Influence of weather and air pollution on the occurrence of idiopathic pulmonary embolism in the region of Sousse (Tunis
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RESEARCH ARTICLE
Influence of weather and air pollution on the occurrence of idiopathic pulmonary embolism in the region of Sousse (Tunisia) Imène Kacem 1,2 & Mohamed Kahloul 1,3 & Meriam Hafsia 1,2 & Haifa Aroui 1,2 & Maher Maoua 1,2 & Mohamed Ajmi 1,3 & Maher Jedidi 1,4 & Jridi Gouider 1,5 & Neirouz Ghannouchi 1,6 & Chadia Laouani 1,7 & Imed Chouchane 1,8 & Dalila Taieb 9 & Ajmi Chaouch 1,3 & Walid Naija 1,3 & Nejb Mrizak 1,2 Received: 18 December 2019 / Accepted: 25 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Pulmonary embolism (PE) is the most serious manifestation of thromboembolic conditions. Its incidence varies considerably between countries, suggesting its interaction with the external environment. To analyze the influence of climate and air pollution on the occurrence of idiopathic PE in the region of Sousse (Tunisia). A total of 142 patients with idiopathic PE at two academic hospitals in Sousse (Tunisia) were enrolled in the study over a 7-year period. An analysis of two time series (environmental data and PE cases) was performed. Climatic data were collected from the National Institute of Meteorology. Air pollution data were obtained from the modeling platform of the National Agency for Protection of the Environment. The year 2015 was marked by the occurrence of the highest number of cases (24.6%). A statistically significant decrease in PE risk of 41.9% was observed during the summer with an OR of 0.59 (95% CI [0.36–0.94] and p = 0.026), compared with other seasons. Poisson GLM regression showed a significant increased risk of PE of 3.3% for each 1 °C temperature drop. After multiple binary logistic regression, the elevation of PM10 concentration was independently associated with an increased risk of PE (p < 10−3, OR 79.55, 95% CI [42.28–149.6]). Some environmental parameters may predispose to the onset of idiopathic PE. Understanding their accurate influence may have preventive and curative implications. Keywords Pulmonary embolism . Environment . Air pollution . Climate
Introduction Pulmonary embolism (PE) is the most serious manifestation of thromboembolic conditions. It remains today one of the leading causes of death in the general population. It is defined by the obstruction of the pulmonary arteries or their branches
by emboli, most often from the lower extremity deep veins (Tapson 2008). In the literature, its incidence ranges all over the world from 11.7 to 189 per 100,000 persons suggesting disparity between countries (Law et al. 2018). In addition, variation in the number of patients admitted to hospital for PE per day has also
Responsible editor: Lotfi Aleya * Mohamed Kahloul [email protected]
5
Department of Cardiology, FarhatHached University Hospital, Sousse, Tunisia
6
Department of Internal Medicine, Farhat Hached University Hospital, Sousse, Tunisia
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Department of Internal Medicine, Sahloul University Hospital, Sousse, Tunisia
1
Faculty of Medicine of Sousse, Université du centre, Sousse, Tunisia
2
Department of Occupational Med
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