An association of particulate air pollution and traffic exposure with mortality after lung transplantation in Europe

[摘要] Air pollution from road traffic is a serious health risk; especially for susceptible individuals. Single-centre studies showed an association with chronic lung allograft dysfunction (CLAD) and survival after lung transplantation; but there are no large studies.13 lung transplant centres in 10 European countries created a cohort of 5707 patients. For each patient; we quantified residential particulate matter with aerodynamic diameter xe2x89xa410xe2x80x85xc2xb5m (PM10) by land use regression models; and the traffic exposure by quantifying total road length within buffer zones around the home addresses of patients and distance to a major road or freeway.After correction for macrolide use; we found associations between air pollution variables and CLAD/mortality. Given the important interaction with macrolides; we stratified according to macrolide use. No associations were observed in 2151 patients taking macrolides. However; in 3556 patients not taking macrolides; mortality was associated with PM10 (hazard ratio 1.081; 95% CI 1.000xe2x80x931.167); similarly; CLAD and mortality were associated with road lengths in buffers of 200xe2x80x931000 and 100xe2x80x93500xe2x80x85m; respectively (hazard ratio 1.085xe2x80x93 1.130). Sensitivity analyses for various possible confounders confirmed the robustness of these associations.Long-term residential air pollution and traffic exposure were associated with CLAD and survival after lung transplantation; but only in patients not taking macrolides.

[学科分类] 呼吸医学