Emergency Department, CHU de Besançon, 3 boulevard Alexandre Fleming, 25030 Besançon, France; Laboratory Chrono-environnement, UMR 6249 Centre National de la Recherche Scientifique, 16 route de Gray, 25000 Besançon, France; Université Bourgogne Franche-Comté, 32 avenue de l'Observatoire, 25000 Besançon, France.
Laboratory Chrono-environnement, UMR 6249 Centre National de la Recherche Scientifique, 16 route de Gray, 25000 Besançon, France; Laboratory TheMA, UMR 6049 Centre National de la Recherche Scientifique, 16 route de Gray, 25000 Besançon, France; Université Bourgogne Franche-Comté, 32 avenue de l'Observatoire, 25000 Besançon, France.
Environ Int. 2019 Jun;127:317-323. doi: 10.1016/j.envint.2019.01.056. Epub 2019 Apr 3.
A link is established between air pollution and respiratory diseases. Very few studies evaluated this link with primary spontaneous pneumothorax (PSP). Contrasted results, low statistical power and methodological limits of these studies brought us to evaluate in a more thorough way this link.
(1) to estimate the relation between PSP and air pollutants namely nitrogen dioxide (NO, ozone (O and particulate matter with a diameter ≤ 10 μm (PM); (2) to investigate a time lag effect between these pollutants and occurrence of PSP.
This study has a case-crossover design. Subjects aged ≥18 years admitted from 1st June 2009 to 31st May 2013, in 14 Emergency Departments centers on the French territory. Were excluded: patients with traumatic, secondary, recurrent or history of previous pneumothorax. NO, O and PM data were collected hourly in monitoring stations. Three exposure assessments were retained: quantitative values, fast increase concentration of air pollutants and peak of pollution. These assessments were calculated for the entire exposure period and for each of the four days of all case and control periods.
948 subjects included. Whatever the pollutant considered, no differences were observed between case and control periods, regardless of whether the quantitative values of air pollutants exposure (p > 0.09), fast increase concentration (p > 0.46) and peak of pollution (p > 0.20).
We failed to show a relation between PSP and short-term air pollution exposure to low levels of NO and PM. An association between O exposure and PSP cannot be ruled out. An impact at higher exposure level, and/or a potentiating effect of different meteorological factors remain to be demonstrated.
空气污染与呼吸道疾病之间存在关联。只有少数研究评估了原发性自发性气胸（PSP）与这一关联。由于这些研究的对照结果、低统计效力和方法学限制，我们需要更全面地评估这一关联。
（1）评估 PSP 与空气污染物（即二氧化氮（NO）、臭氧（O₃）和直径≤10μm 的颗粒物（PM））之间的关系；（2）调查这些污染物与 PSP 发生之间的时间滞后效应。
本研究采用病例交叉设计。2009 年 6 月 1 日至 2013 年 5 月 31 日期间，14 个法国领土上的急救中心收治了年龄≥18 岁的患者。排除标准为：创伤性、继发性、复发性或既往气胸病史的患者。在监测站每小时收集 NO、O₃ 和 PM 数据。保留了三种暴露评估：污染物的定量值、快速增加浓度和污染峰值。这些评估是针对整个暴露期和病例期和对照期的每一天计算的。
共纳入 948 例患者。无论考虑哪种污染物，病例期和对照期之间均无差异，无论空气污染物暴露的定量值（p＞0.09）、快速增加浓度（p＞0.46）还是污染峰值（p＞0.20）均如此。
我们未能显示 PSP 与低水平 NO 和 PM 的短期空气污染暴露之间存在关系。不能排除 O₃ 暴露与 PSP 之间的关联。需要进一步研究更高暴露水平的影响，以及/或不同气象因素的增强作用。
