Abstract
Introduction: Previous research has shown that traffic-related chronic air pollution exposure increases risk of death in patients with non-cystic fibrosis bronchiectasis (NCFB). However the effect of acute air pollution exposure in patients with NCFB remains to be established.
Aims: We aimed to establish the effect of acute air pollution fluctuations on NCFB pulmonary exacerbations.
Methods: NCFB patients from the Royal Infirmary of Edinburgh, UK, suffering an exacerbation between July 2012 and October 2014 were included in the case-crossover analysis. An exacerbation was defined as the use for antibiotic treatment due to respiratory deterioration. We linked these data with concentrations of particulate matter with a diameter smaller than 2.5 mm (PM2.5) and ozone on the day of the event and on the 2 days prior to the event near each patient's home address.
Results: Forty patients (median 68 year, IQR 57-74; 17 male) each had one exacerbation during the study period. Thirty patients had no identifiable cause of their NCFB, 5 had post-infectious NCFB with the remaining five suffering from an auto-immune disease. The mean FEV1 was 81% (±SD 24%) and four patients had chronic Pseudomonas aeruginosa colonization. An increase of 1 µg/m3 of daily mean PM2.5 concentrations was associated with a 10.2% increase in the risk of suffering an exacerbation in the next 24 hours (p=0.02; 95% CI 1.6%-19.7%). We found no evidence of an association between ozone levels and NCFB exacerbations.
Conclusion: Ambient concentrations of PM2.5 were associated with a higher risk of exacerbations, suggesting that ambient air pollution affects the health of patients with NCFB.
- Copyright ©ERS 2015
