University of Washington (UW) researchers have shown for the first time that air pollution has adverse effects on people with cystic fibrosis (CF). The research results are published in the April 1 edition of the American Journal of Respiratory and Critical Care Medicine.
The study found a significant relationship between the amount of airborne fine particles of soot from sources such as power plants and motor vehicles and the number of CF-related lung infections requiring special medical care such as intravenous antibiotics.
Dr. Christopher Goss, a study author, UW assistant professor of medicine and medical director of the CF Foundation’s Therapeutics Development Network said, “The findings do not come as a major surprise, given the growing body of evidence that these particles are unhealthy, but this is the first time the effects of air pollution have been studied in CF patients.”
Previous research has indicated that long-term exposure to fine-particle air pollution increases cardiovascular mortality in the general population, and that daily increases in air pollutants can worsen asthma.
Cystic fibrosis is a life-threatening, genetic disease, affecting as many as 1 in 3,900 live births in the United States. Approximately 30,000 children and adults in the United States are living with the disease that causes thick, sticky mucus that clogs the lungs and blocks the pancreas. Median life expectancy of those born with CF has increased in recent decades to the early 30s.
The UW researchers matched patients in the CF Foundation’s national patient registry with air pollution monitoring data collected across the United States. The study included 11,484 people with CF from every part of the nation. This study was made possible by the data available in the CF Foundation’s patient registry and the greatly improved air pollution monitoring network, Goss said.
The Environmental Protection Agency (EPA) and local air pollution control agencies have increased monitoring for these fine soot particles in recent years as air pollution regulations have been changed to reflect the increasing evidence of health effects from fine particles. Average air pollution exposures for the year 2000 were determined for each patient, and linked to information on each patient’s lung function measurements and needs for specialized medical treatment.
“Our study found that higher average levels of particulate and ozone air pollution exposure were related to more serious episodes of CF lung infections," Goss reported. "Lung function also worsened in those with more fine particulate exposures. These findings are consistent with previous studies of the effects of ambient air pollution. People with CF are at special risk from air pollution.”
“We found that CF patients living in areas with more air pollution had a 21 percent increased risk of requiring more courses of intravenous antibiotics than those living in the least polluted areas,” said Dr. Joel Kaufman, also a study author and director of UW's Occupational and Environmental Medicine Program in the School of Public Health and Community Medicine.
Further, Kaufman noted, “Clean air laws need to protect the most sensitive members of the population, and it seems that CF patients may be among the most susceptible groups for air pollution’s effects.”
However, he cautioned that this is the first finding of this effect in CF patients: "The finding will definitely need to be repeated before we would make recommendations to families of CF patients based on this. In many cases, the same urban locations where air pollution is worst are also much closer to the life-extending medical treatment these patients need.”
The research was primarily supported by the EPA-sponsored Northwest Research Center for Particulate Air Pollution and Health at the UW, one of five specialized Particulate Matter Research Centers, and by Cystic Fibrosis Foundation Therapeutics, the nonprofit drug discovery and development affiliate of the Cystic Fibrosis Foundation.