AUTHOR=Mariscal-Aguilar Pablo , Gómez-Carrera Luis , Carpio Carlos , Zamarrón Ester , Bonilla Gema , Fernández-Velilla María , Torres Isabel , Esteban Isabel , Regojo Rita , Díaz-Almirón Mariana , Gayá Francisco , Villamañán Elena , Prados Concepción , Álvarez-Sala Rodolfo 

TITLE=Relationship between air pollution exposure and the progression of idiopathic pulmonary fibrosis in Madrid: Chronic respiratory failure, hospitalizations, and mortality. A retrospective study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1135162

DOI=10.3389/fpubh.2023.1135162

ISSN=2296-2565

ABSTRACT=Introduction: Air pollution has a significant impact on the morbidity and mortality of various respiratory diseases. However, this has not been widely studied in diffuse interstitial lung diseases, specifically in idiopathic pulmonary fibrosis.
Objective: In this study we aimed to assess the relationship between four major air pollutants (carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and nitrogen oxides (NOx)) and the development of chronic respiratory failure, hospitalization due to respiratory causes and mortality in patients with idiopathic pulmonary fibrosis.

Methods: We conducted an exploratory retrospective cohort study from 2011 to 2020 in 69 patients with idiopathic pulmonary fibrosis from the pulmonary medicine department of a tertiary hospital. Based on their geocoded residential address, levels of each pollutant were associated 1, 3, 6, 12 and 36 months prior to each event (chronic respiratory failure, hospital admission and mortality). Data was collected from the air quality monitoring stations of the Community of Madrid located less than 3.5 km (2.2 miles) from each patient's home.

Results: The increase in cumulative average values of CO (OR 1.62 (1.11‒2.36) and OR 1.84 (1.1‒3.06)), NO2 (OR 1.64 (1.01‒2.66)), and NOx (OR 1.11 (1‒1.23) and OR 1.19 (1.03‒1.38)) were significantly associated with the probability of developing chronic respiratory failure in different periods. In addition, the cumulative averages of NO2, O3 and NOx were significantly associated with the probability of hospital admissions due to respiratory causes and mortality in these patients.

Conclusion: Air pollution caused by the escalation of the main urban pollutants (CO, NO2, O3 and NOx) is associated with an increase in the probability of developing chronic respiratory failure, hospitalization due to respiratory causes and mortality in patients with idiopathic pulmonary fibrosis.