Abstract
Purpose: India has been identified as having the 2nd most number of births with sickle cell anemia in the world, after Africa. Apart from biomarkers, environmental factors play an important role in the clinical severity. As there are no such studies from India,current study attempts to address the effects of environmental factors in children with SCD. Materials and methods: Prospective observational study was conducted in 122 consecutively recruited hospitalized children of 1-12 years of age with SCD diagnosed by HPLC,living within a 10km radius of the tertiary care centre.Convenience sampling method was used.This a hospital based study conducted from 1st January 2020 to 31st December 2021.The severity of morbidity were identified by duration of hospital stay,number of blood transfusions,infections & VOCs and correlated with various environmental factors like temperature,rainfall,humidity,windspeed & particulate matters on the day of admission. Results: The study was conducted in Jan 2020-Dec 2021.A total of 212 admissions from 122 subjects were included, 88 females(41.51%) & 124 males(58.49%).Of this,35.85% of children were under 5 years & 64.15% of children above 5 years.The causes of admission included vasoocclusive crisis(54.25%),severe anemia requiring blood transfusions(41.98%) & infections(34.91%). Various environmental factors recorded during this period were as follows, maximum temp 32.85(22-46.8),min temp 21.46(0-30.8), relative humidity 78.41(20-100),wind speed 5.98(0-28km/hr),rainfall 4.89(0-100.3), atmospheric NO2 levels 27.29(0-95ug/m3),SO2 7.06(0-39ug/m3) & Ozone 41.76(0-148ug/m3). We noted an increase in the admissions as the relative humidity increases.Both extremes of temperature & relative humidity were the 3 important factors in causing VOCs & infections across 3 different seasons(p=0.0001).Among air pollutants, rising NO2 levels were significantly related to VOCs(p=0.0002).Rainfall had a strong correlation with infections(p=0.0035).All the environmental factors, except ozone were found significantly correlated with VOC & severe anemia while Infection was significantly related to all the environmental factors except wind speed,NO2 & Ozone. Conclusion: Studying the effect of environmental factors in SCD is important,as it allow patients and families to be given accurate information on how to reduce the risk of acute complications, because they can be manipulated relatively easy with simple advices,unlike genetic factors.However,further long term studies need to be conducted, to assess the effects on chronic complications and to drive public health policies. The authors do not declare any conflict of interest
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
