Ambient Air Pollution and Dysanapsis: Associations with Lung Function and Chronic Obstructive Pulmonary Disease in the Canadian Cohort Obstructive Lung Disease Study
Authors: Jean Bourbeau, Dany Doiron, Sharmistha Biswas, Benjamin M. Smith, Andrea Benedetti, Jeffrey R. Brook, Shawn D. Aaron, Kenneth R. Chapman, Paul Hernandez, François Maltais, Darcy D. Marciniuk, Denis O’Donnell, Don D. Sin, Brandie Walker, Liesel Dsilva, Gilbert Nadeau, Valérie Coats, Chris Compton, Bruce E. Miller, Wan C. Tan, Jean Bourbeau, Wan C. Tan, J. Mark FitzGerald, Don D. Sin, Darcy D. Marciniuk, Denis E. O’Donnell, Paul Hernandez, Kenneth R. Chapman, Brandie Walker, Shawn Aaron, François Maltais, Jonathon Samet, Milo Puhan, Qutayba Hamid, James C. Hogg, Dany Doiron, Palmina Mancino, Pei Zhi Li, Dennis Jensen, Carolyn Baglole, Yvan Fortier, Julia Yang, Jeremy Road, Joe Comeau, Adrian Png, Kyle Johnson, Harvey Coxson, Miranda Kirby, Jonathon Leipsic, Cameron Hague, Mohsen Sadatsafavi, Teresa To, Andrea Gershon, Zhi Song, Andrea Benedetti, Christine Lo, Sarah Cheng, Elena Un, Cynthia Fung, Wen Tiang Wang, Liyun Zheng, Faize Faroon, Olga Radivojevic, Sally Chung, Carl Zou, Jacinthe Baril, Laura Labonté, Patricia McClean, Nadeen Audisho, Brandie Walker, Curtis Dumonceaux, Lisette Machado, Paul Hernandez, Scott Fulton, Kristen Osterling, Denise Wigerius, Shawn Aaron, Kathy Vandemheen, Gay Pratt, Amanda Bergeron, Sandra Vincent, Matthew McNeil, Kate Whelan, François Maltais, Cynthia Brouillard, Ron Clemens, Janet Baran, Candice Leuschen
Journal: American Journal of Respiratory and Critical Care Medicine (2022)

Rationale: Outdoor air pollution is a potential risk factor for lower lung function and chronic obstructive pulmonary disease (COPD). Little is known about how airway abnormalities and lung growth might modify this relationship. Objectives: To evaluate the associations of ambient air pollution exposure with lung function and COPD and examine possible interactions with dysanapsis. Methods: We made use of cross-sectional postbronchodilator spirometry data from 1,452 individuals enrolled in the CanCOLD (Canadian Cohort Obstructive Lung Disease) study with linked ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) air pollution estimates. Dysanapsis, or the ratio of the airway-to-lung volume calculated from thoracic computed tomography images, was used to examine possible interactions. Measurements and Main Results: In adjusted models, 101.7 ml (95% confidence interval [CI], −166.2 to −37.2) and 115.0 ml (95% CI, −196.5 to −33.4) lower FEV1 were demonstrated per increase of 2.4 ug/m3 PM2.5 and 9.2 ppb NO2, respectively. Interaction between air pollution and dysanapsis was not statistically significant when modeling the airway-to-lung ratio as a continuous variable. However, a 109.8 ml (95% CI, −209.0 to −10.5] lower FEV1 and an 87% (95% CI, 12% to 213%) higher odds of COPD were observed among individuals in the lowest, relative to highest, airway-to-lung ratio, per 2.4 μg/m3 increment of PM2.5. Conclusions: Ambient air pollution exposure was associated with lower lung function, even at relatively low concentrations. Individuals with dysanaptic lung growth might be particularly susceptible to inhaled ambient air pollutants, especially those at the extremes of dysanapsis.