TY - JOUR
T1 - Air Pollution and Cardiovascular Risks in Testicular Cancer Survivors
T2 - An Exploratory Case-Crossover Study
AU - Ou, Judy Y.
AU - Ramsay, Joemy M.
AU - Kaddas, Heydon K.
AU - VanDerslice, James A.
AU - O’Neil, Brock
AU - García, Sarah M.
AU - Horne, Benjamin D.
AU - Hanson, Heidi
AU - Kirchhoff, Anne C.
N1 - Publisher Copyright:
Copyright 2025, Mary Ann Liebert, Inc., publishers.
PY - 2025
Y1 - 2025
N2 - Objectives: Testicular cancer survivors can experience cardiovascular and respiratory complications due to cancer treatment. We assessed associations between nitrogen dioxide (NO2) and ozone (O3) air pollution and health care encounters among survivors of adolescent and young adult (AYA) testicular cancer. Methods: A total of 385 AYA testicular cancer survivors, diagnosed 2000-2016, with cardiovascular and/or respiratory health care encounters (emergency department/urgent care [ED/UC], inpatient) were identified using a statewide Utah-based resource. Continuous and dichotomous (≥moderate air quality index) exposure measures were included for NO2 and O3 for the 1-4 days (lag days) before events. A case-crossover framework using conditional logistic regression with robust standard errors computed the association of lag days 0-3 with cardiovascular or respiratory encounters and stratified by encounter type (ED/UC, inpatient). Models that were significant in the full cohort were also stratified on demographic and treatment factors. All models were controlled for temperature and humidity. Results: Survivors contributed 257 cardiovascular and 685 respiratory encounters. NO2 ≥moderate on lag day 1 was associated with increased odds of any cardiovascular encounter (odds ratio [OR] = 1.97, 95% confidence interval [CI] = 1.08-3.59) and inpatient cardiovascular encounters in the full cohort (OR = 2.48, 95% CI = 1.21-5.10), survivors treated with radical orchiectomy and chemotherapy (OR = 3.00, 95% CI = 1.29-7.00), and Hispanic survivors (OR = 4.32, 95% CI = 1.18-15.85). O3 ≥moderate on lag day 4 was associated with respiratory ED/UC encounters (OR = 1.34, 95% CI = 1.00-1.79) and O3 on lag day 4 was associated with any cardiovascular encounter (OR = 1.02/parts per billion [ppb], 95% CI = 1.00-1.03) and inpatient cardiovascular encounters (OR = 1.03/ppb, 95% CI + 1.00-1.05). Conclusions: NO2 and O3 are associated with risk for health care encounters among testicular cancer survivors and could increase health disparities in survivorship.
AB - Objectives: Testicular cancer survivors can experience cardiovascular and respiratory complications due to cancer treatment. We assessed associations between nitrogen dioxide (NO2) and ozone (O3) air pollution and health care encounters among survivors of adolescent and young adult (AYA) testicular cancer. Methods: A total of 385 AYA testicular cancer survivors, diagnosed 2000-2016, with cardiovascular and/or respiratory health care encounters (emergency department/urgent care [ED/UC], inpatient) were identified using a statewide Utah-based resource. Continuous and dichotomous (≥moderate air quality index) exposure measures were included for NO2 and O3 for the 1-4 days (lag days) before events. A case-crossover framework using conditional logistic regression with robust standard errors computed the association of lag days 0-3 with cardiovascular or respiratory encounters and stratified by encounter type (ED/UC, inpatient). Models that were significant in the full cohort were also stratified on demographic and treatment factors. All models were controlled for temperature and humidity. Results: Survivors contributed 257 cardiovascular and 685 respiratory encounters. NO2 ≥moderate on lag day 1 was associated with increased odds of any cardiovascular encounter (odds ratio [OR] = 1.97, 95% confidence interval [CI] = 1.08-3.59) and inpatient cardiovascular encounters in the full cohort (OR = 2.48, 95% CI = 1.21-5.10), survivors treated with radical orchiectomy and chemotherapy (OR = 3.00, 95% CI = 1.29-7.00), and Hispanic survivors (OR = 4.32, 95% CI = 1.18-15.85). O3 ≥moderate on lag day 4 was associated with respiratory ED/UC encounters (OR = 1.34, 95% CI = 1.00-1.79) and O3 on lag day 4 was associated with any cardiovascular encounter (OR = 1.02/parts per billion [ppb], 95% CI = 1.00-1.03) and inpatient cardiovascular encounters (OR = 1.03/ppb, 95% CI + 1.00-1.05). Conclusions: NO2 and O3 are associated with risk for health care encounters among testicular cancer survivors and could increase health disparities in survivorship.
KW - air pollution
KW - cancer late effects
KW - testicular cancer survivors
UR - https://www.scopus.com/pages/publications/105008979902
U2 - 10.1089/jayao.2024.0144
DO - 10.1089/jayao.2024.0144
M3 - Article
AN - SCOPUS:105008979902
SN - 2156-5333
JO - Journal of Adolescent and Young Adult Oncology
JF - Journal of Adolescent and Young Adult Oncology
ER -