Air Pollution Exacerbates Cystic Fibrosis

This is the first study to investigate the impact of air pollutants on cystic fibrosis patients.

Cystic fibrosis is an inherited fatal disease with an incidence of between 1 in 2,000 to 1 in 3,200 births in the white population. As the disease progresses, it is characterized by chronic and recurrent lung infections, inflammation, and a loss of lung function over time.

Investigators at the University of Washington followed a cohort of more than 11,000 patients older than 6 years of age enrolled in the Cystic Fibrosis Foundation National Patient Registry for which medical information was available. Exposures were assessed based on air quality monitors correlated with the patients’ home zip codes.

After controlling for confounders, annual average exposure to PM10, PM2.5 and ozone was associated with an increased risk of pulmonary exacerbations. The association was most pronounced for patients who experienced two or more exacerbations per year. PM2.5 was also associated with a significant loss in lung function.

Researchers speculate that the decline in lung function may be due to chronic exposure to air pollutants, which may be part of the causal pathway in the worsening prognosis of cystic fibrosis.

Researchers concluded: “Exposure to ambient PM10, PM2.5 and ozone may increase the risk for pulmonary exacerbations and increase the rate of change in lung function in the CF (cystic fibrosis) population. Ambient air pollution may also impact survival.”

Goss, CH, Newsom, SA, Schildcrout, JS, Sheppard, L, and Kaufman, JD. Effect of Ambient Air Pollution on Pulmonary Exacerbations and Lung Function in Cystic Fibrosis. Am J Respir Crit Care Med 2004;169:816-821.

The American Thoracic Society [www.atsjournals.org] offers the abstract online.