Exposure to Air Pollutants Increases the Risk of Chronic Rhinosinusitis in Taiwan Residents

Abstract

Air pollution triggers a tissue-specific inflammatory response. However, studies on the association between exposure to air pollutants and chronic rhinosinusitis (CRS) risk remain limited. Thus, we conducted this nationwide study to define the association between air pollution and CRS. We used the Longitudinal Health Insurance Database (LHID) and Taiwan Air Quality-Monitoring Database (TAQMD) to conduct a population-based cohort study. Study participants were recruited from the LHID, a data subset of the National Health Insurance Research Database that randomly sampled one million individuals. TAQMD has been an air pollutant database since 1998. In univariate and multivariate Cox proportional hazards regression models, adjusted hazard ratios (aHRs) and 95% CIs of CRS in five air pollutants were accounted. We adjusted for age, sex, urbanization level, insurance fee, comorbidities, and pollutant levels in the multivariate model. The total number of participants enrolled in this study was 160,504. The average age was 40.46 ± 14.62 years; males constituted 43.8% of the total participants. The percentages of alcoholism, tobacco dependence, and COPD were 1.5%, 2.8%, and 28.3%, respectively. After adjustment for age, sex, urbanization level, insurance fee, and comorbidities, the highest levels of air pollutants, including PM2.5 (aHR = 1.14, 95% CI = 1.06–1.22), NO2 (aHR = 1.07, 95% CI = 1.00–1.15), and PM10 (aHR = 1.13, 95% CI = 1.05–1.21) had a significantly greater CRS risk; we selected the lower concentration as the reference but did not correlate with CO. We found a significantly increased risk of CRS in residents with air pollutant exposure.

The Impact of Social Determinants and Air Pollution on Healthcare Disparities in Chronic Rhinosinusitis With Nasal Polyps

“…32 International studies have also demonstrated that exposure to high levels of air pollution is associated with significantly greater risk for the development of CRS. 3…”

“…32 International studies have also demonstrated that exposure to high levels of air pollution is associated with significantly greater risk for the development of CRS. 3 These associations between increased air pollution exposure and increased risk for the development of CRS, notably severe, refractory CRS, are important to consider in healthcare disparities associated with CRS. Velasquez et al demonstrated that neighborhoods with residents of lower SES were more likely to be exposed to higher levels of air pollutants, including fine particulate matter, black carbon, and nitrogen dioxide, with an incremental increase in air pollutant levels per decrease in standardized measures of SES.…”

“…Although the exact pathophysiology is not fully understood, environmental pollutants have been shown to be associated with the development of CRS, likely through an increased inflammatory response in the nasal passages. 2,3 Globally, increasing air pollution levels have been linked to a variety of respiratory conditions, including allergic rhinitis, asthma, and CRS. Studies have shown an increased incidence of CRS in areas with higher traffic-related air pollution, which may also be areas with residents of lower SES.…”

Machine Learning-Based Analyses of the Effects of Various Types of Air Pollutants on Hospital Visits by Asthma Patients

“…Air pollution is described as the presence of substances in the air that are harmful to humans and linked to a higher risk of diseases [1][2][3][4][5], such as asthma, as a result of increased airway hyperresponsiveness. Various types of air pollutants, such as particulate matter (PM), nitrogen dioxide (NO 2 ), carbon monoxide (CO), carbon dioxide (CO 2 ), sulfur dioxide (SO 2 ), and ozone (O 3 ), have been found to trigger or exacerbate asthma attacks [6][7][8][9][10][11][12][13].…”