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2627043 
Journal Article 
Abstract 
Air pollution and the risk of venous thromboembolism 
Tor, M; Cevik, C; Kurcer, M; Akbulut, S; Altuntas, M; Atalay, F 
2010 
Yes 
American Journal of Respiratory and Critical Care Medicine
ISSN: 1073-449X
EISSN: 1535-4970 
181 
A1726 
English 
WOS:000208771000726 
is part of a larger document 3452678 Proceedings of the American Thoracic Society 2010 International Conference, May 14-19, 2010, New Orleans
RATIONALE: Particulate air pollution is associated with increased risk of arterial cardiovascular disease possibly resulting from enhanced coagulation and arterial thrombosis. But there is few available data on air pollution exposure and the risk of venous thrombosis. In this study, we investigated the possible relation of air pollution and venous thromboembolism (VTE) , either as pulmonary emboli (PE) and deep venous thrombosis (DVT) in the city of Zonguldak, Turkey.

METHODS: All VTE cases diagnosed in the calender year of 2008 were retrospectively recorded from the hospital database with the appropriate ICD codes. Demographic and clinical data were obtained. Daily air quality (SO2 and PM) data for this region were obtained from the local authorities.

RESULTS: 197 VTE cases (49.75 % males and 50.25 % females) were enrolled to the study. Of them 170(67.51%) were PE, 64(32.6%) were DVT and 37(13.71%) had both diagnoses. At least one known risk factor (surgery, cancer, immobilization, genetic) was present in the medical history of 140(71.1%) patients (Group 1), and in 57(28.9%) no risks were identified (Group 2). In the city of Zonguldak, mean SO2 and PM values were 46.18 mcg/m3 (0-347 mcg/m3) and 105.65 mcg/m3 (14-326 mcg/m3) respectively for 2008. There was a significant difference for SO2 exposure between Group 1 and 2 (p: 0.004). On day by day evaluation, we found that maximum three VTE cases were diagnosed on a single day. Statistical analysis (nonparametric correlation (pearson)) showed no correlation between the VTE occurrence and air pollution parameters, SO2 and PM (r: 0.002, p:0.486 and r: 0.007, p:0.447 respectively) in general, but one-way ANOVA analysis with respect to daily number of VTE patients (0,1,2,3 respectively) showed no correlation for SO2 (p: 0.468), but a significant correlation for PM between the days with one and two case numbers (p: 0.005) and with two and zero case numbers (p:0.015).

CONCLUSION: Particulate air pollution is associated with increased risk of VTE on most days but not all days analysed for this study as other risk factors for VTE may modulate the effect of particulate air pollution. Interestingly, the patients with no known risk factor for VTE showed a significantly higher SO2 exposure in comparison to the patients with a known risk factor which needs to be further analysed in future studies. 
American Thoracic Society 2010 International Conference 
New Orleans, LA 
May 14-19, 2010