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Air pollution linked to blood clots 5-13-08

Long-term exposure to a type of air pollution, the air-borne fine particles, appears to dramatically increase the risk of deep vein thrombosis, a condition that can lead to a life-threatening pulmonary embolism, according to a study in the May 12 issue of the Archives of Internal Medicine.

Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein blood clots occur in the lower leg or thigh although they can also occur in other parts of the body. This type of clots is dangerous when they break loose and travel through the bloodstream to the lungs, causing pulmonary embolism.

The study showed that people with DVT tended to have a higher exposure to air pollution than controls. After considering other factors, researchers found an increase in particulate matter of 10 micrograms per cubic meter increased the risk of DVT by 70 percent. Blood from people exposed to more air pollution of this sort needed less time to clot.

Air pollution with particulate matter smaller than 10 micrometers in diameter or about one-40th the width of a human hair has been known to increase risk of a number of diseases including asthma, chronic bronchitis, heart attack, stroke and death in people with heart or lung disease.

Particulate air pollution can be caused by a range of fine particles often coming from the exhaust of vehicles, particularly those with diesel engines and burning of fossil fuels. It can be caused also by other pollutants such as road dust, fly ask, wood smoke and sulfate aerosols.

National Resources Defense Council estimated that particulate air pollution causes approximately 64,000 premature deaths from cardiopulmonary causes each year, accounting for 6.5% of all cardiopulmonary deaths - 986,000 per year.

Dr. Andrea Baccarelli an assistant professor at the University of Milan and colleagues conducted the study at the Harvard School of Public Health. They compared 870 residents with DVT in the Lombardy region of Italy with 1,210 residents without this condition for their exposure to the air pollution of particulate matter between 1995 and 2005.

The researchers found the association between fine particle exposure and blood clots was stronger in men than in women, but non-existent among women taking oral contraceptives or hormone therapy, which are known independent risk factors for DVT as the current study confirmed.

"Given the magnitude of the observed effects and the widespread diffusion of particulate pollutants, our findings introduce a novel and common risk factor into the pathogenesis of deep vein thrombosis and, at the same time, give further substance to the call for tighter standards and continued efforts aimed at reducing the impact of urban air pollutants on human health," the researchers conclude.

Air Pollution May Increase DVT Risk

Chronic exposure to air pollution alters the blood's coagulation properties and heightens the risk of deep vein thrombosis (DVT), investigators here concluded.

The risk of a clot increased by 70% with each 10 μg/m3 rise in particulate matter, Andrea Baccarelli, M.D., Ph.D., of Harvard School of Public Health, and colleagues, reported in the May 12 issue of Archives of Internal Medicine.

A near-linear relationship emerged from the range of particulate matter concentrations.

"Given the magnitude of the observed effects and the widespread diffusion of particulate pollutants, our findings introduce a novel and common risk factor into the pathogenesis of DVT and, at the same time, give further substance to the call for tighter standards and continued efforts aimed at reducing the impact of urban air pollutants on human health," the authors concluded.

Exposure to air pollution has been linked to hypercoagulability and increased risk of heart disease and stroke, the researchers said. Moreover, recent studies have demonstrated a shortened prothrombin time in association with higher levels of particulate air pollution of less than 10 μm in aerodynamic diameter (PM10).

Procoagulant abnormalities correlate more strongly with venous rather than arterial thrombosis, they said.

In preclinical models, they noted, experimental exposure to air pollution induced venous thrombosis. Whether air pollution has a similar effect on humans had not been reported.

To examine that, Dr. Baccarelli and colleagues studied 870 patients with DVT diagnoses from 1995 through 2005 in the Lombardy region of northern Italy. Investigators estimated exposure to PM10 in the year before DVT diagnosis and in 1,210 individuals without DVT from the same area.

Comparison of the two groups showed that a higher mean PM10 was associated with a shortened prothrombin time in cases and controls (P=0.04).

A 10 μg/m3 rise in PM10 was associated with an odds ratio of 1.70 for DVT (95% CI 1.30 to 2.23, P<0.001).

The association was weaker in women than in men (OR 1.40, 95% CI 1.02 to 1.92, P=0.02 versus OR 2.07, 95% CI 1.50 to 2.84, P<0.001). Use of oral contraceptives or hormone therapy further lowered the risk in women (OR 0.97, 95% CI 0.58 to 1.61).

"We surmise that prothrombotic mechanisms are already activated in [women] receiving hormone therapy so that they undergo less or no further induction after air particle exposure," the authors said, alluding to the procoagulant effects of oral contraceptives and hormone therapy.

Although increased exposure to air pollution shortened prothrombin time in cases and controls, the authors said the thrombosis patients tended to have higher PM10 levels compared with controls.

The study had several limitations including choice of controls from the same locations as patients, raising the possibility that the controls were exposed to more air pollution than the general population, and lack of data about the amount of time spent outdoors by both groups. Air pollution exposure was determined by ambient air pollution at the location.

The premise that air pollution increases DVT risk is plausible, "given the underlying common soil behind arterial atherosclerosis and venous thrombosis," Robert D. Brook, M.D., of the University of Michigan, said in an editorial in the same issue.

However, Dr. Brook questioned the magnitude of the reported association. The difference is greater than that reported for arterial thrombosis and for other factors that influence DVT risk, such as cigarette smoking.

Dr. Brook also said the lack of an additive effect of air pollution on underlying mechanisms of thrombophilia was unexpected and should be explored further in future studies.

Despite his questioning, Dr. Brook concluded that "some degree of clinically meaningful association between ambient particulate air pollution and venous thrombosis appears to be likely existent and worthy of future attention."

What you can do about Indoor Air Pollution to Reduce Asthma:

Reducing all dirty and foreign particles your children's air not only raises IQ, but reduces asthma and allergies. The greatest gift you can give your children as well as yourself is to quit smoking. If you choose not to, at least never allow smoking in your house or car even when your children aren't present. The over 3000 chemical particles found in cigarette smoke cling to everything and can be stirred back up at anytime.

Use allergen barrier covers for all mattresses and pillows. They are not plastic like they used to be and are not noticeable at all under sheets. If you have to have carpets in your Child's room vacuum weekly and use Fabreeze Allergen Reducer (Do Not use Regular Fabreeze use only the one marked Alleregen Reducer, Do not use any Fabreeze if you have Multiple Chemical Sensitivity) or a dust mite spray on all fabric or furry things. Always run an ionizing HEPA filter. The Holmes brand room size for under $25 works just fine!

When it comes to carpet care there is a brand of vacuum that uses water to run the air through so 100% of all airborne pollutants are captured. It's called HYLA and is the best vacuum around. For more information on it email me. In your current vacuum make sure you use HEPA Filters if your vacuum has them. Or buy the strongest filtration you can get. If you have a bin type vacuum, never empty inside the home; all the dust you just vacuumed up will go everywhere.

If you have a furnace don't use those cheap Blue filters. Make sure your filter has a MERV rating of  7+ or it is useless. A MERV 7 or higher filter will remove mold, dander and many other dangerous pollutants.

Strive to use no chemical cleaners. These release harmful volatile organic compounds into the air. Read the Article Easy Substitutions for Healthier Living for hints on switching to healthy cleaners.

If you own pets bathe them at least once a month. Feed them correctly and they will produce very few allergens.

Following these simple tips will drastically reduce dust and millions of other nasty particles; which will keep you and your children healthier and as this new study show, smarter.

The Best Option Is:

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