title: Analysis of spontaneous pneumothorax in the city of Cuneo: environmental correlations with meteorological and air pollutant variables.
abstract: OBJECTIVE
  Primary spontaneous pneumothorax (PSP) tends to cluster. Previous studies have found a correlation between PSP and atmospheric pressure variations or thunderstorms. We conducted this study to analyze the PSP correlations with meteorological variables and the concentrations of air pollutants in the city of Cuneo in Italy (IT).
  
  
  METHODS
  We evaluated prospectively 451 consecutive PSP patients treated between 2004 and 2010. For each day within the period analyzed, the meteorological parameters and pollutants data were recorded. Statistical analyses on PSP were done for distribution characteristics, spectral autocorrelation, and spectral analysis. Multivariate regression analyses were performed using artificial neural networks.
  
  
  RESULTS
  Analysis of annual, seasonal, and monthly distributions showed no significant correlation between PSP and the time series. The spectral analysis showed that PSP events were not random. Correlations between meteorological and environmental variables confirmed that PSP was significantly more likely to occur on warm windy days with high atmospheric pressure and high mean nitrogen dioxide concentration.
  
  
  CONCLUSIONS
  Meteorological parameters and atmospheric pollutants might explain the cluster onset of PSP.
authors.affiliation: Thoracic Surgery Unit, Sacro Cuore Hospital, Via Don Angelo Sempreboni 5, 37024, Negrar Verona, Italy, luca.bertolaccini@gmail.com.
authors.forename: Luca
authors.initials: L
authors.lastname: Bertolaccini
authors.forename: Andrea
authors.initials: A
authors.lastname: Viti
authors.forename: Lucia
authors.initials: L
authors.lastname: Boschetto
authors.forename: Antonello
authors.initials: A
authors.lastname: Pasini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Attanasio
authors.forename: Alberto
authors.initials: A
authors.lastname: Terzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Cassardo
mesh_terms: D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008685:Meteorological Concepts; D008875:Middle Aged; D011030:Pneumothorax / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012621:Seasons; D055815:Young Adult
chemical_list: D000393:Air Pollutants