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. 2008 May 12;168(9):920-7.
doi: 10.1001/archinte.168.9.920.

Exposure to particulate air pollution and risk of deep vein thrombosis

Andrea Baccarelli  1 , Ida Martinelli, Antonella Zanobetti, Paolo Grillo, Li-Fang Hou, Pier A Bertazzi, Pier Mannuccio Mannucci, Joel Schwartz
Affiliations

Exposure to particulate air pollution and risk of deep vein thrombosis

Andrea Baccarelli et al. Arch Intern Med. .

Abstract

Background: Particulate air pollution has been linked to heart disease and stroke, possibly resulting from enhanced coagulation and arterial thrombosis. Whether particulate air pollution exposure is related to venous thrombosis is unknown.

Methods: We examined the association of exposure to particulate matter of less than 10 microm in aerodynamic diameter (PM10) with deep vein thrombosis (DVT) risk in 870 patients and 1210 controls from the Lombardy region in Italy, who were examined between 1995 and 2005. We estimated exposure to PM10 in the year before DVT diagnosis (cases) or examination (controls) through area-specific mean levels obtained from ambient monitors.

Results: Higher mean PM10 level in the year before the examination was associated with shortened prothrombin time (PT) in DVT cases (standardized regression coefficient [beta] = -0.12; 95% confidence interval [CI], -0.23 to 0.00) (P = .04) and controls (beta = -0.06; 95% CI, -0.11 to 0.00) (P = .04). Each increase of 10 microg/m3 in PM10 was associated with a 70% increase in DVT risk (odds ratio [OR], 1.70; 95% CI, 1.30 to 2.23) (P < .001) in models adjusting for clinical and environmental covariates. The exposure-response relationship was approximately linear over the observed PM10 range. The association between PM10 level and DVT risk was weaker in women (OR, 1.40; 95% CI, 1.02 to 1.92) (P = .02 for the interaction between PM10 and sex), particularly in those using oral contraceptives or hormone therapy (OR, 0.97; 95% CI, 0.58 to 1.61) (P = .048 for the interaction between PM10 level and hormone use).

Conclusions: Long-term exposure to particulate air pollution is associated with altered coagulation function and DVT risk. Other risk factors for DVT may modulate the effect of particulate air pollution.

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Figures

Figure 1
Figure 1
Lombardia Region Map showing the location of the 53 air pollution monitors in the nine areas identified for the study.
Figure 2
Figure 2
Level of Exposure to Fine Particulate Matter and the Risk of Deep Vein Thrombosis. The graph demonstrates the observed relationship between the relative risk of deep vein thrombosis and the level of particulate matter of less than 10 µm in aerodynamic diameter (PM10) in the year preceding the diagnosis. These results suggest a linear relationship between exposure and risk, though the 95% confidence intervals (shaded areas) are wide at the extremes of exposure. Risk is depicted in comparison with a reference value of 12.0 µg per cubic meter (minimum observed PM10 level). The histogram in the bottom part illustrates the density of exposure distribution for air pollution. Risk estimates are adjusted for age, sex, year of diagnosis, area of residence, body mass index, education, current use of oral contraceptives or hormone-replacement therapy, Leiden V or prothrombin mutations, season, and ambient temperature
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References

    1. Dockery DW, Pope CA, 3rd, Xu X, et al. An association between air pollution and mortality in six U.S. cities. N Engl J Med. 1993;329(24):1753–1759. - PubMed
    1. Miller KA, Siscovick DS, Sheppard L, et al. Long-term exposure to air pollution and incidence of cardiovascular events in women. N Engl J Med. 2007;356(5):447–458. - PubMed
    1. Pope CA, 3rd, Burnett RT, Thun MJ, et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. Jama. 2002;287(9):1132–1141. - PMC - PubMed
    1. Brook RD, Franklin B, Cascio W, et al. Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation. 2004;109(21):2655–2671. - PubMed
    1. Utell MJ, Frampton MW, Zareba W, Devlin RB, Cascio WE. Cardiovascular effects associated with air pollution: potential mechanisms and methods of testing. Inhal Toxicol. 2002;14(12):1231–1247. - PubMed

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