Air Pollution Exposure

Abstract

Th e interstitial lung diseases (ILDs) comprise a diverse group of entities primarily characterized by the proliferation and thickening of the pulmonary interstitium. Despite a wide range of etiologic processes, many share a common phenotype of irreversible lung fi brosis that, in some patients, leads to progressive hypoxemia, respiratory failure, and death. Inhaled environmental causes have been identifi ed in several well-described forms of ILD, including hypersensitivity pneumonitis, asbestosis, and silicosis.Ambient air pollution has received relatively little attention in the fi eld of ILD but is known to contribute to a range of pulmonary and systemic diseases. Air pollution exposure is increasingly implicated in adverse health outcomes, including asthma, COPD, cardiovascular disease, and, most recently, lung cancer. We believe that a plausible argument can be made for a relationship between ambient air pollution and ILD. Th is article reviews the current clinical and biologic evidence linking air pollution exposure to the development and progression of ILD and proposes a new way of conceptualizing cumulative environmental risk factors in this patient population.

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