{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:42:27Z","timestamp":1792345347558,"version":"4.4.0"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["BESWIC22Y5"],"award-info":[{"award-number":["BESWIC22Y5"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["BESWICK20A0"],"award-info":[{"award-number":["BESWICK20A0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Environmental air pollutants may contribute to chronic rhinosinusitis (CRS), but their relationship with upper airway disease in people with cystic fibrosis (CF) remains poorly understood. This study evaluated associations between long\u2010term ambient air pollutant exposure and CRS severity and olfactory dysfunction in adults with CF and CRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      80 adults with CF and comorbid CRS were prospectively enrolled from 2019 to 2023 at multiple U.S. academic rhinology centers. Long\u2010term exposure to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      , CO, SO\n                      <jats:sub>2<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      , and ozone was estimated using the nearest U.S. Environmental Protection Agency monitor linked to each participant's residential ZIP code, with 3\u2010year mean exposure calculated before enrollment. CRS severity and olfaction were assessed using Lund\u2010Kennedy endoscopy scores, Lund\u2010Mackay CT scores, SNOT\u201022, Questionnaire of Olfactory Disorders\u2010Negative Statements, and 40\u2010item Smell Identification Test. Analyses used Spearman correlations and nonparametric group comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher ozone exposure was associated with worse total SNOT\u201022 scores (R\n                      <jats:sub>s<\/jats:sub>\n                      = 0.34\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), including ear\/facial, psychological, and sleep dysfunction domains, as well as worse olfactory\u2010specific outcomes, including higher QOD\u2010NS scores (R\n                      <jats:sub>s<\/jats:sub>\n                      = 0.30,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.007) and lower Smell Identification Test scores (R\n                      <jats:sub>s<\/jats:sub>\n                      = \u22120.30,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.018). Other pollutants did not show significant associations with CRS or olfactory outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adults with CF and CRS, higher long\u2010term ambient ozone exposure was associated with greater sinonasal symptom burden and worse olfactory function. These findings suggest that ozone may be an environmental contributor to upper airway disease severity in this population and support further study in larger, adjusted analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Increased ozone pollution correlates with more severe CRS in people with CF.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Among people with CF and CRS, higher ozone exposure is associated with worse olfactory function.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70204","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:30:46Z","timestamp":1792344646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Exposures, Chronic Sinusitis, and Olfaction in People With Cystic Fibrosis"],"prefix":"10.1002","author":[{"given":"Benton","family":"Tullis","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0886-6849","authenticated-orcid":false,"given":"Larissa","family":"Nicolas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0560-5028","authenticated-orcid":false,"given":"Jeremiah A.","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd E.","family":"Bodner","sequence":"additional","affiliation":[{"name":"Department of Psychology Portland State University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-5880","authenticated-orcid":false,"given":"Michael","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naweed I.","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sei","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Texas Southwestern  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Eshaghian","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing A.","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Getz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amarbir S.","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0786-4675","authenticated-orcid":false,"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University  Stanford California 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T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas A.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatric Pulmonary Medicine University of California Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5009-3426","authenticated-orcid":false,"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4454-0861","authenticated-orcid":false,"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1152-2512","authenticated-orcid":false,"given":"Jonathan B.","family":"Overdevest","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Columbia University Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-982X","authenticated-orcid":false,"given":"Zara M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Poch","sequence":"additional","affiliation":[{"name":"Department of Medicine National Jewish Health  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6480-0275","authenticated-orcid":false,"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary 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