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Multiple observational studies have demonstrated that chronic alcohol use is a risk factor for the development of acute respiratory distress syndrome (ARDS).
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Alcohol use may promote the development of ARDS via increased angiotensin II, producing increasing oxidative stress, which creates baseline alveolar epithelial dysfunction and primes the lung for developing noncardiogenic pulmonary edema.
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Although less studied than alcohol use, cigarette smoke exposure also seems likely to be a risk factor
Environmental Risk Factors for Acute Respiratory Distress Syndrome
Section snippets
Key points
Alcohol abuse
Alcohol is one of the most commonly used and abused drugs worldwide. In the United States, nearly 20 million adults annually meet the criteria for alcohol abuse or dependence.1, 2 Alcohol is known to have numerous systemic health effects, including on the liver and central nervous system.3 From a respiratory standpoint, alcohol abuse has long been associated with an increased risk of pneumonia.4, 5 More recently, alcohol abuse has been strongly linked in epidemiologic studies to the development
Smoking
Smoking remains a global epidemic. Although antismoking efforts in the United States continue to slowly decrease the rate of smoking among adults (currently 18.1%),55 tobacco use continues to be the leading cause of preventable death both in the United States and worldwide, killing nearly 6 million people annually.56 Although many harmful effects of smoking, particularly on the lung, have been known for quite some time, the link between ARDS and smoking has been established only recently.
Early
Air pollution
Air pollution has been associated with a variety of adverse health outcomes, including all-cause mortality.94 It is thought that this phenomenon is driven primarily by an increase in cardiorespiratory events. Several epidemiologic studies have shown that air pollution is associated with an increased risk of myocardial infarction and cardiovascular disease mortality.95, 96, 97, 98 The association between air pollution and respiratory mortality is less clear, with some studies showing an increase
Summary
Significant progress has been made since the search for environmental risk factors for ARDS began nearly 2 decades ago. Chronic alcohol use and smoking have been identified in numerous studies to independently increase the risk of developing ARDS and potentially affect the outcomes of patients who go on to develop the disease. These findings have important implications for public health and for ARDS prevention. Additionally, scientific studies have yielded tremendous insight into many of the
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Cited by (23)
Environmental Factors
2021, Critical Care ClinicsCitation Excerpt :Although some retrospective studies have not found an association between cigarette smoking and ARDS,47 many studies demonstrate that both active smoking and passive cigarette smoke exposure are associated with ARDS, especially among certain clinical populations. Importantly, this association is independent of alcohol use, which is frequently associated with smoking and is a known risk factor for ARDS.48 A retrospective cohort study of patients in Northern California found that ARDS was more common among self-reported smokers in a dose-dependent manner.
Therapeutic potential of plant-derived tannins in non-malignant respiratory diseases
2021, Journal of Nutritional BiochemistryCitation Excerpt :The respiratory system is the most vulnerable to infection and injury because it has the constant interaction with the external environment. In particular, occupational (metal, wood, stock, and freight workers) and environmental (outdoor air pollution, tobacco smoke, and the use of biomass fuel for indoor cooking or heating) exposures cause injury to the lung in various fashions, resulting in acute and chronic lung diseases, including acute lung injury (ALI) and its more severe form acute respiratory distress syndrome (ARDS), allergic asthma, and chronic obstructive pulmonary disease (COPD) [1,2]. These diseases impose a significant health burden and mortality worldwide.
Alcohol consumption and lung damage: Dangerous relationships
2018, Revue des Maladies RespiratoiresEffects of ethanol on RhoA/Rho-kinase-mediated calcium sensitization in mouse lung parenchymal tissue
2015, European Journal of PharmacologyCitation Excerpt :Several studies have been reported that KCl can cause Ca2+ sensitization and ROCK occurs to be contributing in KCl-induced Ca2+ sensitization (Sakurada et al., 2003; Urban et al., 2003; Ratz et al., 2005). Alcohol (ethanol) is involved in many deleterious effect on the respiratory system, such as respiratory distress syndrome (Moazed and Calfee, 2014), pneumonia (Chalmers et al., 2009; Mehta et al., 2013). The attenuation of smooth muscle contraction by ethanol-treatment have been demonstrated in several studies (Boselli and Govoni, 2000; Kesim et al., 2004; Verde et al., 2014).
Disclosure: Dr. Calfee has received grant funding from and served on medical advisory boards for Glaxo Smith Kline.