• Author
    Victor Arechiga
  • Discovery PI

    Dr. Jivianne Lee

  • Project Co-Author

    Mishek Thapa, BS; Hong-Ho Yang, MD; Melodyanne Y. Cheng, MD; Rory Lubner, MD; Jeffrey D. Suh, MD; Marilene B. Wang, MD; Daniel M. Beswick, MD; Jivianne T. Lee, MD

  • Abstract Title

    Ambient Air Pollutant Exposure and Radiographic Assessment of Chronic Rhinosinusitis Using Lund-Mackay Scoring

  • Discovery AOC Petal or Dual Degree Program

    Basic, Clinical, & Translational Research

  • Abstract

    Background: Ambient air toxicants have been implicated in chronic airway inflammation, but their contribution to chronic sinusitis (CRS) progression remains poorly understood. We evaluated associations between pollutant exposure using objective residential data and CRS severity via the Lund-Mackay (LM) scoring system.

    Methods: We conducted a retrospective review of patients presenting for rhinology evaluation with sinus CT imaging between January 2018 and December 2022. Residential ZIP codes of patients meeting CRS diagnostic criteria were linked to modeled concentrations of six airborne pollutants from the California Air Toxics Assessments dataset. The dichotomous independent variable of exposure level (severe or not severe) was determined by screening ZIP codes at the top 20% of pollutant exposure. The primary outcome was LM score. Verified multivariable ordinal regression models assessed the association between mean pollutant exposure and LM score, controlling for demographic factors, smoking status, hypertension, year of surgery, and LA County residence. 

    Results: In adjusted models of 1,172 patients with CRS (median age 54, 46% female), higher ZIP-code exposure to Benzene (OR[95% CI] = 1.55[1.13–2.14]), Butane (OR[95% CI] = 1.69[1.24-2.31]), Lead (OR[95% CI] = 1.44[1.06-1.96]), Chromium (OR[95% CI] = 1.54[1.13-2.11]), and Nickel (OR[95% CI] = 1.54[1.13–2.10]) was independently associated with significantly higher LM scores. Zinc exposure showed no significant association with LM score.

    Conclusion: This retrospective cohort analysis demonstrated that multiple airborne pollutants were independently associated with radiologic CRS burden, suggesting environmental exposure may be an underrecognized and modifiable risk factor.

Back