Breathing polluted air in the days before surgery may increase the risk of serious complications afterward, according to new research from the University of Utah that adds to growing evidence about the health effects of fine particulate pollution.
The study examined nearly 50,000 surgical patients in northern Utah and found that higher exposure to PM2.5 was linked to a greater chance of postoperative complications.
Researchers analysed medical records from 49,615 adults who underwent surgery between 2016 and 2018, linking patients’ home addresses to local daily air pollution estimates. They focused on the highest level of PM2.5 exposure in the week leading up to surgery and tracked whether patients later developed complications such as pneumonia, sepsis, surgical site infections, heart attacks or blood clots.
The results showed that for every 10μg/m³ increase in PM2.5 exposure, the odds of developing a complication rose by 8.2%. Patients exposed to pollution levels rising from 1 to 30μg/m³ faced more than a 27% increase in complication risk.
Overall, about 4.9% of patients in the study experienced at least one major postoperative complication. But among those exposed to especially high pollution levels – above the U.S. Environmental Protection Agency’s daily safety threshold of 35μg/m³ – complication rates climbed to 6.9%.
The study does not prove that air pollution directly causes complications, but the authors say the findings fit with what is already known about PM2.5. Fine particles can trigger inflammation, stress the cardiovascular system and affect blood clotting, all processes that are already strained by surgery itself.
The risk appeared even greater for patients with existing health problems, suggesting pollution may have the biggest impact on medically vulnerable groups.
Beyond the findings themselves, the research also highlights a new way of studying surgical risks. The team used Bayesian statistical modeling, an approach that allows researchers to estimate probability more directly than traditional methods and better account for uncertainty.
The study supports previous research, which has found that under general anesthesia, young children with a history of reactive airway disease such as asthma, had a greater chance of suffering of adverse respiratory events during wildfire episodes.
At the time, the American Society of Anesthesiologists pointed out that current weather forecasting now allows for accurate smoke plume spread prediction, which triggers air pollution warning systems and suggests that changes could be made in the scheduling of surgical cases in high-risk patients during these periods.
The full research can be read here.
Photo: Husien Bisky
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