Chronic lung disease: Air pollution impact is similar to a cigarette pack a day

The results of an 18-year long-term study showed that ozone pollution significantly contributes to the accelerated development of pulmonary emphysema.

The air we breath is becoming more harmful in large cities

The results of an 18-year long-term study showed that ozone pollution significantly contributes to the accelerated development of pulmonary emphysema.

Previous studies have shown that air pollution is clearly associated with various heart and lung diseases. The most recent research results show that x-ray images have shown pulmonary emphysema, caused by long-term exposure to air pollution.

Dr. Joel Kaufman, a co-author of the latest study on the topic, comments on the findings: "We were surprised at the extent to which the influence of air pollution on chronic lung diseases is reflected in pulmonary screenings. This can only be caused otherwise by the effects of smoking."

A rising number of chronic lung diseases are also impacting non-smokers

In a comparison between regions where the ozone level was 3 parts per billion or higher, versus, less affected areas, the researchers found significant differences on pulmonary diseases impact after an investigation lasting more than ten years: the effects of air pollution were comparable to consuming a pack of cigarettes a day for 29 years. In addition, the scientists identified that some large American cities were having dangerous annual average ozone values of between 10 to 25 parts per billion.

"The number of pulmonary emphysema illnesses continues to increase in the US. This can also be observed in non-smokers," said Dr. Kaufman. "We need to have a better focus on what causes chronic lung diseases. And this is precisely where air pollution plays a major role according to the current state of affairs."

A first long-term study investigating the relationship between ozone pollution and chronic lung diseases

The results are based on an extensive 18-year study with 7,000 participants and a detailed analysis of air pollution in six major cities between 2000 and 2018: Chicago, Winston-Salem, Baltimore, Los Angeles, St. Paul and New York.

As Meng Wang, head of the study said: "To the best of our knowledge, this is the first comprehensive, multi-ethnic, long-term study that focuses on the long-term uptake of ozone pollution and the development of chronic lung diseases.

Evaluation of over 15,000 CT scans

The study authors developed precise measurement methods to determine air pollution in the apartments and houses of the study participants. This enabled them to collect data over the years for city air pollution levels. Although many pollutants in large cities are declining as a result of successful control measures, ozone pollution continues to increase.

Dr. R. Graham Barr noted: "Here we have a very extensive study with precise evaluation of over 15,000 CT scans from thousands of participants, over a period of more than 18 years. These data are extremely important as ozone levels continue to rise and the amount of emphysema detected on the scans provides further information about hospital admissions and deaths from chronic lung disease."

A better understanding of pollutant effects is needed

Dr. Barr added: "With increasing temperatures due to climate change, ozone pollution will continue to increase unless measures are taken to combat it. However, it is unclear whether reduced values are sufficient to protect human health."

Dr. James Kiley, head of the Lung Disease Division at the National Heart, Lung and Blood Institute, reports: "The study establishes a clear link between air pollution and chronic lung disease. A better understanding of the effects of pollutants on the lungs could help prevent and treat pulmonary emphysema more effectively. Therefore, it is important that we continue to investigate the factors that favor chronic lung disease. This is particularly well supported by such extensive long-term studies."

Meng Wang, Carrie Pistenmaa Aaron, Jaime Madrigano, Eric A. Hoffman, Elsa Angelini, Jie Yang, Andrew Laine, Thomas M. Vetterli, Patrick L. Kinney, Paul D. Sampson, Lianne E. Sheppard, Adam A. Szpiro, Sara D. Adar, Kipruto Kirwa, Benjamin Smith, David J. Lederer, Ana V. Diez-Roux, Sverre Vedal, Joel D. Kaufman, R. Graham Barr. Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function. JAMA, 2019; 322 (6): 546 DOI: 10.1001/jama.2019.10255