THE AIR POLLUTION IMPACT ON PULMONARY EXACERBATIONS AND RESPIRATORY FUNCTION IN PATIENTS WITH CYSTIC FIBROSIS

Elena Gjinovska-Tasevska; Emilija Vlashki; Tatjana Jakjovska; Katerina Boshkovska; Ivana Arnaudova Daneva; Filip Doksimovski; Hristijan Nestorov; Enfale Ismaili

Elena Gjinovska-Tasevska University Clinic for respiratory diseases in children-Kozle, Skopje, North Macedonia
Emilija Vlashki University Clinic for respiratory diseases in children-Kozle, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Tatjana Jakjovska University Clinic for respiratory diseases in children-Kozle, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Katerina Boshkovska University Clinic for respiratory diseases in children-Kozle, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Ivana Arnaudova Daneva University Clinic for respiratory diseases in children-Kozle, Skopje, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Filip Doksimovski University Clinic for Respiratory Diseases in Children-Kozle, Skopje, North Macedonia
Hristijan Nestorov University Clinic for Respiratory Diseases in Children-Kozle, Skopje, North Macedonia
Enfale Ismaili University Clinic for Respiratory Diseases in Children-Kozle, Skopje, North Macedonia

Abstract

Pulmonary exacerbation in cystic fibrosis (CF) contribute to the burden of disease, with a negative impact on quality of life, treatment cost, but most significantly affect lung function. Data regarding the impact of environmental factors, especially air pollution, on CF are limited. This study aimed to assess the impact of air pollutants on pulmonary exacerbations and lung function in CF. The study included 25 patients with CF. Air quality parameters 5 days before and on the day of hospitalization were provided by measuring stations in cooperation with the State Automatic Monitoring System for Ambient Air Quality. Concentration of PM2.5 and PM10 above the maximum allowed concentration five days before and on the day of exacerbation in almost all patients were determined, with their significant mutual association (highest OR 16.33, p<0.001 on the day of exacerbation for PM2.5 and OR 7.0, p<0.01 on the third day before exacerbation for PM10). A significant difference was found in the patients' lung function during periods with and without air pollution (p<0.001), with lower values during the periods with air pollution. Air pollution with PM2.5 and PM10 particles was associated with an increased risk of pulmonary exacerbations and reduced lung function in patients with CF.

Keywords: air pollution, cystic fibrosis,exacerbation, lungs function.

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