{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:15:00Z","timestamp":1791234900987,"version":"4.1.0"},"reference-count":44,"publisher":"European Respiratory Society (ERS)","issue":"1","funder":[{"DOI":"10.13039\/100008593","name":"European Respiratory Society","doi-asserted-by":"publisher","award":["EMBARC"],"award-info":[{"award-number":["EMBARC"]}],"id":[{"id":"10.13039\/100008593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000351","name":"British Lung Foundation","doi-asserted-by":"publisher","award":["GSK\/British Lung Foundation Chair of Respiratory R"],"award-info":[{"award-number":["GSK\/British Lung Foundation Chair of Respiratory R"]}],"id":[{"id":"10.13039\/501100000351","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2018,5,25]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>In bronchiectasis, exacerbations are believed to be triggered by infectious agents, but often no pathogen can be identified. We hypothesised that acute air pollution exposure may be associated with bronchiectasis exacerbations.<\/jats:p><jats:p>We combined a case-crossover design with distributed lag models in an observational record linkage study. Patients were recruited from a specialist bronchiectasis clinic at Ninewells Hospital, Dundee, UK.<\/jats:p><jats:p>We recruited 432 patients with clinically confirmed bronchiectasis, as diagnosed by high-resolution computed tomography. After excluding days with missing air pollution data, the final model for particles with a 50% cut-off aerodynamic diameter of 10 \u00b5m (PM<jats:sub>10<\/jats:sub>) was based on 6741 exacerbations from 430 patients and for nitrogen dioxide (NO<jats:sub>2<\/jats:sub>) it included 6248 exacerbations from 426 patients. For each 10\u2005\u00b5g\u00b7m<jats:sup>\u2212<\/jats:sup>\u00b3 increase in PM<jats:sub>10<\/jats:sub>and NO<jats:sub>2<\/jats:sub>, the risk of having an exacerbation that same day increased significantly by 4.5% (95% CI 0.9\u20138.3) and 3.2% (95% CI 0.7\u20135.8) respectively. The overall (lag zero to four) increase in risk of exacerbation for a 10\u2005\u03bcg\u00b7m<jats:sup>\u22123<\/jats:sup>increase in air pollutant concentration was 11.2% (95% CI 6.0\u201316.8) for PM<jats:sub>10<\/jats:sub>and 4.7% (95% CI 0.1\u20139.5) for NO<jats:sub>2<\/jats:sub>. Subanalysis showed higher relative risks during spring (PM<jats:sub>10<\/jats:sub>1.198 (95% CI 1.102\u20131.303), NO<jats:sub>2<\/jats:sub>1.146 (95% CI 1.035\u20131.268)) and summer (PM<jats:sub>10<\/jats:sub>2.142 (95% CI 1.785\u20132.570), NO<jats:sub>2<\/jats:sub>1.352 (95% CI 1.140\u20131.602)) when outdoor air pollution exposure would be expected to be highest.<\/jats:p><jats:p>In conclusion, acute air pollution fluctuations are associated with increased exacerbation risk in bronchiectasis.<\/jats:p>","DOI":"10.1183\/13993003.02557-2017","type":"journal-article","created":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T11:56:01Z","timestamp":1528977361000},"page":"1702557","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":69,"title":["The impact of acute air pollution fluctuations on bronchiectasis pulmonary exacerbation: a case-crossover analysis"],"prefix":"10.1183","volume":"52","author":[{"given":"Pieter 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