Chest
Volume 116, Issue 3, September 1999, Pages 676-681
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Clinical Investigations
The Pleura
Atmospheric Pressure Changes and Outdoor Temperature Changes in Relation to Spontaneous Pneumothorax

https://doi.org/10.1378/chest.116.3.676Get rights and content

Study aims

To examine the influence of atmospheric pressure (AP) and temperature changes on the incidence of idiopathic spontaneous pneumothorax (SP).

Methods

From December 1991 through November 1993, 115 consecutive SP cases were selected. Patients were included after being in Amsterdam at least 1 full day before contracting the SP. Differences in air temperature and AP (provided hourly by the national weather bureau) for the days of the SP occurrence and the days previous to it were recorded to measure influences of air temperature and AP. The correlation between days with lightning and SP and clustering of SP was evaluated.

Results

SP occurred on 14.7% of the days in the 2-year period. There was no relationship between SP and a rise or fall in AP (Poisson regression). There was an average temperature rise of 0.57°C from the day prior to the day of the SP, compared with a 0.08°C fall on the days without SP. This difference is statistically significant and was consistent over the four seasons and both years. Seventy-three percent of the SP cases were clustered. A relationship between SP and thunderstorms was found.

Conclusions

AP differences do not seem to influence the chance of developing SP. SP occurs in clusters, and more often 1 to 2 days after thunderstorms. Whether the identified temperature rise prior to the SP is a causative factor is unlikely; coexisting weather phenomena might explain this unexpected finding and should be studied in the future.

Section snippets

Patients

One hundred fifteen consecutive SP events that occurred between December 1, 1991, and November 30, 1993 were retrospectively analyzed; all cases were drawn from two hospitals in Amsterdam, the Free University Hospital and the Onze Lieve Vrouwe Gasthuis. The initial onset of SP was defined as the onset of patient-reported complaints. Only patients who contracted SP in Amsterdam, and who were there for at least 1 day before, were included. Seventy-nine percent were men, the mean age was 33.4 ±

Results

SP occurred on 14.7% of the 731 days recorded (115 cases in all; on 8 days, two SP cases were reported).

Amsterdam, a relatively small but highly populated area, had 724,000 inhabitants in 1993 and nine hospitals. During the study period, 409 SP cases were seen in all nine hospitals. During the 2-year study, 28.9% of the SP patients in Amsterdam were treated in the two study hospitals.19 No seasonal differences were found between our incidence data and the complete Amsterdam group, which

Discussion

The confirmation of the feeling of clinicians, that SP patients are admitted in clusters, strongly supports the hypothesis that weather changes (or related conditions) play a role in the mechanism responsible for development of SP.15 Our findings of SP clustering were later supported by a retrospective analysis of Boulay et al.22 The first question we had was whether pressure differences in the atmosphere exert an influence on the chance of contracting a pneumothorax. Because AP and temperature

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