Jessica Germaine Shull1, Maria Teresa Pay2, Carla Lara Compte1, Miriam Olid2, Guadalupe Bermudo1, Karina Portillo3, Jacobo Sellarés4, Eva Balcells5, Vanesa Vicens-Zygmunt1, Lurdes Planas-Cerezales1, Diana Badenes-Bonet5,6,7, Rosana Blavia8, Pilar Rivera-Ortega1, Amalia Moreno9, Jordi Sans10, Damià Perich10, Silvia Barril11, Leonardo Esteban12, Laia Garcia-Bellmunt13, Jordi Esplugas14, Guillermo Suarez-Cuartin1, Jaume Bordas-Martinez1, Diego Castillo15, Rosa Jolis16, Inma Salvador17, Saioa Eizaguirre Anton18, Ana Villar19, Alejandro Robles-Perez20, M Josefa Cardona21, Enric Barbeta22, Maria Guadalupe Silveira23, Claudia Guevara24, Jordi Dorca1, Antoni Rosell3,7,25, Patricio Luburich1, Roger Llatjós1, Oriol Jorba2, Maria Molina-Molina1,7. 1. ILD Multidisciplinary Unit, Bellvitge University Hospital, IDIBELL, Hospitalet de Llobregat, Spain. 2. Barcelona Supercomputing Center, BSC, c/Jordi Girona, 29,, Barcelona, Spain. 3. ILD Multidisciplinary Unit, University Hospital Trias i Pujol, Badalona, Spain. 4. ILD Multidisciplinary Unit, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain. 5. Respiratory Medicine Department, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain. 6. School of Health & Life Sciences, Pompeu Fabra University (UPF), Barcelona, Spain. 7. CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain. 8. Respiratory Department, Hospital Moises Broggi, San Joan Despi, Spain. 9. Respiratory Department, Hospital Parc Taulí, Sabadell, Spain. 10. Respiratory Department, Consorci Sanitari de Terrassa, Terrassa, Spain. 11. Respiratory Department, Hospital Arnau de Vilanova, Lleida, Spain. 12. Respiratory Department, Hospital Joan XXIII, Tarragona, Spain. 13. Respiratory Department, Hospital Sant Joan, Reus, Spain. 14. Respiratory Department, Hospital de Martorell, Barcelonès, Spain. 15. ILD Multidisciplinary Unit, Hospital Sant Pau i Santa Creu, Barcelona, Spain. 16. Respiratory Department, Hospital de Figueres, Figueres, Spain. 17. Respiratory Department, Hospital de Tortosa, Tortosa, Spain. 18. Respiratory Department, Hospital Trueta de Girona, Girona, Spain. 19. ILD Multidisciplinary Unit, Hospital Vall d'Hebron, Barcelona, Spain. 20. Respiratory Department, Hospital de Mataró, Mataró, Spain. 21. Respiratory Department, Hospital de Igualada, Igualada, Spain. 22. Respiratory Department, Hospital de Granollers, Granollers, Spain. 23. Respiratory Department, Parc Sanitari Sant Joan de Déu, Sant Boi, Spain. 24. Respiratory Department, Hospital Sant Camil, Vilanova, Spain. 25. Translational Respiratory Research Group, Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Spain.
Abstract
BACKGROUND AND OBJECTIVE: The relationship between IPF development and environmental factors has not been completely elucidated. Analysing geographic regions of idiopathic pulmonary fibrosis (IPF) cases could help identify those areas with higher aggregation and investigate potential triggers. We hypothesize that cross-analysing location of IPF cases and areas of consistently high air pollution concentration could lead to recognition of environmental risk factors for IPF development. METHODS: This retrospective study analysed epidemiological and clinical data from 503 patients registered in the Observatory IPF.cat from January 2017 to June 2019. Incident and prevalent IPF cases from the Catalan region of Spain were graphed based on their postal address. We generated maps of the most relevant air pollutant PM2.5 from the last 10 years using data from the CALIOPE air quality forecast system and observational data. RESULTS: In 2018, the prevalence of IPF differed across provinces; from 8.1 cases per 100 000 habitants in Barcelona to 2.0 cases per 100 000 in Girona. The ratio of IPF was higher in some areas. Mapping PM2.5 levels illustrated that certain areas with more industry, traffic and shipping maintained markedly higher PM2.5 concentrations. Most of these locations correlated with higher aggregation of IPF cases. Compared with other risk factors, PM2.5 exposure was the most frequent. CONCLUSION: In this retrospective study, prevalence of IPF is higher in areas of elevated PM2.5 concentration. Prospective studies with targeted pollution mapping need to be done in specific geographies to compile a broader profile of environmental factors involved in the development of pulmonary fibrosis.
BACKGROUND AND OBJECTIVE: The relationship between IPF development and environmental factors has not been completely elucidated. Analysing geographic regions of idiopathic pulmonary fibrosis (IPF) cases could help identify those areas with higher aggregation and investigate potential triggers. We hypothesize that cross-analysing location of IPF cases and areas of consistently high air pollution concentration could lead to recognition of environmental risk factors for IPF development. METHODS: This retrospective study analysed epidemiological and clinical data from 503 patients registered in the Observatory IPF.cat from January 2017 to June 2019. Incident and prevalent IPF cases from the Catalan region of Spain were graphed based on their postal address. We generated maps of the most relevant air pollutant PM2.5 from the last 10 years using data from the CALIOPE air quality forecast system and observational data. RESULTS: In 2018, the prevalence of IPF differed across provinces; from 8.1 cases per 100 000 habitants in Barcelona to 2.0 cases per 100 000 in Girona. The ratio of IPF was higher in some areas. Mapping PM2.5 levels illustrated that certain areas with more industry, traffic and shipping maintained markedly higher PM2.5 concentrations. Most of these locations correlated with higher aggregation of IPF cases. Compared with other risk factors, PM2.5 exposure was the most frequent. CONCLUSION: In this retrospective study, prevalence of IPF is higher in areas of elevated PM2.5 concentration. Prospective studies with targeted pollution mapping need to be done in specific geographies to compile a broader profile of environmental factors involved in the development of pulmonary fibrosis.