Venous thromboembolism in an industrial north american city: temporal distribution and association with particulate matter air pollution.
Venous thromboembolism in an industrial north american city: temporal distribution and association with particulate matter air pollution.
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DOI：
10.1371/journal.pone.0068829
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Whittaker P
中科院分区：
文献类型：
--
作者：
Chiu HH;Whittaker P
主要来自欧洲和亚洲的新证据表明，静脉血栓栓塞症（VTE）最常发生在冬季。与这种季节性相关的因素包括低温介导的凝血加剧以及高水平的颗粒物（PM）空气污染。然而，与大多数欧洲和亚洲城市不同的是，许多北美城市的颗粒物污染在夏季达到峰值。
我们旨在利用这种地理差异，研究在一个寒冷天气且夏季PM峰值的北美城市——底特律，VTE的时间分布。我们的目标是由此确定温度和PM水平对VTE的影响。
我们的回顾性、分析性半生态学研究通过病历审查确认了1907例急性、门诊VTE病例，按地点（底特律与郊区）进行划分，并绘制了每月VTE频率分布图。我们利用美国环境保护署的数据确定底特律PM污染成分的时间分布。郊区的PM空气污染被假定为可忽略不计，因此未进行监测。
底特律的急性VTE病例（1490例）呈现夏季峰值（6月24日），与均匀分布（P<0.01）以及1123例非VTE病例的分布（P<0.02）均不同。直径为10μm的PM和粗颗粒物（2.5 - 10μm）的水平也呈现夏季峰值，而直径为2.5μm的PM呈现冬季峰值。与城市病例相反，郊区的急性VTE病例（417例）没有月度变化。
底特律急性VTE的夏季峰值表明低温不是VTE发病机制的主要因素。相反，直径为10μm的PM、粗颗粒物与底特律VTE月度分布的一致性，再加上郊区VTE无月度变化，与PM污染的作用相符。此外，VTE和2.5μm PM分布的差异表明颗粒大小可能起作用。
Emerging evidence, mainly from Europe and Asia, indicates that venous thromboembolism (VTE) occurs most often in winter. Factors implicated in such seasonality are low temperature-mediated exacerbation of coagulation and high levels of particulate matter (PM) air pollution. However, in contrast to most European and Asian cities, particulate matter pollution peaks in the summer in many North American cities. We aimed to exploit this geographical difference and examine the temporal distribution of VTE in a cold-weather, North American city, Detroit, with a summer PM peak. Our goal was thereby to resolve the influence of temperature and PM levels on VTE. Our retrospective, analytical semi-ecological study used chart review to confirm 1,907 acute, ambulatory VTE cases, divided them by location (Detroit versus suburban), and plotted monthly VTE frequency distributions. We used Environmental Protection Agency data to determine the temporal distribution of PM pollution components in Detroit. Suburban PM air pollution is presumed negligible and therefore not monitored. Acute VTE cases in Detroit (1,490) exhibited a summer peak (June 24th) and differed from both a uniform distribution (P<0.01) and also that of 1,123 no-VTE cases (P<0.02). Levels of 10 µm diameter PM and coarse particle (2.5 to 10 µm) PM also exhibited summer peaks versus a winter peak for 2.5 µm diameter PM. Contrary to their urban counterparts, suburban cases of acute VTE (417) showed no monthly variation. The summer peak of acute VTE in Detroit indicates that low temperature is not a major factor in VTE pathogenesis. In contrast, concordance of the 10 µm diameter PM, coarse particle, and the Detroit VTE monthly distributions, combined with no monthly suburban VTE variation, is consistent with a role for PM pollution. Furthermore, divergence of the VTE and 2.5 µm PM distributions suggests that particle size may play a role.
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影响因子：
2.1
作者：
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通讯作者：
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影响因子：
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