The link was also found in another study by Dr. Ramanathan and his colleagues. They looked at data on military personnel around the United States, finding a 3-fold increase in CRS for every 5 microgram per cubic meter increase in PM 2.5 exposure. The findings are persuasive, he said, especially because of the reliability of military data.
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August 2022“We know exactly where the military personnel are, and they’re required to get routine physical exams,” he said. “I think this is one example of how climate change and related air pollution are associated with a high incidence of CRS.”
Particulate Matter and CRS
In the clinic, rhinologists are noticing the effects of exposure to these conditions, added Dr. Ramanathan. “You’ll find that patients who are in highly polluted areas do tend to be more symptomatic,” he said, “and, retrospectively, you begin to see that they have this type of exposure.”
Recent research has also shown that environmental conditions seem to play a role in the severity of disease. Researchers at the University of Pittsburgh looked at 113 patients with CRS with nasal polyps, 96 patients with CRS without polyps, and 25 patients with aspirin-exacerbated respiratory disease. They found that patients exposed to vapors, gases, dusts, fumes, fibers and mists, or diesel fumes required more steroid use than those without such exposure. In addition, those with higher levels of exposure were more likely to undergo functional endoscopic sinus surgery compared to those who were not exposed (Int Forum Allergy Rhinol. 2020;10:175-182). “We’re seeing a lot of people who have had CRS who are doing well, but the ones who are in environments where they’re exposed to higher levels of air pollution are more prone to exacerbations,” Dr. Ramanathan said.
In the Central Valley of California, researchers are examining the effects that these conditions are having on the body. “In some of the cohorts that we have, the asthma rates are up to 20 to 25 percent, which is much higher than the national or even state average,” said Mary Prunicki, MD, PhD, senior director of air pollution and health research at Stanford University. “Even though the [air quality] regulations have improved, we continue to have poor air quality.”
“The Central Valley is similar to a basin,” added Juan Aguilera, MD, PhD, MPH, director of translational environmental and climate health at Stanford University. “Basically, air pollution stagnates, and the Valley has several contributors coming from nearby air pollution sources, such as heavy traffic. Also, during wildfire season, the smoke tends to stall longer around the Central Valley.”