Luo Cheng, Wu Xinhui, Zhang Shipeng, Tan Junwen, Song Xingling, Ning Bo, Tang Qi, Huo Yuzhi, Li Jiajie, Ye Yuanhang, Wang Fei
Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China.
BMC Public Health. 2025 Aug 22;25(1):2880. doi: 10.1186/s12889-025-24158-1.
The widespread distribution of air pollutants poses a major challenge to global public health, causing a range of health problems, including the incidence and progression of idiopathic pulmonary fibrosis (IPF). This study aims to provide insights into the specific effects of air pollutants on the risk of IPF through a systematic evaluation and meta-analysis approach.
The present study was conducted through a comprehensive search of four data-Embase, Web of Science, PubMed, and Cochrane Library-from their inception to 25th November 2024, limited to English-language literature. To assess the potential relationship between a wide range of air pollutants and IPF, a random effects model was used to estimate the risk factors in this study. In addition, subgroup analyses of the data according to age, sex, smoking habits, and geographic location were performed, with the aim of exploring the relationship between air pollutants and the risk of IPF in different populations.
A total of 17 papers covering 14 countries were included in this study, totaling 18 studies involving 858,557 participants and 25,968 event occurrences. Our systematic evaluation and meta-analysis showed an increased risk of IPF disease progression for every 5 µg/m increase in PM (RR = 1.08, 95% CI:1.01,1.15; I = 63.51%; p = 0.01; 7 studies). The risk of IPF progression was increased for every 10 µg/m increase in NO ( RR = 1.32,95% CI:1.16,1.50; I = 38.59%; p = 0.12; 7 studies). For every 10 µg/m increase in O, there was an increased risk of IPF progression (RR = 1.19, 95% CI:1.03,1.38; I = 29.05%; p = 0.24; 4 studies). For every 10 µg/m increase in CO increase of 10 µg/m was associated with an increased risk of IPF progression (RR = 1.28, 95% CI:1.01,1.63; I = 20.03%; p = 0.29; 3 studies). For every 10 µg/m increase in NO, the risk of IPF progression was increased (RR = 1.21, 95% CI:1.11, 1.33; I = 13.69%; p = 0.31; 3 studies). For every 10 µg/m increase in NO, there was an increased risk of IPF incidence (RR = 1.67, 95% CI:1.05,2.66; I = 36.94%; p = 0.20; 3 studies).
This study found that NO and PM increase the risk of IPF disease progression, while NO, CO, and O also increase this risk, albeit with limited data. In addition, NO increases the risk of IPF occurrence. Therefore, global health policies targeting reductions in air pollutants like NO and PM may reduce the risk of the occurrence and progression of IPF, with significant implications for the future prevention and treatment of IPF.
空气污染物的广泛分布对全球公共卫生构成重大挑战，引发一系列健康问题，包括特发性肺纤维化（IPF）的发病和进展。本研究旨在通过系统评价和荟萃分析方法，深入了解空气污染物对IPF风险的具体影响。
本研究通过全面检索四个数据库——Embase、Web of Science、PubMed和Cochrane图书馆，检索时间从各数据库建库至2024年11月25日，限于英文文献。为评估多种空气污染物与IPF之间的潜在关系，本研究采用随机效应模型估计风险因素。此外，根据年龄、性别、吸烟习惯和地理位置对数据进行亚组分析，以探讨空气污染物与不同人群中IPF风险之间的关系。
本研究共纳入来自14个国家的17篇论文，共计18项研究，涉及858,557名参与者和25,968例事件发生。我们的系统评价和荟萃分析表明，PM每增加5 μg/m³，IPF疾病进展风险增加（RR = 1.08，95% CI：1.01，1.15；I² = 63.51%；p = 0.01；7项研究）。NO每增加10 μg/m³，IPF进展风险增加（RR = 1.32，95% CI：1.16，1.50；I² = 38.59%；p = 0.12；7项研究）。O₃每增加10 μg/m³，IPF进展风险增加（RR = 1.19，95% CI：1.03，1.38；I² = 29.05%；p = 0.24；4项研究）。CO每增加10 μg/m³与IPF进展风险增加相关（RR = 1.28，95% CI：1.01，1.63；I² = 20.03%；p = 0.29；3项研究）。NO₂每增加10 μg/m³，IPF进展风险增加（RR = 1.21，95% CI：1.11，1.33；I² = 13.69%；p = 0.31；3项研究）。NO₂每增加10 μg/m³，IPF发病风险增加（RR = 1.67，95% CI：1.05，2.66；I² = 36.94%；p = 0.20；3项研究）。
本研究发现，NO₂和PM增加IPF疾病进展风险，而NO、CO和O₃也增加此风险，尽管数据有限。此外，NO₂增加IPF发生风险。因此，针对减少NO₂和PM等空气污染物的全球卫生政策可能降低IPF发生和进展的风险，对IPF未来的预防和治疗具有重要意义。
