Chronic effects of air pollution on lung function after lung transplantation in the Systems prediction of Chronic Lung Allograft Dysfunction (SysCLAD) study

Eur Respir J. 2017 Jan 18;49(1):1600206. doi: 10.1183/13993003.00206-2016. Print 2017 Jan.

Abstract

An irreversible loss in lung function limits the long-term success in lung transplantation. We evaluated the role of chronic exposure to ambient air pollution on lung function levels in lung transplant recipients (LTRs).The lung function of 520 LTRs from the Cohort in Lung Transplantation (COLT) study was measured every 6 months. The levels of air pollutants (nitrogen dioxide (NO2), particulate matter with an aerodynamic cut-off diameter of x µm (PMx) and ozone (O3)) at the patients' home address were averaged in the 12 months before each spirometry test. The effects of air pollutants on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in % predicted were estimated using mixed linear regressions. We assessed the effect modification of macrolide antibiotics in this relationship.Increased 12-month levels of pollutants were associated with lower levels of FVC % pred (-2.56%, 95% CI -3.86--1.25 for 5 µg·m-3 of PM10; -0.75%, 95% CI -1.38--0.12 for 2 µg·m-3 of PM2.5 and -2.58%, 95% CI -4.63--0.53 for 10 µg·m-3 of NO2). In patients not taking macrolides, the deleterious association between PM and FVC tended to be stronger and PM10 was associated with lower FEV1Our study suggests a deleterious effect of chronic exposure to air pollutants on lung function levels in LTRs, which might be modified with macrolides.

Trial registration: ClinicalTrials.gov NCT00980967.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Air Pollution / adverse effects*
  • Allografts
  • Bronchiolitis Obliterans / etiology
  • Bronchiolitis Obliterans / physiopathology
  • Chronic Disease
  • Environmental Exposure
  • Female
  • Forced Expiratory Volume
  • France
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Lung / physiopathology*
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Nitrogen Dioxide / analysis
  • Ozone / analysis
  • Particulate Matter / analysis*
  • Primary Graft Dysfunction / physiopathology*
  • Spirometry
  • Vital Capacity
  • Young Adult

Substances

  • Particulate Matter
  • Ozone
  • Nitrogen Dioxide

Associated data

  • ClinicalTrials.gov/NCT00980967