Air pollution may worsen chest syndrome in SCD, study finds
Young patients in polluted areas more likely to be hospitalized with ACS
Young people with sickle cell disease (SCD) who live in areas with more air pollution are more likely to be hospitalized due to acute chest syndrome (ACS), an SCD complication marked by symptoms that can include chest pain and difficulty breathing, a study found.
“As ACS is a severe complication of SCD, this result indicates that environmental pollutants may exacerbate respiratory complications in [children and young adults] living with SCD,” the researchers wrote. The finding “underscores the urgent need for environmental interventions to reduce exposure levels in vulnerable populations.”
The study, “Airborne injustice: a preliminary exploration of the associations between pollutants and hospitalizations, sleep, and cognition in children and young adults living with sickle cell disease,” was published in the Journal of Pediatric Psychology.
SCD is a genetic disorder marked by the production of an abnormal form of hemoglobin, the protein red blood cells use to carry oxygen through the bloodstream. The abnormal hemoglobin is prone to clumping inside red blood cells, deforming them and making them inclined to get stuck inside blood vessels, interrupting blood flow and leading to complications like ACS or vaso-occlusive crisis.
Air pollution has a range of well-documented negative health impacts on the general population, but few studies have looked into how it affects people with SCD specifically.
Looking at environment’s role in SCD
To learn more, the researchers analyzed data from 94 children and young adults with SCD in the U.K. Almost all of these patients identified as Black, and most lived in communities with relatively high levels of economic deprivation.
“This study seeks to contribute to a deeper understanding of the interplay between environmental pollutants and SCD, considering the role of asthma diagnosis and community deprivation,” the researchers wrote.
Their analysis focused on two types of air pollution: nitrogen dioxide (NO2), a gas produced when fossil fuels are burned; and particulate matter (PM10), which refers to dust or debris particles smaller than 10 micrometers. The researchers used statistical models to look for associations between the levels of these pollutants in the places where young people with SCD lived and their clinical outcomes.
Results showed that patients with higher exposure to NO2 or PM10 had significantly higher rates of hospitalizations related to ACS.
Analyses also indicated that patients with more pollution exposure were more likely to have asthma, though this trend was not statistically significant — meaning that, mathematically, the likelihood this difference could be due to random chance is non-negligible. The researchers noted, however, that ACS-related hospitalizations were more common among patients with asthma.
Analyses did not show statistically significant associations between pollution and measures of pain-related hospitalizations, sleep quality, or cognition. However, the researchers highlighted a few non-significant trends they said may be worth exploring in further analyses with larger datasets.
The scientists also noted a need for further studies to delve deeper into the relationship between air pollution and ACS. Still, they said the available data support the idea that reducing pollution may help improve health outcomes for young people with SCD.
“These findings underscore the need for continued research into the effects of air pollution on this minoritized population, as well as targeted interventions to reduce exposure and improve health outcomes,” they wrote.
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