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SALT LAKE CITY — Childhood cancer survivors are at a higher risk for respiratory-related hospitalizations on poor air quality days, according to new research from the Huntsman Cancer Institute.
"Cancer treatments are a miracle of modern medicine and we're able to cure a lot of people that we couldn't save before," said Dr. Judy Ou, lead author of the study. "Because of this growing survivor population, preserving their health and making sure they can live their lives in a high quality fashion is really important."
About 80 percent of children diagnosed with cancer will survive their disease according to the cancer institute. With the childhood cancer-surviving population on the rise, researchers thought it was important to better understand health concerns that could impact this growing group.
Researchers used the Utah Population Database to study a sample of nearly 4,000 child, adolescent and young adult cancer survivors who were treated at Primary Children's Hospital between 1986 and 2012.
The study, titled "Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers," had three groups: those who received chemotherapy as part of treatment, those who did not, and a cancer-free control group.
Researchers tracked medical records for participants, paying special attention to hospitalizations or emergency room visits for respiratory illnesses that occurred on unhealthy air days.
Cancer treatments are a miracle of modern medicine and we're able to cure a lot of people that we couldn't save before. ... preserving their health and making sure they can live their lives in a high quality fashion is really important.
–Dr. Judy Ou, Huntsman Cancer Institute
The Utah Department of Environmental Quality tracks air quality conditions by area and rates air quality for that day on a color scale where red indicates unhealthy air and green indicates healthy air.
The results of the study showed cancer survivors were at a higher risk for respiratory-related hospitalizations when air pollution was below the standard considered unhealthy for sensitive groups.
In other words, researchers saw cancer survivors were at a higher risk for hospitalization on yellow days, or a moderately healthy day, rather than orange days, which are considered unhealthy for sensitive groups.
The chemotherapy group was twice as likely to need medical attention for respiratory issues.
Ou noted that respiratory issues are a leading non-cancer cause of death among survivors. Air pollution can contribute to respiratory problems, Ou said.
"There's I think an increasing amount of research showing that the thresholds we use for air pollution may not really be protecting everyone the way that they should be," added Dr. Anne Kirchhoff, researcher on the study and a pediatrics professor at the University of Utah.
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The research was funded by St. Baldrick's Foundation, a nonprofit dedicated to childhood cancer research. Ou and Kirchhoff said they plan to conduct future studies examining adult cancer survivors.
A majority of hospitalizations, at 91 percent, and 75 percent of emergency room visits occurred along the Wasatch Front in Salt Lake, Davis, Utah and Weber counties.
The study examined acute, or short-term respiratory issues and the pair said they plan to conduct future studies that look at long-term problems for childhood cancer survivors potentially caused by low air quality.
Ou said reducing air pollution is a win-win for everybody — it would protect both the vulnerable and the general population, create a healthier environment and potentially reduce economic impacts.
"We know that people who had cancer are susceptible to respiratory health issues, cardiac issues as well as second cancers," she said. "And so just from an economics perspective, if we can reduce their burden of disease we'll be saving our society a lot of money in the long run. And compared to the cost of medical care, reducing particulate matter could be a very cost-effective way to reduce their impact on our health care system."
Dr. Douglas Fair, a pediatric oncologist at Primary Children's Hospital, advised childhood cancer survivors to speak with their physicians if they are concerned they're at risk for air pollution-related respiratory issues.
"I would also encourage them to advocate for cleaner air in Utah," he said. "I think we can all work in this state to improve air quality because I think there are lots of vulnerable populations."
Doctors and health care providers work hard to cure these patients of cancer, he added, and said survivors deserve a high quality of life.
"I think it's important for all of us to really try to help them live the healthiest lives possible after that," he said. "And in Utah, one of the things that we really can do is decrease the air pollution that they're exposed to."
