Thromb Haemost 2009; 102(04): 676-682
DOI: 10.1160/TH09-04-0214
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

The influence of meteorological variables on the development of deep venous thrombosis

Helen K. Brown
1   Department of Community Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK
,
John A. Simpson
2   Department of Respiratory Medicine, University of Edinburgh, Edinburgh, Scotland, UK
,
John T. Murchison
3   Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK
› Author Affiliations
Financial support: The University of Edinburgh paid £2,000 towards the cost of statistical analysis for this study.
Further Information

Publication History

Received: 03 April 2009

Accepted after minor revision: 16 June 2009

Publication Date:
24 November 2017 (online)

Summary

The influence of weather on deep venous thrombosis (DVT) incidence remains controversial. We aimed to characterize the temporal association between DVT and meteorological variables including atmospheric pressure. Data relating to hospital admissions with DVT in Scotland were collected retrospectively for a 20 year period for which corresponding meteorological recordings were available. Weather variables were calculated as weighted daily averages to adjust for variations in population density. Seasonal variation in DVT and short-term effects of weather variables on the relative risk of developing DVT were assess using Poisson regression modelling. The models allowed for the identification of lag periods between variation in the weather and DVT presentation. A total of 37,336 cases of DVT were recorded. There was significant seasonal variation in DVT with a winter peak. Seasonal variation in wind speed and temperature were significantly associated with seasonal variation in DVT. When studying more immediate meteorological influences, low atmospheric pressure, high wind speed and high rainfall were significantly associated with an increased risk of DVT approximately 9–10 days later. The effect was most strikingly demonstrated for atmospheric pressure, every 10 millibar decrease in pressure being associated with a 2.1% increase in relative risk of DVT. Alterations in weather have a small but significant impact upon the incidence of DVT. DVT is particularly associated with reduction in atmospheric pressure giving weight to the hypothesis that reduced cabin pressure in long haul flights contributes to DVT. These findings have implications for our understanding of the pathogenesis of DVT.

 
  • References

  • 1 White RH. The epidemiology of venous thromboembolism. Circulation 2003; 107: I4-I8.
  • 2 Becker T, Schickedanz H, Petrat H. et al. Relationship between weather and incidence of pulmonary embolism. Longitudinal study of case histories occurring during a 50 year period. Z Erkr Atmungsorgane 1978; 152: 177-183.
  • 3 Gallerani M, Manfredini R, Ricci L. et al. Sudden death from pulmonary thromboembolism: chronobiological aspects. Eur Heart J 1992; 13: 661-665.
  • 4 Scott JA, Palmer EL, Fischman AJ. et al. Meteorologic influences on the frequency of pulmonary embolism. Invest Radiol 1992; 27: 583-586.
  • 5 Clauss R, Mayes J, Hilton P. et al. The influence of weather and environment on pulmonary embolism: pollutants and fossil fuels. Med Hypoth 2005; 64: 1198-1201.
  • 6 Meral M, Mirici A, Aslan S. et al. Barometric pressure and the incidence of pulmonary embolism. Chest 2005; 128: 2190-2194.
  • 7 Boulay F, Berthier F, Schoukroun G. et al. Seasonal variations in hospital admissions for deep vein thrombosis and pulmonary embolism: analysis of discharge data. Br Med J 2001; 323: 601-602.
  • 8 Lawrence JC, Xabregas A, Gray L. et al. Seasonal variation in the incidence of deep vein thrombosis. Br J Surg 1977; 64: 777-780.
  • 9 Allan TM, Douglas AS. Seasonal variation in deep vein thrombosis. Br Med J 1996; 312: 1227.
  • 10 Ferrari E, Baudoy M, Cerboni P. et al. Clinical epidemiology of venous thromboembolic disease. Results of a French multicentre registry. Eur Heart J 1997; 18: 685-691.
  • 11 Gallerani M, Boari B, de Toma D. et al. Seasonal variation in the occurrence of deep vein thrombosis. Med Sci Monit 2004; 10 CR 191-196.
  • 12 Manfredini R, Gallerani M, Boari B. et al. Seasonal variation in onset of pulmonary embolism is independent of patients’ underlying risk comorbid conditions. Clin Appl Thromb Hemost 2004; 10: 39-43.
  • 13 Wroblewski BM, Siney PD, White R. Fatal pulmonary embolism after total hip arthroplasty. Seasonal variation. Clin Orthop Relat Res 1992; 276: 222-224.
  • 14 Luthi H, Gruber UF. Is there a seasonal fluctuation in the appearance of deep venous thrombosis?. Anasth Intensivther Notfallmed 1982; 17: 158-160.
  • 15 Reasbeck PG, Guerrini S, Harper J. et al. Incidence of deep vein thrombosis after major abdominal surgery in Brisbane. Br J Surg 1988; 75: 440-443.
  • 16 Bounameaux H, Hicklin L, Desmarais S. Seasonal variation in deep vein thrombosis. Br Med J 1996; 312: 284-285.
  • 17 Galle C, Wautrecht JC, Motte S. et al. The role of season in the incidence of deep venous thrombosis. J Mal Vasc 1998; 23: 99-101.
  • 18 Mavri A, Guzic-Salobir B, Salobir-Pajnic B. et al. Seasonal variation of some metabolic and haemostatic risk factors in subjects with and without coronary artery disease. Blood Coagul Fibrinolysis 2001; 12: 359-365.
  • 19 Smeeth L, Cook C, Thomas S. et al. Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting. Lancet 2006; 367: 1075-1079.
  • 20 Esquenet P, Boudet J, Sevestre-Pietri MA. et al. Effect of meteorological variations on the emergence of deep venous thrombosis of the leg. J Mal Vasc 1997; 22: 244-248.
  • 21 Ageno W, Dentali F. venous thromboembolism and arterial thromboembolism. Many similarities, far beyond thrombosis per se. Thromb Haemost 2008; 100: 181-183.
  • 22 Keatinge WR, Donaldson GC. on behalf of the Eurowinter Group Study Organisation. Cold exposure and winter mortality from ischaemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions of Europe. Lancet 1997; 349: 1341-1346.
  • 23 Larcan A, Gilgenkrantz JM, Stoltz JF. et al. Climatologic parameters and myocardial infarction. Ann Cardiol Angeiol 1983; 32: 83-92.
  • 24 Dilaveris PE, Synetos A, Giannopoulos G. et al. The climate impacts on myocardial infarction deaths in the Athens territory (The Climate Study). Heart 2006; 92: 1747-1751.
  • 25 Bendz B, Rostrup M, Sevre K. et al. Association between acute hypobaric hypoxia and activation of coagulation in human beings. Lancet 2000; 356: 1657-1658.
  • 26 Crosby A, Talbot NP, Harrison P. et al. Relation between acute hypoxia and activation of coagulation in human beings. Lancet 2003; 361: 2207-2208.
  • 27 Hodkinson PD, Hunt BJ, Parmar K. et al. Is mild normobaric hypoxia a risk factor for venous thromboembolism?. J Thromb Haemost 2003; 01: 2131-2133.
  • 28 Hoffmann R, Schimmer RC, Largiader F. Surgery and environmental influence as risk-factors for the development of deep vein thrombosis in animal experiments. Thromb Haemost 1993; 70: 712-716.
  • 29 Toff WD, Jones CI, Ford I. et al. Effect of hypobaric hypoxia, simnulating conditions during long-haul air travel, on coagulation, fibrinolysis, platelet function, and endothelial activation. JAMA 2006; 295: 2251-2261.
  • 30 Lapostolle F, Surget V, Borron SW. et al. Severe pulmonary embolism associated with air travel. N Engl J Med 2001; 345: 779-783.
  • 31 Pheby DF, Codling BW. Pulmonary embolism at autopsy in a normal population: implications for air travel fatalities. Aviat Space Environ Med 2002; 73: 1208-1214.
  • 32 Hughes RJ, Hopkins RJ, Hill S. et al. Frequency of venous thromboembolism in low to moderate risk long distance air travellers: the New Zealand Air Traveller’s Thrombosis (NZATT) study. Lancet 2003; 362: 2039-2044.
  • 33 Jacobson BF, Munster M, Smith A. et al. The BEST study – a prospective study to compare business class versus economy class air travel as a cause of thrombosis. S Afr Med J 2003; 93: 522-528.
  • 34 Schwarz T, Siegert G, Oettler W. et al. Venous thrombosis after long-haul flights. Arch Intern Med 2003; 163: 2759-2764.
  • 35 Adi Y, Bayliss S, Rouse A. et al. The association between air travel and deep vein thrombosis: systematic review and meta-analysis. BMC Cardiovasc Disord 2004; 04: 7.
  • 36 Prentice AG, Lowe GDO, Forbes CD. Diagnosis and treatment of venous thromboembolism by consultants in Scotland. Br Med J 1982; 285: 630-632.
  • 37 Neilly JB, Walker ID, Lowe GDO. Management of suspected acute venous thromboembolism in a general and maternity hospital. Scott Med J 1996; 41: 49-53.
  • 38 Arcelus JI, Montreal M, Caprini JA. et al. Clinical presentation and time-course of postoperative venous thromboembolism: Results from the RIETE Registry.