Air pollution and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis (MESA) air–lung study

Abstract

We sought to determine whether ambient air pollution is associated with interstitial lung abnormalities (ILA) and high attenuation areas (HAA), which are qualitative and quantitative measurements of subclinical ILD on computed tomography. We performed analyses of 6813 community-based dwellers enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), a U.S.-based prospective cohort study. We used cohort-specific spatiotemporal models to estimate predictions of ambient pollution (PM2.5, NOx, NO2 and O3) at each home. Participants underwent serial assessment of HAA by cardiac CT-scan and a subset of participants was assessed for ILA using full lung CT scan at 10 year follow-up. We used multivariable logistic regression and linear mixed models adjusted for age, sex, ethnicity, education, tobacco use, scanner technology and study site. The odds of ILA increased 1.62-fold per 40ppb increment in NOx (95%CI 0.97 to 2.71, p-value 0.06), and were strongest in non-smokers (2.60-fold increase per 40ppb increment in NOx, 95% CI 1.20 to 5.61, p-value 0.02). HAA increased by 0.54% per year per 5μg/m3 increment in PM2.5 (95%CI 0.02% to 1.10%, p-value 0.04) and by 0.55% per year per 40ppb increment in NOx (95%CI 0.08% to 1.00%, p-value 0.02). Ambient air pollutants were associated with measurements of subclinical ILD.

Is chronic exposure to air pollutants a risk factor for the development of idiopathic pulmonary fibrosis?

“…Nevertheless, although more research is needed before drawing a causal relationship between air pollution and the development of IPF, this study provides the first evidence on the chronic effects of air pollution on the incidence of IPF and converges with previous work identifying air pollution as a risk factor for acute exacerbation and lung function decline in IPF patients [8][9][10]. These findings expand recent results from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, which reported that higher exposure to oxides of nitrogen and NO 2 increased risk of interstitial lung abnormalities and the 6-year progression of high attenuation areas, two measurements of subclinical interstitial lung disease [11]. From a broader point of view, this study adds to the literature showing association between air pollution exposure and the development of chronic lung diseases such as asthma [12], chronic obstructive pulmonary disease [13] or lung cancer [14].…”

Trends in prevalence and incidence of chronic respiratory diseases from 1990 to 2017

“…Interstitial lung diseases are a group of diffuse parenchymal lung disorders [15] that are related to occupational or ambient air pollution exposures [16]. Pulmonary sarcoidosis is an inflammatory lung disorder associated with ethnicity and latitude [17].…”

Aberrantly expressed long non‐coding RNAs in air pollution‐induced congenital defects

“…Air pollution has been a serious public health problem over the past decades all over the world. [1][2][3][4] Previous studies indicated that at least half of the population lived in areas which did not satisfy the World Health Organization (WHO) guidelines-24-hours mean of 50 μg/m 3 for PM 10 (particulate matter <10 μm) and 24-hours mean of 25 μg/m 3 for PM 2.5 (particulate matter <2.5 μm). 5 Pollutants of air pollution also include gaseous substances, namely ozone, nitrogen oxides and sulphur dioxide.…”