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Environmental exposures and systemic hypertension are risk factors for decline in lung function
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  • Published on:
    The effect of living at high altitude and living in urban settings on lung function decline
    • Dinh S Bui, Epidemiologist School of population and global health, the University of Melbourne
    • Other Contributors:
      • Caroline J Lodge, Epidemiologist

    We read with interest the findings of Miele et al. on the relationship between environmental exposures and decline in lung function (1). The authors reported that living in urban settings and living at high altitude were associated with accelerated decline in pre-bronchodilator FEV1 and FVC. Investigating the effects at area level is important from a public health perspective and extra analysis on this valuable dataset as suggested below will help to untangle these links further.
    Study participants were recruited from four settings in Peru: Lima, Tumbles, urban Puno and rural Puno (1). Urban living and high-altitude dwelling (as binary variables) were defined based on these four settings. The authors compared the effect of urban living (Lima and urban Puno) with rural living (Tumbes and rural Puno); and the effect of high-altitude dwelling (urban Puno and rural Puno) with low-altitude dwelling (Lima and Tumbes). It is possible that the observed independent effects found by the authors of urban living and high-altitude dwelling may be driven by the urban Puno group (high altitude and urban living). In other words, there may be an interaction between urban living and high-altitude dwelling and investigating this potential interaction would be informative.
    As discussed by the authors, the adverse effect of high-altitude dwelling on lung function decline may partly be related to hypoxia and adverse effects from living in urban settings may be related to outdoor air...

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    Conflict of Interest:
    None declared.