.2021.112321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/15/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) is a life-threatening condition. Few studies have evaluated the relationship between air pollution and PE, and these results have been inconsistent. Therefore, our study aimed to investigate the association between air pollutant exposure and the risk of hospitalization due to PE. MATERIALS AND METHODS Daily PE admissions, meteorological data, and ambient pollution data from January 1, 2015, to December 31, 2018, were collected in Beijing. A quasi-Poisson regression model combined with time-stratified case-crossover design and a distributed lag nonlinear model was used to determine the effect of air pollutant exposure on PE admission. To examine the stability of air pollutants' effects, multi-pollutant analyses were performed. Stratified analyses by age and sex were further conducted. RESULTS There were 5060 PE admissions during the study period, with an estimated incidence of 6.5 per 100,000. PM2.5, PM10, SO2, O3 and CO exposures were significantly associated with elevated risk of PE hospitalization. The highest cumulative risks were observed at a lag of 0-28 days for PM2.5 (relative risk [RR] = 1.056, 95% confidence intervals [CI]: 1.015-1.098), PM10 (RR = 1.042, 95%CI: 1.010-1.075), and CO (RR = 1.466, 95%CI: 1.127-1.906), at a lag of 0-27 days for SO2 (RR = 1.674, 95%CI: 1.200-2.335), and at a lag of 0-4 days for O3 (RR = 1.019, 95%CI: 1.001-1.038). All associations mentioned above except O3 remained significant in multi-pollutant models. Stratified analyses showed that women and those aged ≥65 years people were more sensitive to PM10 and CO exposure than men and those aged <65 years. The effect of PM2.5 exposure was statistically significant in all subgroups. CONCLUSIONS Exposure to PM2.5, PM10, SO2, and CO showed a positive association with PE hospitalization. High-risk PE groups should take special precautions on days with poor air quality.
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Affiliation(s)
- Zhaohui Li
- Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yunjian Zhang
- Department of Respiratory Medicine, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Yuan Yuan
- Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jingwen Yan
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Xiaoqing Liu
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Clinical Epidemiology Unit, International Epidemiology Network, Beijing, 100730, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Juhong Shi
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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