Air pollutants may be environmental risk factors in chronic rhinosinusitis disease progression

Mady, Leila J.; Schwarzbach, Hannah L.; Moore, John Bassett; Boudreau, Robert M.; Willson, Thomas D.; Lee, Stella E.

doi:10.1002/alr.22052

Cited by 55 publications

(87 citation statements)

References 48 publications

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“…Mady et al showed that PM 2.5 was significantly associated with incidence of FESS with a 1.89‐fold increased risk in need for FESS in the CRSsNP population with each unit increase in PM 2.5 ( p = 0.015). Furthermore, worse symptom levels were seen with increasing exposure to BC in patients with CRSsNP, with SNOT‐22 scores increasing by 7.97 points with each 0.1‐unit increase in BC ( p = 0.0008) …”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, worse symptom levels were seen with increasing exposure to BC in patients with CRSsNP, with SNOT-22 scores increasing by 7.97 points with each 0.1-unit increase in BC (p = 0.0008). 4 The comparative analysis of distribution of air pollutants based on residence demonstrated that overall PM 2.5 concentrations were significantly higher in Pittsburgh compared with other locations in Allegheny County. In our study, the subgroup analysis between the studied groups (AERD, CRSwNP, and CRSsNP) showed that mean PM 2.5 and BC were not significantly different between the study groups.…”

Section: Discussionmentioning

confidence: 99%

“…There was a 1.89‐fold increased risk in need for FESS in the population of those with chronic rhinosinusitis without nasal polyps (CRSsNP) with each unit increase in PM 2.5 ( p = 0.015). Furthermore, worse symptoms were seen with increasing exposure to BC levels in patients with CRSsNP, with scores on the 22‐item Sino‐Nasal Outcome Test increasing by 7.97 with each 0.1‐unit increase in BC ( p = 0.0008) …”

mentioning

confidence: 98%

“…Furthermore, worse symptoms were seen with increasing exposure to BC levels in patients with CRSsNP, with scores on the 22-item Sino-Nasal Outcome Test increasing by 7.97 with each 0.1-unit increase in BC (p = 0.0008). 4 The health hazards of air pollutants on lower respiratory inflammation have also been demonstrated, and several studies have shown a relationship between PM exposure and asthma, chronic obstructive pulmonary disease (COPD), and decreased pulmonary function. [5][6][7] Moreover, it has been established that respiratory symptoms and asthma may be caused by occupational factors, and inhaled occupational exposures have been related to adult-onset asthma and work-aggravated asthma; the populationattributable fraction has been estimated to be 15%.…”

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confidence: 99%

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Association of air pollutants, airborne occupational exposures, and chronic rhinosinusitis disease severity

Velasquez

Moore

Boudreau

et al. 2019

Int Forum Allergy Rhinol

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Background Previous work has shown that chronic rhinosinusitis (CRS) severity may be associated with particulate matter 2.5 (PM2.5) and black carbon (BC) in CRS patients without nasal polyps (CRSsNP). Data regarding occupational exposures, however, are lacking. We assessed the impact of PM2.5, BC, as well as occupational airborne exposure on CRS disease severity. Methods Patients with CRS with nasal polyps (CRSwNP), CRSsNP, and aspirin‐exacerbated respiratory disease (AERD) were identified from an institutionwide database. Spatial modeling from 37 pollutant monitoring sites in Allegheny County was used to estimate exposures. Patient occupations using the 2010 Standard Occupation Classification (SOC10) and airborne occupation exposures to vapors, gases, dusts, fumes, fibers and mists (VGDFFiM) or diesel fumes were recorded. Disease severity was measured by modified Lund‐Mackay score (LMS), systemic corticosteroid therapy, and incidence of functional endoscopic sinus surgery (FESS). Results Two hundred thirty‐four patients were included (CRSwNP, n = 113; CRSsNP, n = 96; AERD, n = 25). The prevalence of AERD among those with CRSwNP was 18%. Patients exposed to VGDFFiM or diesel fumes required higher steroid doses vs nonexposed patients (p = 0.015 and p = 0.03, respectively); patients with VGDFFiM levels >5% were more likely to undergo FESS vs nonexposed patients (p = 0.0378). There was no difference in PM2.5 and BC with regard to disease severity and FESS between CRSwNP, CRSsNP, and AERD patients. Steroid use was significantly higher in CRSwNP and AERD vs CRSsNP (p = 0.001). LMS was significantly higher in AERD as compared with CRSwNP and CRSsNP (p = 0.001). Conclusion Occupational airborne exposure to VGDFFiM correlated with increased prevalence of FESS and need for corticosteroids in CRS patients. There was no difference in PM2.5 and BC levels and disease severity outcome measures between CRS subtypes in this subset.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

mentioning

confidence: 99%

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Association of air pollutants, airborne occupational exposures, and chronic rhinosinusitis disease severity

Velasquez

Moore

Boudreau

et al. 2019

Int Forum Allergy Rhinol

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“…CRS is a multifactorial disease that is characterized by significant goblet hyperplasia, mucus hypersecretion, mucociliary dysfunction, and persistent sinonasal inflammation. The etiology of CRS is not well known, but air pollution, particularly fine particulate matter (particulate matter ≤2.5 μm, PM2.5), a major air pollutant, is a principal environmental risk factor for CRS, as evidenced by population studies . Compared with coarse particles, PM2.5 is considered to be more harmful to the human respiratory system due to its smaller diameters and larger surface area to absorb various toxic substances.…”

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confidence: 99%