LAUSR

BACKGROUND The prothrombotic effects of particulate matter (PM) may underlie the association of air pollution with increased risks of cardiovascular disease. This study aimed to investigate the association between long-term exposure to PM with an aerodynamic diameter ≤2.5 μm (PM2.5) and platelet counts, a marker of coagulation profiles. METHODS The study participants were from a cohort consisting of 362,396 Taiwanese adults who participated in a standard medical examination program between 2001 and 2014. Platelet counts were measured through Complete Blood Count tests. A satellite-based spatio-temporal model was used to estimate 2-year average ambient PM2.5 concentration at each participant's address. Mixed-effects linear regression models were used to investigate the association between PM2.5 exposure and platelet counts. RESULTS This analysis included 175,959 men with 396,248 observations and 186,437 women with 397,877 observations. Every 10-μg/m3 increment in the 2-year average PM2.5 was associated with increases of 0.42% (95% CI: 0.38%, 0.47%) and 0.49% (95% CI: 0.44%, 0.54%) in platelet counts in men and women, respectively. A series of sensitivity analyses, including an analysis in participants free of cardiometabolic disorders, confirmed the robustness of the observed associations. Baseline data analyses showed that every 10-μg/m3 increment in PM2.5 was associated with higher risk of 17% and 14% of having elevated platelet counts (≥90th percentile) in men and women, respectively. CONCLUSIONS Long-term exposure to PM2.5 appears to be associated with increased platelet counts, indicating potential adverse effects on blood coagulability.