Kwas Hamida, Rangareddy Harish, Rajhi Hayfa H
Pulmonology, University Hospital of Gabès, Gabès, TUN.
Biochemistry, Haveri Institute of Medical Sciences, Haveri, IND.
Cureus. 2024 Aug 10;16(8):e66578. doi: 10.7759/cureus.66578. eCollection 2024 Aug.
Background Acute community-acquired pneumonia (CAP) is considered the leading cause of infectious death worldwide. Air pollution and prolonged exposure to airborne contaminants have been implicated in various respiratory conditions, including asthma and chronic obstructive pulmonary disease (COPD). However, the specific impact of air pollution on pneumonia, particularly CAP, remains underexplored. Given the rising levels of urban air pollution and its potential health ramifications, our study aimed to examine the association between exposure to outdoor air pollution and severity as well as the outcomes of pneumonia cases requiring hospitalization. Methodology A cohort analytical study with retrospective data collection was carried out in the pulmonology department of the Gabès University Hospital between January and October 2022. We compared levels of particulate matter less than or equal to 10µm in aerodynamic diameter (PM), sulfur dioxide (SO), ozone (O), moisture and ambient temperature with severity and outcomes of pneumonia requiring hospitalization. The choice of these specific pollutants and environmental factors was based on their established impact on respiratory health and their prevalence in the study region. Results Increased sulfur dioxide (SO2) levels were associated with increased use of non-invasive ventilation (NIV) (r = 0.400). Higher levels of particulate matter (PM10) were significantly associated with the development of lung abscesses. Similarly, increased humidity and ambient temperature were strongly correlated with the development of lung abscesses. Increased air SO2 levels were correlated with a higher CURB65 score (r = 0.299). High outdoor SO2 levels and increasing moisture content were associated with increased Pneumonia Severity Index (PSI) score (r = 0.303 and = 0.310, respectively). Higher levels of PM10 were associated with an increased risk of pleural effusion, a serious complication of pneumonia. Finally, higher ambient temperatures were correlated with more extensive opacities on chest X-rays (r = 0.706), suggesting the severity of pneumonia. Conclusion This study highlights the significant associations between environmental factors and various clinical parameters in pneumonia patients. The findings underscore the importance of considering environmental exposures, such as air quality and weather conditions, in understanding and managing the severity of pneumonia.
背景 急性社区获得性肺炎（CAP）被认为是全球感染性死亡的主要原因。空气污染以及长期暴露于空气传播污染物与包括哮喘和慢性阻塞性肺疾病（COPD）在内的各种呼吸道疾病有关。然而，空气污染对肺炎，尤其是CAP的具体影响仍未得到充分研究。鉴于城市空气污染水平不断上升及其潜在的健康影响，我们的研究旨在探讨室外空气污染暴露与肺炎病例严重程度以及住院结局之间的关联。
方法 在2022年1月至10月期间，在加贝斯大学医院呼吸科进行了一项回顾性数据收集的队列分析研究。我们将空气动力学直径小于或等于10µm的颗粒物（PM）、二氧化硫（SO）、臭氧（O）、湿度和环境温度水平与需要住院治疗的肺炎的严重程度和结局进行了比较。选择这些特定污染物和环境因素是基于它们对呼吸健康的既定影响以及在研究区域的普遍程度。
结果 二氧化硫（SO2）水平升高与无创通气（NIV）使用增加相关（r = 0.400）。较高的颗粒物（PM10）水平与肺脓肿的发生显著相关。同样，湿度和环境温度升高与肺脓肿的发生密切相关。空气SO2水平升高与较高的CURB65评分相关（r = 0.299）。高室外SO2水平和湿度增加与肺炎严重程度指数（PSI）评分增加相关（分别为r = 0.303和r = 0.310）。较高的PM10水平与胸腔积液风险增加相关，胸腔积液是肺炎的一种严重并发症。最后，较高的环境温度与胸部X光片上更广泛的混浊相关（r = 0.706），提示肺炎的严重程度。
结论 本研究强调了环境因素与肺炎患者各种临床参数之间的显著关联。这些发现强调了在理解和管理肺炎严重程度时考虑环境暴露，如空气质量和天气条件的重要性。
