Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.
Division of Rhinology and Sinus Surgery/Oregon Sinus Center, Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University (OHSU), Portland, Oregon, USA.
Int Forum Allergy Rhinol. 2024 Apr;14(4):755-764. doi: 10.1002/alr.23250. Epub 2023 Aug 15.
Poor air quality increases the risk of developing chronic rhinosinusitis (CRS) and other airway diseases. However, there are limited data on air pollutants and CRS-specific disease severity. We assessed the impact of air pollutants on sinonasal-specific and general quality-of-life (QOL) measures in a multi-institutional cohort of patients with CRS.
Participants with CRS were prospectively enrolled in a cross-sectional study and self-selected continued appropriate medical therapy or endoscopic sinus surgery (ESS). The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility value scores were recorded. Patient exposure to air pollutants was determined using residence zip codes. Unadjusted group differences were compared, and correlation coefficients were evaluated to identify the magnitude of bivariate association.
A total of 486 patients were enrolled and followed for a mean of 6.9 (standard deviation [SD] ± 2.3) months. Pollutant exposure did not significantly correlate with baseline SNOT-22 or SF-6D scores. Revision ESS was associated with higher median fine particulate matter (PM2.5; Δ = 0.12, [95% confidence interval {CI}: 0.003, 0.234]; p = 0.006) compared with primary surgery. PM2.5, PM10, and nitrogen dioxide concentrations (μg/m) did not correlate with change in total SNOT-22 or SF-6D scores after treatment. Nevertheless, sulfur dioxide (SNOT-22: ρ = -0.121 [95% CI: -0.210, -0.030]; p = 0.007; SF-6D: ρ = 0.095 [95% CI: 0.002, 0.186]; p = 0.04) and carbon monoxide (SNOT-22: ρ = -0.141 [95% CI: -0.230, 0.050]; p = 0.002) exposure did correlate with these outcome measures.
Air pollutants may contribute, at least in part, to disease severity in CRS; future investigation is needed to further elucidate the nature of this relationship.
空气质量差会增加患慢性鼻-鼻窦炎（CRS）和其他气道疾病的风险。然而，关于空气污染物与 CRS 特定疾病严重程度的数据有限。我们评估了空气污染物对多机构队列中 CRS 患者的鼻-鼻窦特异性和一般生活质量（QOL）测量的影响。
前瞻性招募患有 CRS 的患者参加横断面研究，并自行选择继续接受适当的药物治疗或内镜鼻窦手术（ESS）。记录 22 项鼻-鼻窦结局测试（SNOT-22）和医疗结局研究短式 6 项健康调查量表（SF-6D）健康效用值评分。使用居住邮政编码确定患者的空气污染物暴露情况。比较未经调整的组间差异，并评估相关系数以确定双变量关联的大小。
共纳入 486 例患者，平均随访 6.9（标准差±2.3）个月。污染物暴露与基线 SNOT-22 或 SF-6D 评分无显著相关性。与初次手术相比，修正性 ESS 与较高的中位细颗粒物（PM2.5；Δ=0.12，95%置信区间[CI]：0.003，0.234；p=0.006）相关。PM2.5、PM10 和二氧化氮浓度（μg/m）与治疗后总 SNOT-22 或 SF-6D 评分的变化无相关性。然而，二氧化硫（SNOT-22：ρ=-0.121，95%CI：-0.210，-0.030；p=0.007；SF-6D：ρ=0.095，95%CI：0.002，0.186；p=0.04）和一氧化碳（SNOT-22：ρ=-0.141，95%CI：-0.230，0.050；p=0.002）暴露与这些结局测量值相关。
空气污染物可能至少部分导致 CRS 疾病严重程度增加；需要进一步研究来阐明这种关系的性质。
