Association of ozone and pm2.5 air pollution on short-term venous thromboembolism risk, including 10861 vte events in an integrated health system: 17 years of longitudinal data

SESSION TITLE: Occupational and Environmental Lung Diseases Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Report the odds of short-term venous thromboembolism (VTE) risk related to air pollution defined as fine particulate matter (PM2.5) and ozone exposure. METHODS: Air pollution measurement data including PM2.5 and ozone levels were collected in metropolitan Salt Lake City (Wasatch Front) from fixed monitoring stations between 1 January 2008 and 31 March 2022. VTE events defined as deep vein thrombosis of the legs and pulmonary embolism among ambulatory patients were identified using validated natural language processing interrogation of the Intermountain Health® electronic data repository that includes all patient demographics, laboratory results, and imaging reports from 11 hospitals and about 100 Wasatch Front clinics. A time-stratified case-crossover design matched exposures at the time of an event with ≥1 period when the event did not occur (referent periods) to estimate any potential excess risk using conditional Poisson regression. Referent periods were matched for day of the week in the same month and year as the event, resulting in up to 3 or 4 control periods per event date, therefore patients served as their own controls. Odds ratios associated with incremental increases in PM2.5 concentration of each 10 µg/m3, and each 10 parts per billion ozone exposure were calculated. The primary outcome was the odds of VTE stratified by air pollution on the day of (D 0), or day before (D -1) the event, and the moving average (mAvg) during the preceding 3 (mAvg D -2-0) and 7 (mAvg D -6-0) days reported monthly, and by ‘wildfire’ (June-October) and ‘inversion’ (November-March) seasons. RESULTS: No significant increase in VTE odds existed for PM2.5 exposure during D 0, D -1, mAvg D -2-0, or mAvg D -6-0 during wildfire or inversion seasons. VTE odds was significantly increased for ozone exposure during mAvg D -2-0 (OR=1.062; 95% CI 1.001-1.127, p=0.047) and mAvg D -6-0 (OR=1.090; 95% CI 1.006-1.182, p=0.037) during wildfire season and was reduced (OR=0.949; 95% CI 0.914-0.986; p=0.007) during D 0 of inversion season. VTE odds calculated by month was not reliably increased for PM2.5 however VTE odds was significantly increased for ozone exposure during September for mAvg D -2-0 (OR= 1.221; 95% CI 1.072-1.389, p=0.0027) and mAvg D -6-0 (OR= 1.209; 95% CI 1.009-1.450, p=0.041) and was reduced for D 0 (OR=0.866, 95% CI 0.777-0.964, p=0.009) in November. CONCLUSIONS: Acute exposure to PM2.5 does not appear to impact the odds of VTE. Exposure to elevated ozone especially during the antecedent 3 and 7 days, during wildfire season (and especially in the month of September), was associated with increased odds of VTE. CLINICAL IMPLICATIONS: Understanding the association of air pollution and VTE risk may heighted the clinical suspicion for VTE disease and inform policymaker efforts to advance air quality initiatives. DISCLOSURES: Consultant relationship with BD Please note: $5001 - $20000 by Joseph Bledsoe, value=Consulting fee Advisory Committee Member relationship with Baxter Health Please note: 11/4-11/21 2022 Added 03/29/2023 by Joseph Bledsoe, source=Web Response, value=Honoraria No disclosure on file for Daniel Bride PI of research grant relationship with AstraZeneca Please note: $20001 - $100000 by Benjamin Horne, value=Grant/Research Support Removed 03/23/2023 by Benjamin Horne, source=Web Response PI of research grant relationship with GlaxoSmithKline Please note: $1-$1000 by Benjamin Horne, value=Grant/Research Support Removed 03/23/2023 by Benjamin Horne, source=Web Response PI of research grant relationship with CareCentra Please note: $1-$1000 by Benjamin Horne, value=Grant/Research Support Removed 03/23/2023 by Benjamin Horne, source=Web Response Owner of intellectual property relationship with Alluceo Please note: $1-$1000 by Benjamin Horne, value=IP was licensed Owner of intellectual property relationship with CareCentra Please note: $1-$1000 by Benjamin Horne, value=IP was licensed Consultant relationship with Pfizer Please note: 2022-present Added 03/23/2023 by Benjamin Horne, source=Web Response, value=Consulting fee No relevant relationships by James Lloyd No relevant relationships by Gregory Snow No relevant relationships by Scott Stevens No relevant relationships by Scott Woller