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Associations between short-term exposure to ambient air pollution and lung function in adults

Journal of Exposure Science & Environmental Epidemiology (2023)Cite this article

Abstract

Background

Evidence of the acute effects of high-level air pollution on small airway function and systemic inflammation in adults is scarce.

Objective

To examined the associations of short-term (i.e., daily) exposure to multiple air pollutants with lung function and inflammatory markers.

Methods

We assessed short-term (daily) effects of air pollutants, including particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO), on lung function and peripheral immune cell counts over various lag times using generalized linear regression models.

Results

A total of 4764 adults were included from the general community-dwelling population in Shanghai, China. Exposure to air pollutants and lung function were negatively correlated. Decline in FEF between 25% and 75% of vital capacity (FEF25–75%) were found associated with PM2.5, SO2, and CO, and decline in forced expiratory volume in 3 s (FEV3) to forced vital capacity (FVC) ratio were associated with all examined pollutants, indicating obstruction in small airways. Obstructed airflow in large and middle airways as indicated by decline in FEV1/FVC were also associated with all pollutants. In subgroup analysis, significant negative associations between the five pollutants and SAD parameters were found only in males but not in females. The difference in the associations of SO2 with FEF75% between males and females achieved statistical significance. Additionally, all examined pollutants were significantly associated with lower peripheral neutrophil count.

Impact statement

  • Acute exposure to air pollutants were associated with airflow-limitation.

  • Both small airways and proximal airways were affected.

  • Acute exposure to air pollutants were accompanied with a lower neutrophil count.

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Fig. 1: Estimated effects of acute exposure to air pollutants on lung function in adults.
Fig. 2: Associations of acute exposure to air pollution with lung function varied by sex.
Fig. 3: Associations of acute exposure to air pollution with lung function in ever-smokers and never-smokers.
Fig. 4: Associations of acute exposure to air pollution with lung function varied by age.
Fig. 5: Associations of white blood cell, neutrophil, and eosinophil counts with acute air pollution exposure.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Macklem PT. The physiology of small airways. Am J Respir Crit Care Med. 1998;157:S181–3.

    Article  CAS  PubMed  Google Scholar 

  2. Usmani OS, Singh D, Spinola M, Bizzi A, Barnes PJ. The prevalence of small airways disease in adult asthma: A systematic literature review. Respir Med. 2016;116:19–27.

    Article  PubMed  Google Scholar 

  3. Boeck L, Gensmer A, Nyilas S, Stieltjes B, Re TJ, Tamm M, et al. Single-Breath Washout Tests to Assess Small Airway Disease in COPD. Chest 2016;150:1091–100.

    Article  PubMed  Google Scholar 

  4. Incorvaia C, Riario-Sforza GG, Pravettoni C, Yacoub MR, Frati F. Impairment of small airways in COPD patients with frequent exacerbations and effects of treatment with tiotropium. Int J Chron Obstruct Pulmon Dis. 2008;3:123–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Stockley JA, Ismail AM, Hughes SM, Edgar R, Stockley RA, Sapey E. Maximal mid-expiratory flow detects early lung disease in α(1)-antitrypsin deficiency. Eur Respir J. 2017;49:1602055.

  6. Skylogianni E, Triga M, Douros K, Bolis K, Priftis KN, Fouzas S, et al. Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis. Allergol Immunopathol (Madr). 2018;46:313–21.

    Article  CAS  PubMed  Google Scholar 

  7. Xiao D, Chen Z, Wu S, Huang K, Xu J, Yang L, et al. Prevalence and risk factors of small airway dysfunction, and association with smoking, in China: findings from a national cross-sectional study. Lancet Respir Med. 2020;8:1081–93.

    Article  PubMed  Google Scholar 

  8. Lepeule J, Litonjua AA, Coull B, Koutrakis P, Sparrow D, Vokonas PS, et al. Long-term effects of traffic particles on lung function decline in the elderly. Am J Respir Crit Care Med. 2014;190:542–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rice MB, Ljungman PL, Wilker EH, Dorans KS, Gold DR, Schwartz J, et al. Long-term exposure to traffic emissions and fine particulate matter and lung function decline in the Framingham heart study. Am J Respir Crit Care Med. 2015;191:656–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Hou D, Ge Y, Chen C, Tan Q, Chen R, Yang Y, et al. Associations of long-term exposure to ambient fine particulate matter and nitrogen dioxide with lung function: A cross-sectional study in China. Environ Int. 2020;144:105977.

    Article  CAS  PubMed  Google Scholar 

  11. Rice MB, Ljungman PL, Wilker EH, Gold DR, Schwartz JD, Koutrakis P, et al. Short-term exposure to air pollution and lung function in the Framingham Heart Study. Am J Respir Crit Care Med. 2013;188:1351–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Dauchet L, Hulo S, Cherot-Kornobis N, Matran R, Amouyel P, Edmé JL, et al. Short-term exposure to air pollution: Associations with lung function and inflammatory markers in non-smoking, healthy adults. Environ Int. 2018;121:610–9.

    Article  CAS  PubMed  Google Scholar 

  13. Glencross DA, Ho TR, Camiña N, Hawrylowicz CM, Pfeffer PE. Air pollution and its effects on the immune system. Free Radic Biol Med. 2020;151:56–68.

    Article  CAS  PubMed  Google Scholar 

  14. Salvi S, Blomberg A, Rudell B, Kelly F, Sandström T, Holgate ST, et al. Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. Am J Respir Crit Care Med. 1999;159:702–9.

    Article  CAS  PubMed  Google Scholar 

  15. Wang C, Xu J, Yang L, Xu Y, Zhang X, Bai C, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018;391:1706–17.

    Article  PubMed  Google Scholar 

  16. Ferguson GT, Enright PL, Buist AS, Higgins MW. Office spirometry for lung health assessment in adults: a consensus statement from the National Lung Health Education Program. Respir Care. 2000;45:513–30.

    CAS  PubMed  Google Scholar 

  17. Morris ZQ, Coz A, Starosta D. An isolated reduction of the FEV3/FVC ratio is an indicator of mild lung injury. Chest 2013;144:1117–23.

    Article  PubMed  Google Scholar 

  18. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.

    Article  CAS  PubMed  Google Scholar 

  19. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999;159:179–87.

    Article  CAS  PubMed  Google Scholar 

  20. Cai J, Zhao A, Zhao J, Chen R, Wang W, Ha S, et al. Acute effects of air pollution on asthma hospitalization in Shanghai, China. Environ Pollut. 2014;191:139–44.

    Article  CAS  PubMed  Google Scholar 

  21. Ploubidis GB, Silverwood RJ, DeStavola B, Grundy E. Life-Course Partnership Status and Biomarkers in Midlife: Evidence From the 1958 British Birth Cohort. Am J Public Health. 2015;105:1596–603.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Chen R, Kan H, Chen B, Huang W, Bai Z, Song G, et al. Association of particulate air pollution with daily mortality: the China Air Pollution and Health Effects Study. Am J Epidemiol. 2012;175:1173–81.

    Article  PubMed  Google Scholar 

  23. Cirillo I, Klersy C, Marseglia GL, Vizzaccaro A, Pallestrini E, Tosca M, et al. Role of FEF25%-75% as a predictor of bronchial hyperreactivity in allergic patients. Ann Allergy, Asthma Immunol: Off Publ Am Coll Allergy, Asthma, Immunol. 2006;96:692–700.

    Article  Google Scholar 

  24. Xiao D, Chen Z, Wu S, Huang K, Xu J, Yang L, et al. Prevalence and risk factors of small airway dysfunction, and association with smoking, in China: findings from a national cross-sectional study. Lancet Respir Med. 2020;8:1081–1093.

  25. Ji X, Han M, Yun Y, Li G, Sang N. Acute nitrogen dioxide (NO2) exposure enhances airway inflammation via modulating Th1/Th2 differentiation and activating JAK-STAT pathway. Chemosphere 2015;120:722–8.

    Article  CAS  PubMed  Google Scholar 

  26. Wigenstam E, Elfsmark L, Bucht A, Jonasson S. Inhaled sulfur dioxide causes pulmonary and systemic inflammation leading to fibrotic respiratory disease in a rat model of chemical-induced lung injury. Toxicology 2016;368-369:28–36.

    Article  CAS  PubMed  Google Scholar 

  27. Lazarus SC, Wong HH, Watts MJ, Boushey HA, Lavins BJ, Minkwitz MC. The leukotriene receptor antagonist zafirlukast inhibits sulfur dioxide-induced bronchoconstriction in patients with asthma. Am J Respir Crit Care Med. 1997;156:1725–30.

    Article  CAS  PubMed  Google Scholar 

  28. Santus P, Russo A, Madonini E, Allegra L, Blasi F, Centanni S, et al. How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan. Respir Res. 2012;13:95.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Doiron D, de Hoogh K, Probst-Hensch N, Fortier I, Cai Y, De Matteis S, et al. Air pollution, lung function and COPD: results from the population-based UK Biobank study. Eur Respir J. 2019;54:1802140.

  30. Sunyer J, Basagaña X, Belmonte J, Antó JM. Effect of nitrogen dioxide and ozone on the risk of dying in patients with severe asthma. Thorax 2002;57:687–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Poynter ME, Persinger RL, Irvin CG, Butnor KJ, van Hirtum H, Blay W, et al. Nitrogen dioxide enhances allergic airway inflammation and hyperresponsiveness in the mouse. Am J Physiol Lung Cell Mol Physiol. 2006;290:L144–52.

    Article  CAS  PubMed  Google Scholar 

  32. Canova C, Torresan S, Simonato L, Scapellato ML, Tessari R, Visentin A, et al. Carbon monoxide pollution is associated with decreased lung function in asthmatic adults. Eur Respir J. 2010;35:266–72.

    Article  CAS  PubMed  Google Scholar 

  33. Sekiguchi K, Yasui F, Fujii E. Capturing of gaseous and particulate pollutants into liquid phase by a water/oil column using microbubbles. Chemosphere 2020;256:126996.

    Article  CAS  PubMed  Google Scholar 

  34. Nováková Z, Novák J, Kitanovski Z, Kukučka P, Smutná M, Wietzoreck M, et al. Toxic potentials of particulate and gaseous air pollutant mixtures and the role of PAHs and their derivatives. Environ Int. 2020;139:105634.

    Article  PubMed  Google Scholar 

  35. Brunekreef B, Holgate ST. Air pollution and health. Lancet 2002;360:1233–42.

    Article  CAS  PubMed  Google Scholar 

  36. Li Y, Rittenhouse-Olson K, Scheider WL, Mu L. Effect of particulate matter air pollution on C-reactive protein: a review of epidemiologic studies. Rev Environ Health. 2012;27:133–49.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chen X, Liu F, Niu Z, Mao S, Tang H, Li N, et al. The association between short-term exposure to ambient air pollution and fractional exhaled nitric oxide level: A systematic review and meta-analysis of panel studies. Environ Pollut. 2020;265:114833.

    Article  CAS  PubMed  Google Scholar 

  38. Wooding DJ, Ryu MH, Li H, Alexis NE, Pena O, Carlsten C. Acute air pollution exposure alters neutrophils in never-smokers and at-risk humans. Eur Respir J. 2020;55:1901495.

  39. Blomberg A, Krishna MT, Helleday R, Söderberg M, Ledin MC, Kelly FJ, et al. Persistent airway inflammation but accommodated antioxidant and lung function responses after repeated daily exposure to nitrogen dioxide. Am J Respir Crit Care Med. 1999;159:536–43.

    Article  CAS  PubMed  Google Scholar 

  40. Green R, Broadwin R, Malig B, Basu R, Gold EB, Qi L, et al. Long- and short-term exposure to air pollution and inflammatory/hemostatic markers in midlife women. Epidemiology 2016;27:211–20.

    PubMed  PubMed Central  Google Scholar 

  41. Sakai M, Sato Y, Sato S, Ihara S, Onizuka M, Sakakibara Y, et al. Effect of relocating to areas of reduced atmospheric particulate matter levels on the human circulating leukocyte count. J Appl Physiol. 2004;97:1774–80.

    Article  PubMed  Google Scholar 

  42. Swiston JR, Davidson W, Attridge S, Li GT, Brauer M, van Eeden SF. Wood smoke exposure induces a pulmonary and systemic inflammatory response in firefighters. Eur Respir J. 2008;32:129–38.

    Article  CAS  PubMed  Google Scholar 

  43. Brightling C, Greening N. Airway inflammation in COPD: Progress to precision medicine. Eur Respir J. 2019;54:1900651.

  44. Havet A, Hulo S, Cuny D, Riant M, Occelli F, Cherot-Kornobis N, et al. Residential exposure to outdoor air pollution and adult lung function, with focus on small airway obstruction. Environ Res. 2020;183:109161.

    Article  CAS  PubMed  Google Scholar 

  45. Pouwels SD, Zijlstra GJ, van der Toorn M, Hesse L, Gras R, Ten Hacken NH, et al. Cigarette smoke-induced necroptosis and DAMP release trigger neutrophilic airway inflammation in mice. Am J Physiol Lung Cell Mol Physiol. 2016;310:L377–86.

    Article  PubMed  Google Scholar 

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Funding

This study was supported by National key R&D plan (2020YFC2003700, 2022YFC3703000), The National Natural Science Foundation of China (81800008, 82041003), Science and Technology Commission of Shanghai Municipality (20DZ2261200, 20Z11901000, 20XD1401200), Shanghai Municipal Health Commission and Shanghai Municipal Administrator of Traditional Chinese Medicine(ZY(2021-2023)-0207-01), and Shanghai Municipal Key Clinical Specialty (shslczdzk02201).

Author information

Author notes

  1. These authors contributed equally: Tingting Wei, Cuicui Chen.

Authors and Affiliations

  1. Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Tingting Wei, Cuicui Chen, Yanjie Yang, Li Li, Jian Wang, Maosong Ye, Dong Yang, Yuanlin Song & Dongni Hou

  2. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China

    Haidong Kan & Jing Cai

  3. National and Shanghai Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Yuanlin Song

  4. Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China

    Jing Cai

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  1. Tingting Wei
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Contributions

TW contributed substantially to data collection, patient management, statistical analysis and interpretation, and the writing of the manuscript. CC performed guided the design and contributed substantially to data collection, patient management, statistical analysis, and interpretation. YY, LL, JW, and MY contributed to the acquisition, analysis, or interpretation of data; HK contributed to study design, exposure assessment, and statistical analysis and interpretation. DY contributed to study design, statistical analysis and interpretation, and the writing of the manuscript. YS contributed to administrative, technical, and material support and to critical revision of the manuscript for important intellectual content. JC contributed to study design, exposure assessment, statistical analysis and interpretation and the writing of the manuscript. DH contributed substantially to the study design, data collection, statistical analysis and interpretation, and the writing of the manuscript. All authors read and approved the final manuscript. The corresponding authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding authors

Correspondence to Jing Cai or Dongni Hou.

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The ethics committee of Beijing Capital Medical University approved the study (No. 11-ke-42), and all participants signed informed consent.

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Wei, T., Chen, C., Yang, Y. et al. Associations between short-term exposure to ambient air pollution and lung function in adults. J Expo Sci Environ Epidemiol (2023). https://doi.org/10.1038/s41370-023-00550-0

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  • DOI: https://doi.org/10.1038/s41370-023-00550-0

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