Living Near Major Traffic Roads and Risk of Deep Vein Thrombosis

Abstract

Background Particulate air pollution has been consistently linked to increased risk of arterial cardiovascular disease. Few data on air pollution exposure and risk of venous thrombosis are available. We investigated whether living near major traffic roads increases the risk of deep vein thrombosis (DVT), using distance from roads as a proxy for traffic exposure. Methods and Results Between 1995-2005, we examined 663 patients with DVT of the lower limbs and 859 age-matched controls from cities with population>15,000 inhabitants in Lombardia Region, Italy. We assessed distance from residential addresses to the nearest major traffic road using geographic information system methodology. The risk of DVT was estimated from logistic regression models adjusting for multiple clinical and environmental covariates. The risk of DVT was increased (Odds Ratio [OR]=1.33; 95% CI 1.03-1.71; p=0.03 in age-adjusted models; OR=1.47; 95%CI 1.10-1.96; p=0.008 in models adjusted for multiple covariates) for subjects living near a major traffic road (3 meters, 10th centile of the distance distribution) compared to those living farther away (reference distance of 245 meters, 90th centile). The increase in DVT risk was approximately linear over the observed distance range (from 718 to 0 meters), and was not modified after adjusting for background levels of particulate matter (OR=1.47; 95%CI 1.11-1.96; p=0.008 for 10th vs. 90th distance centile in models adjusting for area levels of particulate matter <10 μm in aerodynamic diameter [PM10] in the year before diagnosis). Conclusions Living near major traffic roads is associated with increased risk of DVT.

Air pollution‐associated procoagulant changes: the role of circulating microvesicles

“…Current exposure A portable laser-operated aerosol mass analyzer (Aerocet 531; Met One Instruments Inc., Grant Pass, OR, USA), previously calibrated against a local monitoring station (Flemish Environmental Agency, Borgerhout, Belgium) [31], was used to measure current PM 2.5 and PM 10 concentrations in the hospital waiting room, 1 to 2 h before the patientÕs participation in the study. In general, patients stayed in the waiting room and the neighboring examination room for at least 1 h.…”

“…In addition to the wellrecognized air pollution-related adverse effects on the arterial vascular system [2][3][4][5][6][7][8], recent epidemiological evidence also suggests an association between PM exposure and venous thromboembolism (VTE). Thus, a higher risk for deep vein thrombosis (DVT) was associated with increased annual mean levels of PM with a mean aerodynamic diameter smaller than 10 lm (PM 10 ) in the residential area of the study subjects [9]. In the same study population, living near major traffic roads was also associated with an increased risk of DVT, even after controlling for the community-level PM pollution [10].…”

“…Patients and methods: We assessed potential associations between PM exposure and coagulation and inflammation parameters, including circulating microvesicles, in a group of 233 patients with diabetes. Results: The numbers of circulating blood platelet-derived and annexin V-binding microvesicles were inversely associated with the current levels of PM 2.5 or PM 10 , measured on the day of sampling. Recent past exposure to PM 10 , up to 1 week prior to blood sampling, estimated at the patientsÕ residential addresses, was associated with elevated high-sensitivity C-reactive protein (CRP), leukocytes and fibrinogen, as well as with tissue factor (TF)-dependent procoagulant changes in thrombin generation assays.…”

“…Results: The numbers of circulating blood platelet-derived and annexin V-binding microvesicles were inversely associated with the current levels of PM 2.5 or PM 10 , measured on the day of sampling. Recent past exposure to PM 10 , up to 1 week prior to blood sampling, estimated at the patientsÕ residential addresses, was associated with elevated high-sensitivity C-reactive protein (CRP), leukocytes and fibrinogen, as well as with tissue factor (TF)-dependent procoagulant changes in thrombin generation assays. When longer windows of past exposure were considered, up to 1 year preceding blood sampling, procoagulant changes were evident from the strongly increased numbers of red blood cell-derived circulating microvesicles and annexin V-binding microvesicles, but they no longer associated with TF.…”

“…Thus, a higher risk for deep vein thrombosis (DVT) was associated with increased annual mean levels of PM with a mean aerodynamic diameter smaller than 10 lm (PM 10 ) in the residential area of the study subjects [9]. In the same study population, living near major traffic roads was also associated with an increased risk of DVT, even after controlling for the community-level PM pollution [10]. These initial epidemiological findings by Baccarelli et al [9] were recently confirmed in a time-series analysis in Chile, demonstrating an association between PM exposure and hospital admission for VTE [11], although also challenged by others [12,13].…”