{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:11:47Z","timestamp":1791461507488,"version":"4.3.4"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec id=\"ab-ioi220062-4\"><jats:title>Importance<\/jats:title><jats:p>Particulate matter 2.5 \u03bcm or less in diameter (PM<jats:sub>2.5<\/jats:sub>) is associated with adverse outcomes in idiopathic pulmonary fibrosis, but its association with other fibrotic interstitial lung diseases (fILDs) remains unclear.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi220062-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate the association of PM<jats:sub>2.5<\/jats:sub> exposure with mortality and lung function among patients with fILD.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi220062-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this multicenter, international, prospective cohort study, patients were enrolled in the Simmons Center for Interstitial Lung Disease Registry at the University of Pittsburgh in Pittsburgh, Pennsylvania (Simmons cohort); 42 sites of the Pulmonary Fibrosis Foundation Registry (PFF cohort); and 8 sites of the Canadian Registry for Pulmonary Fibrosis (CARE-PF cohort). A total of 6683 patients were included (Simmons, 1424; PFF, 1870; and CARE-PF, 3389). Data were analyzed from June 1, 2021, to April 3, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi220062-7\"><jats:title>Exposures<\/jats:title><jats:p>Exposure to PM<jats:sub>2.5<\/jats:sub> and its constituents was estimated with hybrid models, combining satellite-derived aerosol optical depth with chemical transport models and ground-based PM<jats:sub>2.5<\/jats:sub> measurements.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi220062-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Multivariable linear regression tested associations of exposures with baseline forced vital capacity (FVC) and diffusion capacity for carbon monoxide (D<jats:sub>L<\/jats:sub>CO), and linear mixed models tested associations with lung function decline. Multivariable Cox models tested associations of 5-year time-varying exposures from enrollment to censoring with mortality or lung transplant. Multiconstituent analyses were performed with quantile-based g-computation. Models were adjusted for age, sex, smoking history, self-reported race, a socioeconomic covariate, and site (for PFF and CARE-PF only). Cohort effect estimates were meta-analyzed with clustering by cohort.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi220062-9\"><jats:title>Results<\/jats:title><jats:p>Median follow-up across the 3 cohorts was 2.9 years (IQR, 1.5-4.5 years), with death for 28% of patients and lung transplant for 10% of patients. Of 6683 patients, 3653 were men (55%), 205 were Black (3.1%), and 5609 were White (84.0%). Median (IQR) age at enrollment was 66 (58-73) years. In Simmons, each 1-\u03bcg\/m<jats:sup>3<\/jats:sup> increase in 5-year preenrollment PM<jats:sub>2.5<\/jats:sub> was associated with a lower estimated percentage baseline FVC, and each 1-\u03bcg\/m<jats:sup>3<\/jats:sup> increase in 5-year precensoring PM<jats:sub>2.5<\/jats:sub> was associated with decreasing FVC and D<jats:sub>L<\/jats:sub>CO, but these associations were not observed in PFF or CARE-PF. In PFF, each 1-\u03bcg\/m<jats:sup>3<\/jats:sup> increase in 5-year preenrollment PM<jats:sub>2.5<\/jats:sub> was associated with lower percentage baseline D<jats:sub>L<\/jats:sub>CO. In cohort-specific analyses, each 1-\u03bcg\/m<jats:sup>3<\/jats:sup> increase in 5-year time-varying PM<jats:sub>2.5<\/jats:sub> exposure was associated with higher mortality or transplant rates in Simmons (hazard ratio [HR], 1.05 [95% CI, 1.01-1.09]; <jats:italic>P<\/jats:italic>\u2009=\u2009.02), but not the other cohorts (PFF HR, 1.02 [95% CI, 0.98-1.06]; <jats:italic>P<\/jats:italic>\u2009=\u2009.38; CARE-PF HR, 0.98 [95% CI, 0.96-1.01]; <jats:italic>P<\/jats:italic>\u2009=\u2009.16). Meta-analysis of pooled individual patient data from the 3 cohorts demonstrated an HR of 1.09 (95% CI, 1.05-1.13; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001) for each 1-\u03bcg\/m<jats:sup>3<\/jats:sup> increase in PM<jats:sub>2.5<\/jats:sub>. Increasing exposures to sulfate, ammonium, and black carbon PM<jats:sub>2.5<\/jats:sub> constituents were also associated with higher rate of mortality or transplant in the meta-analysis, and multiconstituent models demonstrated that black carbon and sulfate were the primary drivers of the adverse mortality rates associated with the PM<jats:sub>2.5<\/jats:sub> mixture.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ioi220062-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, exposure to PM<jats:sub>2.5<\/jats:sub> was associated with worse lung function and mortality or transplant among some but not all patients with fILD. Sulfate, ammonium, and black carbon constituents were associated with the most potential risk, highlighting the need for reductions in human-derived sources of pollution.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamainternmed.2022.4696","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T15:32:28Z","timestamp":1666020748000},"page":"1248","source":"Crossref","is-referenced-by-count":117,"title":["Association of Particulate Matter Exposure With Lung Function and Mortality Among Patients With Fibrotic Interstitial Lung Disease"],"prefix":"10.1001","volume":"182","author":[{"given":"Gillian C.","family":"Goobie","sequence":"first","affiliation":[{"name":"Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"Dorothy P. and Richard P. 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