Palabras clave
enfermedades hematológicas
exposición a riesgos ambientales
hematología
Cómo citar
Resumen
La contaminación atmosférica es uno de los principales riesgos ambientales para la salud, con efectos reconocidos en enfermedades respiratorias y cardiovasculares; sin embargo, su impacto sobre el sistema hematopoyético ha sido poco explorado. Esta revisión narrativa de la literatura sintetiza la evidencia disponible sobre la asociación entre la exposición a contaminantes atmosféricos y el desarrollo de enfermedades hematológicas. Los estudios analizados muestran que la exposición a largo plazo a partículas finas, dióxido de nitrógeno y benceno se vincula con mayor riesgo de leucemias, particularmente leucemia linfoblástica aguda en niños y leucemia mieloide aguda en adultos. En linfomas, los hallazgos son heterogéneos, con asociaciones reportadas en subtipos específicos, como el linfoma folicular. Por otra parte, la evidencia sobre trombosis arterial y venosa es más consistente, relacionada con inflamación sistémica, activación plaquetaria y disfunción endotelial. Se identifican vacíos relevantes en la literatura, destacando la necesidad de estudios multicéntricos y longitudinales que incluyan biomarcadores hematológicos y enfoques exposómicos.
Citas
Manisalidis I, Stavropoulou E, Stavropoulos A y col. Environmental and Health Impacts of Air Pollution: A Review. Front Public Health.. 2020;8:14. doi: 10.3389/fpubh.2020.00014.
Vallero D. Part I: Foundations of air Pollution. 6th ed. Vallero D, editor. NC, United States: Academic Press, Elsevier Inc. 2025;1064 p.
Pryor JT, Cowley LO, Simonds SE. The Physiological Effects of Air Pollution: Particulate Matter, Physiology and Disease. Front Public Health. 2022;10:882569. doi: 10.3389/fpubh.2022.882569.
World Health Organization (WHO). Air pollution. Health Top. 2025. https://www.who.int/health-topics/air-pollution. [Accessed September 19, 2025]
Brauer M, Roth GA, Aravkin AY y col. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet. 2024;403:2162-2203. doi: 10.1016/S0140-6736(24)00933-4.
Nyadanu SD, Dunne J, Tessema GA y col. Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses. Environ Pollut Barking Essex 1987. 2022;306:119465. doi: 10.1016/j.envpol.2022.119465.
Vizcaíno MAC, González-Comadran M, Jacquemin B. Outdoor air pollution and human infertility: a systematic review. Fertil Steril. 2016;106:897-904.e1. doi: 10.1016/j.fertnstert.2016.07.1110.
Straif K, Cohen A, Samet J. Air Pollution and Cancer. International Agency for Research on Cancer (IARC). Lyon, France: WHO Press, World Health Organization (WHO). 2013;177 p.
Wang M, Kim RY, Kohonen-Corish MRJ y col. Particulate matter air pollution as a cause of lung cancer: epidemiological and experimental evidence. Br J Cancer. 2025;132:986-996. doi: 10.1038/s41416-025-02999-2.
Guzmán RD, Schiller J. Air pollution and its impact on cancer incidence, cancer care and cancer outcomes. BMJ Oncol. 2025;4:e000535. doi: 10.1136/bmjonc-2024-000535
Gardner WM, Razo C, McHugh TA y col. Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10:e713-e734. doi: 10.1016/S2352-3026(23)00160-6.
Odo DB, Yang IA, Dey S y col. A cross-sectional analysis of ambient fine particulate matter (PM2.5;exposure and haemoglobin levels in children aged under 5 years living in 36 countries. Environ Res. 2023;227:115734. doi: 10.1016/j.envres.2023.115734.
Jung J, Rahman MM, Rahman MS y col. Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta-analysis. Ann N Y Acad Sci. 2019;1450:69-82. doi: 10.1111/nyas.14112.
Honda T, Pun VC, Manjourides J y col. Anemia Prevalence and Hemoglobin Levels are Associated with Long-Term Exposure to Air Pollution in an Old er Population. Environ Int. 2017;101:125-132. doi: 10.1016/j.envint.2017.01.017.
Kwag Y, Ye S, Oh J y col. Direct and Indirect Effects of Indoor Particulate Matter on Blood Indicators Related to Anemia. Int J Environ Res Public Health. 2021;18:12890. doi: 10.3390/ijerph182412890.
Hwang J, Kim HJ. Association of ambient air pollution with hemoglobin levels and anemia in the general population of Korean adults. BMC Public Health. 2024;24:988. doi: 10.1186/s12889-024-18492-z.
Li W, Dorans KS, Wilker EH y col. Short-Term Exposure to Ambient Air Pollution and Biomarkers of Systemic Inflammation. Arterioscler Thromb Vasc Biol. 2017;37:1793-1800. doi: 10.1161/ATVBAHA. 117.309799.
Ghio AJ, Soukup JM, Dailey LA y col. Air pollutants disrupt iron homeostasis to impact oxidant generation, biological effects, and tissue injury. Free Radic Biol Med. 2020;151:38-55. doi: 10.1016/j.freeradbiomed.2020.02.007.
Bray F, Laversanne M, Sung H y col. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74:229-263. doi: 10.3322/caac.21834.
Taj T, Chen J, Rodopoulou S y col. Long-term exposure to ambient air pollution and risk of leukemia and lymphoma in a pooled European cohort. Environ Pollut. 2024;343:123097. doi: 10.1016/j.envpol.2023.123097.
Wei T, Jiao R, Nakyeyune R y col. Exposure to outdoor air pollution at different periods and the risk of leukemia: a meta-analysis. Environ Sci Pollut Res. 2021;28:35376-35391. doi: 10.1007/s11356-021-14053-8.
Filippini T, Hatch EE, Rothman KJ y col. Association between Outdoor Air Pollution and Childhood Leukemia: A Systematic Review and Dose-Response Meta-Analysis. Environ Health Perspect. 2019;127:046002. doi: 10.1289/EHP4381.
Khorrami Z, Pourkhosravani M, Eslahi M y col. Multiple air pollutants exposure and leukaemia incidence in Tehran, Iran from 2010 to 2016: a retrospective cohort study. BMJ Open. 2022;12:e060562. doi: 10.1136/bmjopen-2021-060562.
Puett RC, Poulsen AH, Taj T y col. Relationship of leukaemias with long-term ambient air pollution exposures in the adult Danish population. Br J Cancer. 2020;123:1818-1824. doi: 10.1038/s41416-020-01058-2.
Taj T, Poulsen AH, Ketzel M y col. Long-term residential exposure to air pollution and Hodgkin lymphoma risk among adults in Denmark: a population-based case-control study. Cancer Causes Control CCC. 2021;32:935-942. doi: 10.1007/s10552-021-01446-w.
Diver WR, Teras LR, Deubler EL y col. Outdoor air pollution and risk of incident adult haematologic cancer subtypes in a large US prospective cohort. Br J Cancer. 2024;131:149-158. doi: 10.1038/s41416-024-02718-3.
Dagher Z, Garçon G, Billet S y col. Role of nuclear factor- kappa B activation in the adverse effects induced by air pollution particulate matter (PM2.5;in human epithelial lung cells (L132;in culture. J Appl Toxicol JAT. 2007;27:284-290. doi: 10.1002/jat.1211.
Morotti A, Crivellaro S, Panuzzo C y col. IκB-α: At the crossroad between oncogenic and tumor-suppressive signals. Oncol Lett. 2017;13:531-534. doi: 10.3892/ol.2016.5465.
Boyle J, Ward MH, Cerhan JR y col. Modeling historic environmental pollutant exposures and non-Hodgkin lymphoma risk. Environ Res. 2023;224:115506. doi: 10.1016/j.envres.2023.115506.
Taj T, Poulsen AH, Ketzel M y col. Long-term exposure to PM2.5 and its constituents and risk of Non-Hodgkin lymphoma in Denmark: A population-based case-control study. Environ Res. 2020;188:109762. doi: 10.1016/j.envres.2020.109762.
Taj T, Poulsen AH, Ketzel M y col. Long-term exposure to air pollution and risk of non-Hodgkin lymphoma in Denmark: A population-based case-control study. Int J Cancer. 2020;147:1874-1880. doi: 10.1002/ijc.32978.
Jasra S, Giricz O, Zeig-Owens R y col. High burden of clonal hematopoiesis in first responders exposed to the World Trade Center disaster. Nat Med. 2022;28:468-471. doi: 10.1038/s41591-022-01708-3.
Landgren O, Zeig-Owens R, Giricz O y col. Multiple Myeloma and Its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster. JAMA Oncol. 2018;4:821-827. doi: 10.1001/jamaoncol.2018.0509.
Hvidtfeldt UA, Chen J, Rodopoulou S y col. Multiple myeloma risk in relation to long-term air pollution exposure - A pooled analysis of four European cohorts. Environ Res. 2023;239:117230. doi: 10.1016/j.envres.2023.117230.
Wysota M, Pradhan K, Jacobs S y col. Fine particulate matter exposure is linked to worse myeloma outcomes in a diverse urban cohort. Blood Cancer J. 2025;15:115. doi: 10.1038/s41408-025-01301-0. 36. Zaidi A, Green L. Physiology of haemostasis. Anaesth Intensive Care Med. 2022;23:111-117. doi: 10.1016/j.mpaic.2021.10.023.
Mannucci PM, Harari S, Franchini M. Novel evidence for a greater burden of ambient air pollution on cardiovascular disease. Haematologica. 2019;104:2349-2357. doi: 10.3324/haematol.2019.225086.
Robertson S, Miller MR. Ambient air pollution and thrombosis. Part Fibre Toxicol. 2018;15:1. doi:10.1186/s12989-017-0237-x.
Signorelli SS, Oliveri Conti G, Zanobetti A y col. Effect of particulate matter-bound metals exposure on prothrombotic biomarkers: A systematic review. Environ Res. 2019;177:108573. doi: 10.1016/j.envres.2019.108573.
Viehmann A, Hertel S, Fuks K y col. Long-term residential exposure to urban air pollution, and repeated measures of systemic blood markers of inflammation and coagulation. Occup Environ Med. 2015;72:656-663. doi: 10.1136/oemed-2014-102800.
Wilson DW, Aung HH, Lame MW y col. Exposure of mice to concentrated ambient particulate matter results in platelet and systemic cytokine activation. Inhal Toxicol. 2010;22:267-276. doi: 10.3109/08958370903278069.
Thompson AMS, Zanobetti A, Silverman F y col. Baseline repeated measures from controlled human exposure studies: associations between ambient air pollution exposure and the systemic inflammatory biomarkers IL-6 and fibrinogen. Environ Health Perspect. 2010;118:120-124. doi: 10.1289/ehp.0900550.
Mutlu GM, Green D, Bellmeyer A y col. Ambient particulate matter accelerates coagulation via an IL-6-dependent pathway. J Clin Invest. 2007;117:2952-2961. doi: 10.1172/JCI30639.
Wauters A, Esmaeilzadeh F, Bladt S y col. Pro-thrombotic effect of exercise in a polluted environment: a P-selectin- and CD63-related platelet activation effect. Thromb Haemost. 2015;113:118-124. doi: 10.1160/TH14-03-0251.
Kannan M, Ahmad F, Saxena R. Platelet activation markers in evaluation of thrombotic risk factors in various clinical settings. Blood Rev. 2019;37:100583. doi: 10.1016/j.blre.2019.05.007.
Todo el material publicado en la revista Hematología (versión electrónica y versión impresa), será cedido a la Sociedad Argentina de Hematología. De conformidad con la ley de derecho de autor (ley 11723) se les enviara a los autores de cada trabajo aceptado formulario de cesión de derechos de autor que deberá ser firmado por todos los autores antes de la publicación. Los autores deberán retener una copia del original pues la revista, no acepta responsabilidad por daños o pérdidas del material enviado. Los autores deberán remitir una versión electrónica al correo: revista@sah.org.ar