Air pollution and coagulation testing: a new source of biological variability?

Area of Science:

• Environmental Science
• Hematology
• Toxicology

Background:

• Coagulation test results are influenced by preanalytical and biological variability.
• Factors like age, gender, ethnicity, diet, and lifestyle are known contributors.
• Emerging evidence suggests environmental influences, including pollutants, significantly affect biological variability.

Purpose of the Study:

• To explore the impact of environmental influences, specifically air pollutants, on coagulation testing.
• To highlight the need to consider environmental factors in interpreting laboratory data.

Main Methods:

• Review of epidemiological evidence on air pollution and coagulation parameters.
• Analysis of reported effects of air pollutants on specific coagulation factors and platelet function.

Main Results:

• Air pollutants are linked to shortened prothrombin time and decreased levels of factor VII, tissue plasminogen activator, and platelet count.
• Evidence suggests air pollutants can increase fibrinogen, factor VIII, von Willebrand factor, and platelet hyperactivity.

Conclusions:

• Environmental factors, particularly air pollution, play a significant role in biological variability of coagulation tests.
• While specific reference ranges for air pollutant concentrations are impractical, awareness of their potential influence is essential for accurate interpretation of coagulation test results.