Effects of short-term air pollution exposure on symptoms development in the course of idiopathic pulmonary fibrosis

ABSTRACT

Background

Lately a potential detrimental effect of air pollution to idiopathic pulmonary fibrosis emerged. We aimed to assess the effects of short-term air pollution exposure to the clinical course of IPF.

Research design and methods

IPF patients were followed intensively for four nonconsecutive study periods between 13 July 2020 and 5 September 2021. Short-term exposure to O₃, NO₂ and PM₁₀ concentrations was estimated using spatio-temporal land use regression models. Associations among symptoms, lung function, oxygen saturation, and short-term personal air pollutant exposure were assessed through multiple mixed effects logistic regression models.

Results

Data for up to 24 IPF patients (mean age: 72.2 ± 7.6 years) were analyzed. We detected positive significant associations between cough and a 10 μg/m³ increase in same day mean level of NO₂ (OR = 1.59, 95%CI: 1.00–2.53), PM₁₀ (OR = 2.42, 95%CI: 1.54–3.79), and O₃ (OR = 1.63, 95%CI: 1.14–2.32). A 10 μg/m³ increase in same day mean level of NO₂ was also associated with the risk of appearance of wheezing (OR = 3.01, 95%CI: 1.00–9.04), while exposure to O₃ was associated with common cold (OR = 6.30, 95%CI: 3.59–11.07). No significant associations were detected between short-term exposure to air pollutants and forced vital capacity or saturation of oxygen.

Conclusions

Short-term exposure to increased concentrations of air pollutants is an independent risk factor for IPF symptoms' aggravation.

KEYWORDS:

• Air pollution
• idiopathic pulmonary fibrosis
• short-term personal exposure
• symptoms
• ozone
• nitrogen dioxide
• particulate matter

Author contributions

I Tomos, A Karakatsani drafted the paper and were involved in study conception and design, data collection, data analyses, data interpretation, and writing of the manuscript. ED Manali was involved in study conception, data collection, data management, and writing of the manuscript. K Dimakopoulou was involved in study design, data analyses, data interpretation, and writing of the manuscript. SA Papiris was involved in data interpretation and critical revision of the manuscript. All authors read and approved the final version of the submitted manuscript.

Competing interests

ED Manali and SA Papiris received honoraria for lectures from Boehringer Ingelheim, Hoffman La Roche, and CSL Behring and support for attending congresses from Boehringer Ingelheim, CSL Behring, and Elpen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Acknowledgments

We would like to thank Mr. A. Adamopoulos, Ms I. Tsilimpari and Ms. I Kokoretsi from the Air Quality Division, Ministry of Environment and Energy for providing air pollution measurement data.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17476348.2023.2281992

Additional information

Funding

This research is co-financed by Greece and the European Union (European Social Fund-ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning 2014–2020” in the context of the project “The effects of air pollution exposure on patients with idiopathic pulmonary fibrosis” (MIS 5048157).”