The impact of acute air pollution fluctuations on bronchiectasis pulmonary exacerbation: A case-crossover analysis

Pieter C. Goeminne (Lead / Corresponding author), Bianca Cox, Simon Finch, Michael Loebinger, Pallavi Bedi, Adam T. Hill, Thomas Fardon, Kees de Hoogh, Tim S. Nawrot, James Chalmers

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)
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Introduction: In bronchiectasis, exacerbations are believed to be triggered by infectious agents, but often no pathogen can be identified. We aimed to establish the effect of acute air pollution fluctuations on bronchiectasis exacerbations.

Methods: We combined a case-crossover design with distributed lag models in an observational record linkage study. Patients were recruited at Ninewells Hospital, Dundee, UK.

Results: We recruited 432 patients with HRCT diagnosed and clinically confirmed bronchiectasis. After excluding days with missing air pollution data, the final model for PM10 was based on 6741 exacerbations from 430 patients and for NO2 it included 6248 exacerbations from 426 patients. For each 10µg/m³ increase in PM10 and NO2, the risk of having an exacerbation that same day increased significantly by 4.5% (95%CI: 0.9-8.3) and 3.2% (95%CI: 0.7-5.8) respectively. The overall increase in the risk of exacerbation for a 10μg/m3 increase in air pollutant concentration was 11.2% (95%CI: 6.0-16.8) for PM10 and 4.7% (95%CI: 0.1-9.5) for NO2. Subanalysis showed significant higher relative risks during spring (PM10 1.198, 95%CI 1.102-1.303; NO2 1.146, 95%CI 1.035-1.268) and summer (PM10 2.142, 95%CI 1.785-2.570; NO2 1.352, 95%CI 1.140-1.602).

Conclusions: Acute air pollution fluctuations are associated with increased exacerbation risk in bronchiectasis.
Original languageEnglish
Article number1702557
JournalEuropean Respiratory Journal
Issue number1
Early online date14 Jun 2018
Publication statusPublished - 27 Jul 2018


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