RT Journal Article
SR Electronic
T1 Air pollution associated with incidence and progression trajectory of chronic lung diseases: a population-based cohort study
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP thorax-2022-219489
DO 10.1136/thorax-2022-219489
A1 Xiaojie Wang
A1 Lan Chen
A1 Miao Cai
A1 Fei Tian
A1 Hongtao Zou
A1 Zhengmin (Min) Qian
A1 Zilong Zhang
A1 Haitao Li
A1 Chongjian Wang
A1 Steven W Howard
A1 Yang Peng
A1 Li’e Zhang
A1 Elizabeth Bingheim
A1 Hualiang Lin
A1 Yunfeng Zou
YR 2023
UL http://thorax.bmj.com/content/early/2023/02/02/thorax-2022-219489.abstract
AB Background No prior study has examined the effects of air pollution on the progression from healthy to chronic lung disease, subsequent chronic lung multimorbidity and further to death.Methods We used data from the UK Biobank of 265 506 adults free of chronic lung disease at recruitment. Chronic lung multimorbidity was defined as the coexistence of at least two chronic lung diseases, including asthma, chronic obstructive pulmonary disease and lung cancer. The concentrations of air pollutants were estimated using land-use regression models. Multistate models were applied to assess the effect of air pollution on the progression of chronic lung multimorbidity.Results During a median follow-up of 11.9 years, 13 863 participants developed at least one chronic lung disease, 1055 developed chronic lung multimorbidity and 12 772 died. We observed differential associations of air pollution with different trajectories of chronic lung multimorbidity. Fine particulate matter showed the strongest association with all five transitions, with HRs (95% CI) per 5 µg/m3 increase of 1.31 (1.22 to 1.42) and 1.27 (1.01 to 1.57) for transitions from healthy to incident chronic lung disease and from incident chronic lung disease to chronic lung multimorbidity, and 1.32 (1.21 to 1.45), 1.24 (1.01 to 1.53) and 1.91 (1.14 to 3.20) for mortality risk from healthy, incident chronic lung disease and chronic lung multimorbidity, respectively.Conclusion Our study provides the first evidence that ambient air pollution could affect the progression from free of chronic lung disease to incident chronic lung disease, chronic lung multimorbidity and death.Data are available on reasonable request.