{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:52:23Z","timestamp":1777899143831,"version":"3.51.4"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T00:00:00Z","timestamp":1632182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["108-2314-B-038-093"],"award-info":[{"award-number":["108-2314-B-038-093"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["108-2314-B-038-113-MY3"],"award-info":[{"award-number":["108-2314-B-038-113-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["109-2314-B-038-093-MY3"],"award-info":[{"award-number":["109-2314-B-038-093-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>The development of emphysema has been linked to air pollution; however, the association of air pollution with the extent of lobar emphysema remains unclear. This study examined the association of particulate matter &amp;lt;2.5 \u03bcm in aerodynamic diameters (PM<jats:sub>2.5<\/jats:sub>) (\u22642.5 \u03bcm), nitrogen dioxide (NO<jats:sub>2<\/jats:sub>), and ozone (O<jats:sub>3<\/jats:sub>) level of exposure with the presence of emphysema in 86 patients with chronic obstructive pulmonary disease (COPD). Exposure to the air pollution estimated using the land-use regression model was associated with lung function, BODE (a body mass index, degree of obstruction, dyspnea severity, and exercise capacity index) quartiles, and emphysema measured as low-attenuation areas on high-resolution CT (HR-CT) lung scans. Using paraseptal emphysema as the reference group, we observed that a 1 ppb increase in O<jats:sub>3<\/jats:sub> was associated with a 1.798-fold increased crude odds ratio of panlobular emphysema (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). We observed that PM<jats:sub>2.5<\/jats:sub> was associated with BODE quartiles, modified Medical Research Council (mMRC) dyspnea score, and exercise capacity (all <jats:italic>p<\/jats:italic> &amp;lt; 0.05). We found that PM<jats:sub>2.5<\/jats:sub>, NO<jats:sub>2<\/jats:sub>, and O<jats:sub>3<\/jats:sub> were associated with an increased degree of upper lobe emphysema and lower lobe emphysema (all <jats:italic>p<\/jats:italic> &amp;lt; 0.05). Furthermore, we observed that an increase in PM<jats:sub>2.5<\/jats:sub>, NO<jats:sub>2<\/jats:sub>, and O<jats:sub>3<\/jats:sub> was associated with greater increases in upper lobe emphysema than in lower lobe emphysema. In conclusion, exposure to O<jats:sub>3<\/jats:sub> can be associated with a higher risk of panlobular emphysema than paraseptal emphysema in patients with COPD. Emphysema severity in lung lobes, especially the upper lobes, may be linked to air pollution exposure in COPD.<\/jats:p>","DOI":"10.3389\/fmed.2021.705792","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T05:00:02Z","timestamp":1632200402000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Association Between Air Pollution and Lung Lobar Emphysema in COPD"],"prefix":"10.3389","volume":"8","author":[{"given":"Nguyen Thanh","family":"Tung","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Chuan","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh-Hsun","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu-Tao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang-Yun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Da","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kian Fan","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han-Pin","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huynh Nguyen Xuan","family":"Thao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoang Ba","family":"Dung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tran Phan Chung","family":"Thuy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-Ming","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiao-Yun","family":"Kou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh-Lun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiao-Chi","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1164\/rccm.201204-0596PP","article-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease","volume":"187","author":"Vestbo","year":"2013","journal-title":"Am J Respir Crit Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"4","DOI":"10.2500\/aap.2015.36.3812","article-title":"Burden of chronic obstructive pulmonary disease: healthcare costs and beyond","volume":"36","author":"May","year":"2015","journal-title":"Allergy Asthma Proc."},{"key":"B3","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1183\/09031936.00130014","article-title":"Adult lung function and long-term air pollution exposure. 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