BACKGROUND: Air pollution is associated with cardiopulmonary disease and death in the general population. Fine particulate matter (PM2.5) is particularly harmful due to its ability to penetrate into areas of gas exchange within the lungs. Persons with advanced lung disease are believed to be particularly susceptible to PM2.5 exposure, but only a few studies have examined the effect of exposure on this population. Here we investigate the association between PM2.5 exposure and adverse waitlist events among lung transplant (LT) candidates. METHODS: US registry data were used to identify LT candidates listed between January 1, 2010 and December 31, 2016. Annual PM2.5 concentration at year of listing was estimated for each candidate's ZIP Code using National Aeronautics and Space Administration's (NASA) Socioeconomic Data and Applications Center Global Annual PM2.5 Grids. We estimated crude and adjusted hazard ratios for adverse waitlist events, defined as death or removal, using Cox proportional hazards regression. RESULTS: Of the 15 075 included candidates, median age at listing was 60, 43.8% were female individuals, and 81.7% were non-Hispanic White. Median ZIP Code PM2.5 concentration was 9.06 µg/m3. When compared with those living in ZIP Codes with lower PM2.5 exposure (PM2.5 <10.53 µg/m3), candidates in ZIP Codes in the highest quartile of PM2.5 exposure (≥10.53 µg/m3) had 1.14-fold (95% confidence interval, 1.04-1.25) risk of adverse waitlist events. The result remained significant after adjusting for demographics, education, insurance, smoking, lung allocation score, body mass index, and blood type (hazard ratio, 1.17; 95% confidence interval, 1.07-1.29). CONCLUSIONS: Elevated ambient PM2.5 concentration was associated with adverse waitlist events among LT candidates. These findings highlight the impact of air pollution on clinical outcomes in this critically ill population.
BACKGROUND: Air pollution is associated with cardiopulmonary disease and death in the general population. Fine particulate matter (PM2.5) is particularly harmful due to its ability to penetrate into areas of gas exchange within the lungs. Persons with advanced lung disease are believed to be particularly susceptible to PM2.5 exposure, but only a few studies have examined the effect of exposure on this population. Here we investigate the association between PM2.5 exposure and adverse waitlist events among lung transplant (LT) candidates. METHODS: US registry data were used to identify LT candidates listed between January 1, 2010 and December 31, 2016. Annual PM2.5 concentration at year of listing was estimated for each candidate's ZIP Code using National Aeronautics and Space Administration's (NASA) Socioeconomic Data and Applications Center Global Annual PM2.5 Grids. We estimated crude and adjusted hazard ratios for adverse waitlist events, defined as death or removal, using Cox proportional hazards regression. RESULTS: Of the 15 075 included candidates, median age at listing was 60, 43.8% were female individuals, and 81.7% were non-Hispanic White. Median ZIP Code PM2.5 concentration was 9.06 µg/m3. When compared with those living in ZIP Codes with lower PM2.5 exposure (PM2.5 <10.53 µg/m3), candidates in ZIP Codes in the highest quartile of PM2.5 exposure (≥10.53 µg/m3) had 1.14-fold (95% confidence interval, 1.04-1.25) risk of adverse waitlist events. The result remained significant after adjusting for demographics, education, insurance, smoking, lung allocation score, body mass index, and blood type (hazard ratio, 1.17; 95% confidence interval, 1.07-1.29). CONCLUSIONS: Elevated ambient PM2.5 concentration was associated with adverse waitlist events among LT candidates. These findings highlight the impact of air pollution on clinical outcomes in this critically ill population.
Authors: Christopher J Winterbottom; Rupal J Shah; Karen C Patterson; Maryl E Kreider; Reynold A Panettieri; Belinda Rivera-Lebron; Wallace T Miller; Leslie A Litzky; Trevor M Penning; Krista Heinlen; Tara Jackson; A Russell Localio; Jason D Christie Journal: Chest Date: 2017-08-09 Impact factor: 9.410
Authors: A Peters; E Liu; R L Verrier; J Schwartz; D R Gold; M Mittleman; J Baliff; J A Oh; G Allen; K Monahan; D W Dockery Journal: Epidemiology Date: 2000-01 Impact factor: 4.822
Authors: Robin Vos; Bart M Vanaudenaerde; Stijn E Verleden; David Ruttens; Annemie Vaneylen; Dirk E Van Raemdonck; Lieven J Dupont; Geert M Verleden Journal: Transplantation Date: 2012-07-27 Impact factor: 4.939
Authors: T M Egan; S Murray; R T Bustami; T H Shearon; K P McCullough; L B Edwards; M A Coke; E R Garrity; S C Sweet; D A Heiney; F L Grover Journal: Am J Transplant Date: 2006 Impact factor: 8.086
Authors: Cong Liu; Renjie Chen; Francesco Sera; Ana M Vicedo-Cabrera; Yuming Guo; Shilu Tong; Micheline S Z S Coelho; Paulo H N Saldiva; Eric Lavigne; Patricia Matus; Nicolas Valdes Ortega; Samuel Osorio Garcia; Mathilde Pascal; Massimo Stafoggia; Matteo Scortichini; Masahiro Hashizume; Yasushi Honda; Magali Hurtado-Díaz; Julio Cruz; Baltazar Nunes; João P Teixeira; Ho Kim; Aurelio Tobias; Carmen Íñiguez; Bertil Forsberg; Christofer Åström; Martina S Ragettli; Yue-Leon Guo; Bing-Yu Chen; Michelle L Bell; Caradee Y Wright; Noah Scovronick; Rebecca M Garland; Ai Milojevic; Jan Kyselý; Aleš Urban; Hans Orru; Ene Indermitte; Jouni J K Jaakkola; Niilo R I Ryti; Klea Katsouyanni; Antonis Analitis; Antonella Zanobetti; Joel Schwartz; Jianmin Chen; Tangchun Wu; Aaron Cohen; Antonio Gasparrini; Haidong Kan Journal: N Engl J Med Date: 2019-08-22 Impact factor: 91.245