Long-Term Exposure to Air Pollution and Incidence of Venous Thromboembolism in the General Population: A Population-Based Retrospective Cohort Study

Abstract

To date, the relationship between air pollutants and venous thromboembolism (VTE) has not been well established. Our aim is to investigate the association between ambient air pollutants and the incidence of VTE using the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) database. From 2003 to 2015, 338,616 subjects from the general population not previously diagnosed with VTE were included. The long-term average concentration of air pollutants before diagnosis for each subject was calculated. During the study period, there were 3196 incident cases of VTE. After adjusting for age, gender, economic status, body mass index, physical activity, smoking, alcohol consumption, comorbid diseases, and meteorological variables, the risk of VTE was observed to increase significantly with the long-term average concentration of particulate matter < 10 μm in diameter: PM10 (hazard ratio (HR) = 1.064 (95% confidence interval [CI] 1.053–1.074) for 1 μg/m3), SO2 (HR = 1.118 (95% CI 1.079–1.158) 1 ppb), and O3 (HR = 1.039 (95% CI 1.026–1.053) for 1 ppb), respectively. A difference between the date of the health screening and the date of diagnosis of the disease was observed. Long-term exposure to air pollutants including PM10, SO2, and O3 may be an independent risk factor for the development of VTE.

Correlation of Air Pollution and Prevalence of Acute Pulmonary Embolism in Northern Thailand

“…When using the first tertile of air pollutants as a reference, the adjusted RR of APE in the second and the third tertile was increased for PM 10 but not for SO 2 , NO 2 , CO and O 3 . However, Gwon et al [36] demonstrated that long-term exposures not only to PM 10 but also to SO 2 and O 3 were correlated with the occurrence of VTE. However, not all studies replicated the same positive findings, making the association between exposure to air pollution and VTE development somewhat uncertain.…”