Study Links High Air Pollution to Increased Post-Surgical Complications on Utah’s Wasatch Front

New research on Utah’s Wasatch Front—an area that occasionally experiences the worst air quality in the nation—has identified a link between high air pollution levels and increased risk of post-surgical complications. The study, which analyzed data from nearly 50,000 surgery patients, found that higher levels of particulate air pollution are associated with a greater likelihood of complications such as sepsis, pneumonia, and surgical wound infections.

“When there was an elevation in PM2.5 air pollution in the week before surgery, even for one day, we saw increased risk of major medical complications and infectious complications,” says John Pearson, first author of the study and former assistant professor of anesthesiology at the University of Utah. Pearson, now a clinical associate professor at Stanford Medicine, remains a research affiliate at the University of Utah.

Fine particulate matter, often linked to the Wasatch Front’s wintertime inversions, can become lodged in the respiratory system and negatively impact health. The study revealed that when PM2.5 levels exceeded the EPA’s daily exposure limit in the week prior to surgery, the risk of post-surgical complications rose from 4.8% to 6.2%. The findings were published in Acta Anaesthesiologica Scandinavica.

The research was led by the University of Utah School of Medicine, with contributions from the College of Social and Behavioral Science. To examine the relationship between air quality and surgical outcomes, the team analyzed post-surgical data from 49,615 non-emergency surgeries performed on the Wasatch Front. They used data from EPA and state-level air quality sensors, as well as satellite observations, to estimate PM2.5 levels at each patient’s home address during the week leading up to surgery.

The study found that higher air pollution levels corresponded with a greater increase in post-surgical complication risks. While a PM2.5 concentration of 35 micrograms per cubic meter is considered unhealthy, the research demonstrated that fluctuations in pollution levels—both above and below this threshold—affect surgical outcomes. Specifically, every 10 microgram increase in PM2.5 was associated with an 8% rise in the relative risk of complications, resulting in an absolute increase of 1.4% when pollution exceeded EPA daily limits.

The researchers focused on fine particulate pollution due to its systemic effects on human health. “Particles of that size or smaller can get down to the smallest part of the lung,” explains Nathan Pace, study coauthor and professor of anesthesiology at the University of Utah. “Some of it will cross into the blood and it can end up anywhere in your body: your brain, your heart, your liver, your kidneys.” This systemic spread increases overall inflammation, placing additional stress on the lungs and heart and potentially heightening infection risks.

The study used a composite measure of complications, combining multiple post-surgical outcomes. As a result, the authors emphasize that further research is needed to determine which specific complications are more likely following exposure to high air pollution. Larger studies involving multiple hospitals could provide additional clarity on these risks.