Indoor air pollution exposure is associated with greater morbidity in cystic fibrosis |
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| Affiliation: | 1. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States;2. Department of Pediatrics, Division of General Pediatrics, Johns Hopkins University, Baltimore, MD, United States;3. Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;4. Department of Pediatrics, Division of Pulmonology, Johns Hopkins University, Baltimore, MD, United States;5. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States;1. Evidence Based Child Health Group, University of Nottingham, Nottingham, United Kingdom;2. Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom;3. School of Medicine, University of Nottingham, Nottingham, United Kingdom;4. Person with CF, Plymouth, United Kingdom;5. Parent of children with CF, Nottingham, United Kingdom;6. York Hull Adult CF Centre, York Teaching Hospital NHS Foundation Trust, York, United Kingdom;1. Cystic Fibrosis Therapeutics Development Network Coordinating Center, Seattle Children''s Hospital, Seattle, WA, United States of America;2. Department of Pediatrics, University of Washington, Seattle, WA, United States of America;3. Department of Biostatistics, University of Washington, Seattle, WA, United States of America;4. Department of Epidemiology, University of Washington, Seattle, WA, United States of America;5. Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America;1. Department of Paediatric Cardiology and Intensive Care Medicine, Paediatric Pulmonary and Allergology Outpatient Clinic, Universitätsmedizin Göttingen, Göttingen, Germany;2. Clinical Research Group ''Molecular Pathology of Cystic Fibrosis'', Department of Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany;3. Department of Paediatric and Adolescent Medicine, Paediatric Gastroenterology Outpatient Clinic, Universitätsmedizin Göttingen, Göttingen, Germany;4. Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany;1. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada;2. The Hospital for Sick Children (SickKids), 555 University Avenue, Toronto, ON, M5G 1X8, Canada;3. St. Michaels Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada;4. Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M6, Canada;1. Université Paris Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-le-Bretonneux, France;2. AP-HP, GHU Paris Saclay, Hôpital Ambroise Paré, Service de Microbiologie, Boulogne-Billancourt, France;3. AP-HP, GHU Paris, Hôpital Necker-Enfants Malades, Service de Microbiologie, Paris 15e, France;4. Hospices Civils de Lyon, Hôpital de la Croix Rousse-Centre de Biologie Nord, Institut des Agents Infectieux, Laboratoire de Bactériologie, Grande Rue de la Croix Rousse, 69004, Lyon, France;5. Centre International de Recherche en Infectiologie, INSERM U1111, Université de Lyon, Lyon, France;6. CHU, Service de Parasitologie-Mycologie, Groupe d''Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), UNIV Angers, UNIV Brest, SFR 4208 ICAT, Angers, France;7. Laboratoire de Bactériologie, CHRU de Besançon, UMR CNRS 6249 Chrono-Environnement, Faculté de Médecine-Pharmacie, Université de Bourgogne Franche-Comté, Besançon, France;8. Université Aix-Marseille, CNRS, LISM, IMM FR3479, Marseille, France;9. Département de bactériologie-virologie, hygiène et parasitologie-mycologie, centre hospitalier régional universitaire (CHRU) de Brest, Brest, France; Inserm, EFS, UMR 1078 France « génétique, génomique fonctionnelle et biotechnologies », GGB, université Brest, 29200 Brest, France;10. AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Service de Microbiologie, Garches, France |
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| Abstract: | BackgroundExposure to higher levels of outdoor air pollution is associated with increased morbidity in individuals with cystic fibrosis. Limited information exist regarding the potential adverse effects of indoor air pollution on those with cystic fibrosis.MethodsIndividuals with cystic fibrosis who were enrolled in the Twin and Sibling Study from 2000-2013, self-reported exposure to four known sources of indoor air pollution (secondhand smoke, forced hot air, wood stove and fireplace). Change in lung function, rates of hospitalizations and pulmonary exacerbations were followed over 4 years to compare outcomes in those who were exposed to those who were not exposed.ResultsOf 1432 participants with data on secondhand smoke exposure, 362 (25.3%) were exposed. Of 765 individuals with data on forced hot air exposure, 491 (64.2%) were exposed. Of 1247 participants with data on wood stove exposure and 830 with data on fireplace exposure, 182 (14.6%) and 373 (44.9%) were exposed, respectively. In longitudinal analysis, pediatric individuals either exposed to secondhand smoke or to forced hot air had a 0.60% predicted/year decrease in FEV1% predicted (P=0.002) or a 0.46% predicted/year decrease in FEV1% predicted (P=0.048), respectively compared to individuals who were not exposed. Adults exposed to secondhand smoke had a 42% increased yearly risk of hospitalization compared to those who were not exposed (P=0.045).ConclusionsOur questionnaire-based data suggest that exposure to sources of indoor air pollution increase morbidity in both the pediatric and adult cystic fibrosis populations. Future studies with quantitative indoor air quality assessments are needed. |
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