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. 2019 Jul 12;16(14):2490.
doi: 10.3390/ijerph16142490.

Association between Ambient Particulate Matter 2.5 Exposure and Mortality in Patients with Hepatocellular Carcinoma

Chern-Horng Lee  1 , Sen-Yung Hsieh  2   3 , Wen-Hung Huang  3   4 , I-Kuan Wang  5 , Tzung-Hai Yen  6   7
Affiliations

Association between Ambient Particulate Matter 2.5 Exposure and Mortality in Patients with Hepatocellular Carcinoma

Chern-Horng Lee et al. Int J Environ Res Public Health. .

Abstract

Air pollution is a severe public health problem in Taiwan. Moreover, Taiwan is an endemic area for hepatocellular carcinoma (HCC). This study examined the effect of particulate matter 2.5 (PM2.5) exposure on mortality in this population. A total of 1003 patients with HCC treated at Chang Gung Memorial Hospital between 2000 and 2009 were included in this study. At the end of the analysis, 288 (28.7%) patients had died. Patients with HCC living in environments with PM2.5 concentrations of ≥36 µg/m3 had a higher mortality rate than patients living in environments with PM2.5 concentrations of <36 µg/m3 (36.8% versus 27.5%, p = 0.034). The multivariate Cox regression analysis confirmed that PM2.5 ≥ 36 µg/m3 was a significant risk factor for mortality (1.584 (1.162-2.160), p = 0.004). A nonlinear relationship was observed between the odds ratio and PM2.5. The odds ratio was 1.137 (1.015-1.264) for each increment of 5 µg/m3 in PM2.5 or 1.292 (1.030-1.598) for each increment of 10 µg/m3 in PM2.5. Therefore, patients with HCC exposed to ambient PM2.5 concentrations of ≥36 µg/m3 had a 1.584-fold higher risk of death than those exposed to PM2.5 concentrations of <36 µg/m3. Further studies are warranted.

Keywords: PM2.5; air pollution; hepatocellular carcinoma; mortality; particulate matter.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic curve analysis. The area under the curve was 0.764, 0.714, and 0.705 in the first, third, and fifth year after the diagnosis of hepatocellular carcinoma, respectively.
Figure 2
Figure 2
Kaplan–Meier analysis. The analysis revealed that patients with hepatocellular carcinoma living in environments with PM2.5 concentrations of ≥36 µg/m3 had a lower cumulative survival than patients living in environments with PM2.5 concentrations of <36 µg/m3 (log-rank test, P = 0.0065).
Figure 3
Figure 3
Plot of the odds ratio versus increments of PM2.5. A nonlinear relationship was observed between the odds ratio and PM2.5. The odds ratio (95% confidence interval) was 1.137 (1.015–1.264) for each increment of 5 µg/m3 in PM2.5 or 1.292 (1.030–1.598) for each increment of 10 µg/m3 in PM2.5.
See this image and copyright information in PMC

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