Associations of community-level particulate matter with high-acuity visit presentation for sinusitis

Exposure to particulate matter <2.5 μm in diameter (PM_2.5) has been linked to increased sinusitis prevalence and morbidity. However, studies analyzing environmental exposures and sinusitis have not explored the effect of PM_2.5 on healthcare presentation patterns.

This study aims to characterize the relationship of community-level PM_2.5 with high-acuity visits in sinusitis patients.

A retrospective analysis based on medical records of 2092 adults presenting with chronic rhinosinusitis, acute rhinosinusitis, or sinus/nasal polyps to an urban academic medical center from 2010 to 2019 was conducted. We linked medical records (individual-level) with data on PM_2.5 exposure at the community level, using residential zip-code data from the Chicago Health Atlas covering the years 2015-2019. Multivariable binary logistic regression with Generalized Estimating Equations examined adjusted associations between PM_2.5 and high-acuity visits - including emergency department and inpatient settings.

Our sample was 69 % female, with a mean age of 46.9 years. From 2015 to 2019, the average PM_2.5 exposure in zip-codes examined was 11.66 μg/m³ with a range of 11.14-11.79 μg/m³. In adjusted models, odds of a high-acuity visit were significantly higher in patients residing in zip-codes in the top tertile of PM_2.5 exposure compared to the bottom tertile (OR: 1.74; CI: 1.20-2.51).

Community-level PM_2.5 exposure was associated with high-acuity visits among sinusitis patients. These associations need to be studied through more rigorous, prospective investigations, as they may have potential public health implications and underscore a need to mitigate PM_2.5 exposures at a community-level.