How Does Outdoor Air Pollution Affect Myeloma?

Dr. Michael Wysota from Montefiore Medical Center presented an abstract at ASH 2023 that discussed how fine particulate matter (usually found in outdoor air pollution) may contribute to worse outcomes in multiple myeloma. 

What Are Fine Particulate Matter and Outdoor Air Pollution? 

Fine particulate matter (FPM), made up of small particles, is an element of outdoor air pollution (OAP). It is considered one of the most dangerous elements of outdoor air pollution. The danger comes from its small size, which allows it to penetrate deeply into the lung tissues. This can cause cells to mutate within the body, resulting in various malignancies. 

OAP is typically generated by motor vehicles, burning fossil fuels, and industrial waste.

How Can FPM and OAP Affect Myeloma Outcomes? 

Dr. Michael Wysota and his colleagues conducted a retrospective study investigating exposure patterns to OAP in myeloma patients. They were inspired by studies showing evidence that environmental exposures (such as 9/11) increase the risk of developing multiple myeloma (Landgren O JAMA Oncol 2015, 2018). 

The researchers investigated their own Montefiore Health System community in the Bronx, New York. 

After gathering information from the Montefiore Electronic Data Warehouse from 1997-2018, they created a cohort of approximately 1,600 patients. Out of the 1600 patients, 1525 of them had multiple myeloma as their first cancer diagnosis.

This patient cohort was highly diverse:

• 50% Black
• 30% Hispanic
• 20% White
• 27% “Other”
• Average age was 66 years old

This group was tracked over 8-9 years. The area had higher-than-average exposure to outdoor air pollution and fine particle matter. Researchers discovered the more exposure to outdoor air pollutants, the worse the survival rate from multiple myeloma.

For every year that a patient was exposed to particulate matter, their survival decreased by approximately 7%.

While pollution exposure does not necessarily tell the entire story of a patient’s multiple myeloma, it is one factor that should be examined in the patient’s overall health journey.

How Does Outdoor Pollution Affect Myeloma Patients Of Color?

34,000 new cases of multiple myeloma are diagnosed each year. Black and Hispanic patients have a higher risk of multiple myeloma when compared to non-Hispanic whites. 

Unfortunately, the worst air pollution is usually found in densely populated urban areas. In a recent study, Racial and Ethnic Diversity in Large Urban Areas, the racial and ethnic diversity of 56 of the largest urban areas was shown to have increased dramatically from 1980 to 2020. Urban areas with the highest levels of diversity had much less than 50% of the population White, with varying mixes of Blacks, Latinos, and Asians.

This shows us that people of color are disproportionately exposed to outdoor air pollution and fine particle matter due to their population density in urban areas.

Action Steps 

It's unrealistic to ask multiple myeloma patients living in urban areas to move to avoid their exposure to outdoor air pollution. 

What else can be done, then, in order to reduce the risk of outdoor air pollution? The American Lung Association shares some helpful tips: 

• Be aware of the daily air pollution forecasts in your area. These forecasts, which come color-coded, can let you know when the air is unhealthy in your community. To check the air forecast, you can use local radio and TV weather reports and newspapers or check online at airnow.gov.
• Avoid exercising outdoors when pollution levels are high. Good indoor workouts include walking in a shopping mall or using a gym. Even if the air quality forecasts are green (or at healthy levels), avoid exercising near busy traffic areas because vehicles can create high pollution levels in their vicinity.
• Be smart about your commutes. Use buses, subways, light rail systems, commuter trains, or other alternatives to driving your car. Walk when possible on green-air days.
• Your indoor air quality is just as important as the outdoor air quality. Learn how to make sure the air you breathe indoors is clean.

Conclusion

Knowing that the air quality around you can impact your health can feel overwhelming. However, studies like this are important if we want to show concrete proof that something must be done about our air quality. Do your part to make our environment's air clean, and if it becomes a large concern, talk to your doctor about possible solutions. 

Curious about other similar investigations presented at medical conferences such as ASCO or ASH? Create a free HealthTree account and view our interviews with international experts explaining the latest research findings and therapeutic advances here: News from Cancer Conferences - HealthTree Univesity for Multiple Myeloma.

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Sources: 

• Multiple Myeloma and Its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster
• Agent Orange Exposure and Monoclonal Gammopathy of Undetermined Significance: An Operation Ranch Hand Veteran Cohort Study
• Exposure to Fine Particulate Matter (PM2.5) Is Associated with Worse Multiple Myeloma Outcomes in a Large, Urban, Multi-Ethnic Cohort
• Fine Particulate Matter and Myeloma Outcomes in Urban Cohort | Michael Wysota, MD | ASH 2023
• Racial and Ethnic Diversity in Large Urban Areas in the U.S., 1980-2020
• UN health agency warns of rise in urban air pollution
• 10 Tips to Protect Yourself from Unhealthy Air