Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers

Judy Y. Ou; Heidi A. Hanson; Joemy M. Ramsay; Claire L. Leiser; Yue Zhang; James A. Vanderslice; C. Arden Pope; Anne C. Kirchhoff

doi:10.3390/ijerph16061081

Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers

Judy Y. Ou
, Heidi A. Hanson
, Joemy M. Ramsay
, Claire L. Leiser
, Yue Zhang
, James A. Vanderslice
, C. Arden Pope
, Anne C. Kirchhoff

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

Some chemotherapies that treat childhood cancers have pulmonary-toxic properties that increase risk for adverse respiratory-health outcomes. PM_2.5 causes similar outcomes but its effect among pulmonary compromised cancer survivors is unknown. This case-crossover study identified the PM_2.5-associated odds for primary-respiratory hospitalizations and emergency department visits among childhood cancer survivors in Utah. We compared risk among chemotherapy-treated survivors to a cancer-free sample. We calculated 3-day-average PM_2.5 by ZIP code and county for event and control days. Conditional logistic regression estimated odds ratios. Models were stratified by cause of admission (infection, respiratory disease, asthma), previous chemotherapy, National Ambient Air Quality Standard (NAAQS), and other variables. Results are presented per 10 µg/m³ of PM_2.5. 90% of events occurred at 3-day PM_2.5 averages <35.4 µg/m³, the NAAQS 24-h standard. For survivors, PM_2.5 was associated with respiratory hospitalizations (OR = 1.84, 95% CI = 1.13–3.00) and hospitalizations from respiratory infection (OR = 2.09, 95% CI = 1.06–4.14). Among chemotherapy-treated survivors, the PM_2.5-associated odds of respiratory hospitalization (OR = 2.03, 95% CI = 1.14–3.61) were significantly higher than the cancer-free sample (OR = 0.84, 95% CI = 0.57–1.25). This is the first study to report significant associations between PM_2.5 and respiratory healthcare encounters in childhood cancer survivors. Chemotherapy-treated survivors displayed the highest odds of hospitalization due to PM_2.5 exposure and their risk is significantly higher than a cancer-free sample.

Original language	English
Article number	1081
Journal	International Journal of Environmental Research and Public Health
Volume	16
Issue number	6
DOIs	https://doi.org/10.3390/ijerph16061081
State	Published - Mar 2 2019
Externally published	Yes

Funding

Funding: This research was funded by a St. Baldrick’s Foundation Childhood Cancer Research Grant. This research was funded by a St. Baldrick’s Foundation Childhood Cancer Research Grant. We thank our partners at the Utah Population Database, Intermountain Health, Primary Children’s Hospital, and the University of Utah.

Keywords

Air pollution
Cancer survivorship
Children
Late effects

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10.3390/ijerph16061081

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@article{e1e4f8635bd64cfda3274a8cfca17183,

title = "Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers",

abstract = "Some chemotherapies that treat childhood cancers have pulmonary-toxic properties that increase risk for adverse respiratory-health outcomes. PM2.5 causes similar outcomes but its effect among pulmonary compromised cancer survivors is unknown. This case-crossover study identified the PM2.5-associated odds for primary-respiratory hospitalizations and emergency department visits among childhood cancer survivors in Utah. We compared risk among chemotherapy-treated survivors to a cancer-free sample. We calculated 3-day-average PM2.5 by ZIP code and county for event and control days. Conditional logistic regression estimated odds ratios. Models were stratified by cause of admission (infection, respiratory disease, asthma), previous chemotherapy, National Ambient Air Quality Standard (NAAQS), and other variables. Results are presented per 10 µg/m3 of PM2.5. 90\% of events occurred at 3-day PM2.5 averages <35.4 µg/m3, the NAAQS 24-h standard. For survivors, PM2.5 was associated with respiratory hospitalizations (OR = 1.84, 95\% CI = 1.13–3.00) and hospitalizations from respiratory infection (OR = 2.09, 95\% CI = 1.06–4.14). Among chemotherapy-treated survivors, the PM2.5-associated odds of respiratory hospitalization (OR = 2.03, 95\% CI = 1.14–3.61) were significantly higher than the cancer-free sample (OR = 0.84, 95\% CI = 0.57–1.25). This is the first study to report significant associations between PM2.5 and respiratory healthcare encounters in childhood cancer survivors. Chemotherapy-treated survivors displayed the highest odds of hospitalization due to PM2.5 exposure and their risk is significantly higher than a cancer-free sample.",

keywords = "Air pollution, Cancer survivorship, Children, Late effects",

author = "Ou, \{Judy Y.\} and Hanson, \{Heidi A.\} and Ramsay, \{Joemy M.\} and Leiser, \{Claire L.\} and Yue Zhang and Vanderslice, \{James A.\} and Pope, \{C. Arden\} and Kirchhoff, \{Anne C.\}",

note = "Publisher Copyright: {\textcopyright} 2019 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2019",

month = mar,

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doi = "10.3390/ijerph16061081",

language = "English",

volume = "16",

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T1 - Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers

AU - Ou, Judy Y.

AU - Hanson, Heidi A.

AU - Ramsay, Joemy M.

AU - Leiser, Claire L.

AU - Zhang, Yue

AU - Vanderslice, James A.

AU - Pope, C. Arden

AU - Kirchhoff, Anne C.

PY - 2019/3/2

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AB - Some chemotherapies that treat childhood cancers have pulmonary-toxic properties that increase risk for adverse respiratory-health outcomes. PM2.5 causes similar outcomes but its effect among pulmonary compromised cancer survivors is unknown. This case-crossover study identified the PM2.5-associated odds for primary-respiratory hospitalizations and emergency department visits among childhood cancer survivors in Utah. We compared risk among chemotherapy-treated survivors to a cancer-free sample. We calculated 3-day-average PM2.5 by ZIP code and county for event and control days. Conditional logistic regression estimated odds ratios. Models were stratified by cause of admission (infection, respiratory disease, asthma), previous chemotherapy, National Ambient Air Quality Standard (NAAQS), and other variables. Results are presented per 10 µg/m3 of PM2.5. 90% of events occurred at 3-day PM2.5 averages <35.4 µg/m3, the NAAQS 24-h standard. For survivors, PM2.5 was associated with respiratory hospitalizations (OR = 1.84, 95% CI = 1.13–3.00) and hospitalizations from respiratory infection (OR = 2.09, 95% CI = 1.06–4.14). Among chemotherapy-treated survivors, the PM2.5-associated odds of respiratory hospitalization (OR = 2.03, 95% CI = 1.14–3.61) were significantly higher than the cancer-free sample (OR = 0.84, 95% CI = 0.57–1.25). This is the first study to report significant associations between PM2.5 and respiratory healthcare encounters in childhood cancer survivors. Chemotherapy-treated survivors displayed the highest odds of hospitalization due to PM2.5 exposure and their risk is significantly higher than a cancer-free sample.

KW - Air pollution

KW - Cancer survivorship

KW - Children

KW - Late effects

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DO - 10.3390/ijerph16061081

M3 - Article

C2 - 30917578

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SN - 1661-7827

VL - 16

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 6

M1 - 1081

ER -

Fine particulate matter and respiratory healthcare encounters among survivors of childhood cancers

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