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The Air Apparent: Pollution, Cancer, and Health

view of the Salt Lake valley on a sunny day
View of the Salt Lake Valley

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For all of its breathtaking mountainous beauty, Salt Lake City comes with the tradeoff of periodic poor air. In the 2019 "Health of the Air" report by the American Thoracic Society, Salt Lake ranked 23rd among U.S. cities with the highest health impacts due to air quality. Among those most vulnerable are the elderly and children.

According to a study conducted by Huntsman Cancer Institute (HCI) researchers Anne Kirchhoff, PhD, Judy Ou, PhD, and Heidi Hanson, PhD, poor air quality days significantly increase the risk of hospitalization for respiratory issues in survivors of childhood cancer.

Childhood cancer survivors often experience long-term health issues related to their treatment. HCI researchers sought to understand what a polluted environment means for the health of childhood, adolescent, and young adult cancer survivors diagnosed or treated at Primary Children’s Hospital between 1986 and 2012. They examined how changes in air pollution affected how often those survivors required emergency room treatment or hospitalization in Utah due to respiratory illness.

The study found the risk for hospitalizations among cancer survivors was higher when fine particulate pollution (PM2.5) was below the standard for sensitive groups, implying that levels below that protective standard may still contribute to respiratory problems for young people who had cancer.

This is the first study to report a connection between PM2.5 levels and childhood cancer survivors requiring emergency treatment or hospitalization for respiratory issues. People treated for cancer as children may be more vulnerable to high levels of PM2.5 because of possible lung damage and weakened immune systems as a side effect of chemotherapy.

Cancer treatments are a miracle of modern medicine. We are able to save a lot of people that we couldn’t before. It is important that we preserve their health and make sure they live high-quality lives.

Judy Ou, PhD 
Research Associate, Kirchhoff Research Group 
Huntsman Cancer Institute

"This innovative study, combined with what is already known, suggests that air pollution exposure is important to health across the cancer continuum. Efforts to reduce pollution have the potential to improve the health and survival of cancer patients," Hanson says.

"We really haven’t thought about how environmental exposures may affect long-term health care needs and health outcomes," Kirchhoff says. "We may need to rethink guidelines, both on air pollution notifications from public health agencies and guidelines we’re giving cancer patients."

Judy Ou, Anne Kirchhoff, and Heidi Hanson
Left to right: Judy Ou, PhD, research associate of epidemiology; Heidi Hanson, PhD, assistant professor of surgery; Anne Kirchhoff, PhD, associate professor of pediatrics
Left to right: Judy Ou, PhD, research associate of epidemiology; Heidi Hanson, PhD, assistant professor of surgery; Anne Kirchhoff, PhD, associate professor of pediatrics

The team is working to identify effective strategies for sharing this information with health advocates, air quality organizations, and families affected by childhood cancers—and beyond.

"This study has wide application to cancer survivors in Utah as well as nationwide. It provides valuable information to the medical community about how air pollution affects young survivors of cancer. We would like to understand the effects of pollution on a large sample and be able to provide guidance to cancer survivors across the country," says Ou.

Cancer touches all of us.