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 and Anne C. Kirchhoff
Additional contact information
Judy Y. Ou: Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
Heidi A. Hanson: Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
Joemy M. Ramsay: Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
Claire L. Leiser: Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA
Yue Zhang: Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT 84132, USA
James A. VanDerslice: Department of Family and Preventive Medicine, Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
C. Arden Pope: Department of Economics, Brigham Young University, Provo, UT 84602, USA
Anne C. Kirchhoff: Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA

IJERPH, 2019, vol. 16, issue 6, 1-16

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/m 3 of PM 2.5 . 90% of events occurred at 3-day PM 2.5 averages <35.4 µg/m 3 , 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.

Keywords: air pollution; children; cancer survivorship; late effects (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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