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Air pollution exposure is associated with restrictive rather than obstructive ventilatory patterns

Kim de Jong, Judith Vonk, Wilma Zijlema, Ronald Stolk, Diana van der Plaat, Cleo van Diemen, Gerard Hoek, Bert Brunekreef, Dirkje Postma, Marike Boezen
European Respiratory Journal 2016 48: PA398; DOI: 10.1183/13993003.congress-2016.PA398
Kim de Jong
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, NetherlandsGroningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Judith Vonk
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, NetherlandsGroningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Wilma Zijlema
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Ronald Stolk
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Diana van der Plaat
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, NetherlandsGroningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Cleo van Diemen
Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Gerard Hoek
Division of Environmental Epidemiology, University of Utrecht, Institute for Risk Assessment Sciences (IRAS), Utrecht, Netherlands
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Bert Brunekreef
Division of Environmental Epidemiology, University of Utrecht, Institute for Risk Assessment Sciences (IRAS), Utrecht, Netherlands
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Dirkje Postma
Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, NetherlandsGroningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Marike Boezen
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, NetherlandsGroningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Abstract

Background Ambient air pollutants have been associated with lower FVC and FEV1 levels, with effect estimates mostly being larger for FVC than for FEV1. We assessed for the first time explicitly whether air pollution exposure is associated with obstructive or restrictive ventilatory patterns.

Methods The residential address of subjects of the LifeLines cohort study was geocoded and annual average exposure to NO2, PM2.5, PM10 and PM2.5 absorbance estimated using land use regression models from the ESCAPE study. We used adjusted linear regression models to assess associations of air pollutants with pre-bronchodilator FEV1, FVC and FEV1/FVC in n=51,855 subjects.

Results Exposure to NO2, PM10 and PM2.5 absorbance showed consistent significant associations with lower levels of FVC, but not with FEV1. Since the estimated effects were smaller for FEV1 than for FVC, this resulted in positive associations with their ratio (FEV1/FVC). Statified analysis suggested that associations between PM10, PM2.5 absorbance and FVC were stronger in females, subjects with overweight, asthma, and airway obstruction, yet without significant interactions.

Conclusions Ambient air pollution exposure is associated with restrictive rather than obstructive ventilatory patterns. This may reflect pulmonary fibrosis, a disease which has, thus far, largely been understudied in relation to air pollution exposure in large scale epidemiological studies (Johannson, K.A. et al. Chest, 2015;147:1161-1167). Identifying susceptible subgroups may help to set exposure limits and pinpoint potential biological mechanisms underlying observed associations, which will render further studies in experimental settings.

  • Air pollution
  • Environment
  • Idiopathic pulmonary fibrosis
  • Copyright ©the authors 2016
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Air pollution exposure is associated with restrictive rather than obstructive ventilatory patterns
Kim de Jong, Judith Vonk, Wilma Zijlema, Ronald Stolk, Diana van der Plaat, Cleo van Diemen, Gerard Hoek, Bert Brunekreef, Dirkje Postma, Marike Boezen
European Respiratory Journal Sep 2016, 48 (suppl 60) PA398; DOI: 10.1183/13993003.congress-2016.PA398

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Air pollution exposure is associated with restrictive rather than obstructive ventilatory patterns
Kim de Jong, Judith Vonk, Wilma Zijlema, Ronald Stolk, Diana van der Plaat, Cleo van Diemen, Gerard Hoek, Bert Brunekreef, Dirkje Postma, Marike Boezen
European Respiratory Journal Sep 2016, 48 (suppl 60) PA398; DOI: 10.1183/13993003.congress-2016.PA398
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