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

BACKGROUND: Lately a potential detrimental effect of air pollution to idiopathic pulmonary fibrosis has emerged. We aimed to assess the effects of short-term personal 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. The associations among symptoms, lung function, oxygen saturation and short-term personal air pollutant exposure on the same day, the average of the same and previous day and the average of the same and 2 previous days, 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, p  = 0.049), PM10 (OR = 2.42, 95%CI:1.54-3.79, p  < 0.001) and O3 (OR = 1.63, 95%CI:1.14-2.32, p  = 0.007). 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, p  = 0.049), while exposure to O3 was associated with common cold (OR = 6.30, 95%CI:3.59-11.07, p  < 0.001). No significant associations were detected in the main study analysis between short-term exposure to air pollutants and forced vital capacity as well as the saturation of oxygen measured by pulse oximeter.

CONCLUSIONS: Short-term exposure to increased concentrations of air pollutants is an independent risk factor for IPF aggravation leading to appearance of cough, expectoration, wheezing and common cold.