{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:57:35Z","timestamp":1781614655797,"version":"3.54.5"},"reference-count":26,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Korea Environment Industry & Technology Institute","award":["2024ER090500"],"award-info":[{"award-number":["2024ER090500"]}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["NRF-2022M3A9E4082647"],"award-info":[{"award-number":["NRF-2022M3A9E4082647"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Korea Ministry of Environment","award":["RS-2022-KE002197"],"award-info":[{"award-number":["RS-2022-KE002197"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2026,5,17]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease characterised by progressive fibrosis. Environmental exposures, including fine particulate matter (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ), have been implicated in the progression of IPF; however, indoor data are limited. We aimed to evaluate the impact of indoor exposure to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      on the progression of IPF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      This prospective, multicentre cohort study involves 15 medical institutions across South Korea. A total of 120 patients with IPF have been recruited and will be followed for 1 year. The impact of indoor exposure to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      on clinical outcomes, including progression of the disease (defined as a relative decline in forced vital capacity \u226510%\u2009or diffusing capacity for carbon monoxide \u226515%), hospitalisation, acute exacerbations and mortality, will be assessed. Pulmonary function tests will be conducted quarterly at institutions, with home-based spirometry performed daily in a subset of 50 participants. The indoor PM\n                      <jats:sub>2.5<\/jats:sub>\n                      level will be continuously measured using a scattering-based indoor air quality monitor (IAQ-CL; KWeather, Seoul, South Korea) and PM\n                      <jats:sub>10<\/jats:sub>\n                      , volatile organic compounds and carbon dioxide will also be measured. Biomarker analysis of Krebs von den Lungen-6 and other related markers will be performed. Statistical analyses will use linear mixed-effects models and time-to-event models to evaluate the association between exposure to PM and clinical and biomarker outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has been approved by the Institutional Review Boards of all institutions, including Asan Medical Center (S2021-1136-0051). Written informed consent was obtained from all participants prior to enrolment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>KCT0008638.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-003486","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:27:29Z","timestamp":1781612849000},"page":"e003486","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of indoor exposure to particulate matter on the progression of idiopathic pulmonary fibrosis: a prospective multicentre cohort study protocol"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9852-0036","authenticated-orcid":false,"given":"Hee-Young","family":"Yoon","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Yongsan-gu, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju Hyun","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Il","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Gyeonggi-do, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-6085","authenticated-orcid":false,"given":"Sun Mi","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimyung","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-6530","authenticated-orcid":false,"given":"Yong Suk","family":"Jo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon-si, Gyeonggi-do, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0932-2826","authenticated-orcid":false,"given":"Jae Ha","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Haeundae-gu, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Kyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song Yee","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala","family":"Woo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea Bucheon St Mary\u2019s Hospital, Bucheon-si, Gyeonggi-do, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongseok","family":"Yoo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3707-3636","authenticated-orcid":false,"given":"Jong Sun","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Koo","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Busan, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Eun","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of 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