Environmental Effects on the Incidence of Spontaneous Pneumothorax

Authors: J. Galea, K. Grech, T. Parnis, L. Camilleri

Corresponding: J. Galea (joseph.f.galea@um.edu.mt)

Keywords: none

Doi: 10.7423/XJENZA.2019.2.02

Issue: Xjenza Online Vol. 7 Iss. 2 - December 2019

Spontaneous pneumothorax (SP) is a common occurrence especially in young male asthmatics and smokers. Several studies have shown that this condition occurs in clusters although other reports showed the contrary. There is evidence that clustering of cases occur as a result of severe changes in atmospheric pressure. The literature is however very limited with regards to the relationship between air pollution and spontaneous pneumothorax. Methodology: Observational study on consecutive patients admitted with SP from January 2010 to December 2014. The data regarding dates of admissions, gender, age, residential address, smoking history, relevant medical history and sequential management of the pneumothorax were collected and tabulated. The admission dates were analysed to test for clustering of admissions of patients. The patients were identified by location to assess the incidence of SP in different locations or areas. The Environment and Resources Agency (ERA) of Malta supplied daily particulate data from 3 different sites in the archipelago for the years 2010-1014. Results: There were 112 patients presenting with 134 episodes of SP. The mean age was 29 years and 86.6% were males. No admission date clustering occurred and therefore linkage to atmospheric pressure changes cannot be made. There was however a very significant increase in incidence in patients hailing from the harbour area (p < 0:00001). ERA data shows that there was a similarly significant increase in particulate material in the air of the harbour locality when compared to non- harbour areas. Discussion and Conclusion: SP is commoner in men and smokers. There was no evidence of admission day clustering but areas with increased air particulate matter had an increased incidence of patients with SP. Increased air pollution seems to increase the incidence of SP either directly or indirectly.

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