Association between Ambient Particulate Matter 2.5 Exposure and Mortality in Patients with Hepatocellular Carcinoma

Abstract

Air pollution is a severe public health problem in Taiwan. Moreover, Taiwan is an endemic area for hepatocellular carcinoma (HCC). This study examined the effect of particulate matter 2.5 (PM2.5) exposure on mortality in this population. A total of 1003 patients with HCC treated at Chang Gung Memorial Hospital between 2000 and 2009 were included in this study. At the end of the analysis, 288 (28.7%) patients had died. Patients with HCC living in environments with PM2.5 concentrations of ≥36 µg/m3 had a higher mortality rate than patients living in environments with PM2.5 concentrations of <36 µg/m3 (36.8% versus 27.5%, p = 0.034). The multivariate Cox regression analysis confirmed that PM2.5 ≥ 36 µg/m3 was a significant risk factor for mortality (1.584 (1.162–2.160), p = 0.004). A nonlinear relationship was observed between the odds ratio and PM2.5. The odds ratio was 1.137 (1.015–1.264) for each increment of 5 µg/m3 in PM2.5 or 1.292 (1.030–1.598) for each increment of 10 µg/m3 in PM2.5. Therefore, patients with HCC exposed to ambient PM2.5 concentrations of ≥36 µg/m3 had a 1.584-fold higher risk of death than those exposed to PM2.5 concentrations of <36 µg/m3. Further studies are warranted.

Long-Term Exposure to Fine Particulate Matter and the Risk of Chronic Liver Diseases: A Meta-Analysis of Observational Studies

“…Finally, 102 articles were reviewed in full, of which 86 articles were excluded based on the following reasons: no PM2.5 data ( n = 19), no PM2.5-increment data ( n = 3), insufficient incidence and outcome data on liver disease ( n = 62), and duplicate data ( n = 2). The remaining 16 studies, which included one cross-sectional study [ 22 ], one retrospective cohort study [ 29 ] and 14 prospective cohort studies [ 24 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], were included in the present meta-analysis.…”

“…In the above studies which reported age, the age range of the participants was more than 18 years. Regarding the types of liver diseases, 13 studies were related to liver cancer [ 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 ], one study was related to liver cirrhosis [ 33 ], and two studies were related to fatty liver disease (metabolic dysfunction-associated fatty liver disease and NAFLD, respectively) [ 23 , 24 ]. Among them, eight studies investigated the correlationship between the incidence of chronic liver disease and PM2.5 exposure [ 23 , 24 , 30 , 31 , 32 , 33 , 34 , 35 ], and other eight studies observed the mortality of chronic liver disease [ 29 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ].…”

“… Long-term exposure to fine particulate matter (PM2.5) and risk of chronic liver disease according to in a random-effects meta-analysis. HR, hazard risk; CI, confidence interval (HR and 95% CI are for a 10 μg/m 3 increase in PM2.5) [ 23 , 24 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. …”

CRISPR/Cas9-Mediated Whole Genomic Wide Knockout Screening Identifies Specific Genes Associated With PM2.5-Induced Mineral Absorption in Liver Toxicity

“…For instance, occurrence of nonalcoholic fatty liver disease – a known silent disease attacking about 20–30% of the population- was linked to exposure to PM 2.5 ( Sivell, 2019 ). Furthermore, people living in environments with high PM 2.5 concentrations generally exhibit high incidence of hepatocellular carcinoma (HCC), with an associated high mortality rate ( VoPham et al, 2018 ; Lee et al, 2019 ).…”

CRISPR/Cas9-Mediated Whole Genomic Wide Knockout Screening Identifies Specific Genes Related to Mineral Absorption Involving in PM2.5 Liver Toxicity

“…PM 2.5 exposure leads to NAFLD which is known as a silent disease and present in around 20-30% of people [6]. What's more, people living in environments with higher PM 2.5 concentrations have a higher incidence rate ratio of hepatocellular carcinoma (HCC) and patients with HCC has a higher mortality rate [7,8]. Some studies discovered the mechanism of PM 2.5 induced liver disease.…”