The Role of Built Environment Factors in Cystic Fibrosis Lung Function Decline

A study published in Pediatric Pulmonology identifies the combination of stressor and multiple pollutants inherent in the built environments of pediatric patients with cystic fibrosis.

There is a lack of research into the collective prognostic value of built environment factors in patients with IPF. The authors of the study hence performed a retrospective longitudinal cohort study of patients with cystic fibrosis receiving care at a Cincinnati, Ohio, hospital (n=173). The primary outcome was the forced expiratory volume in 1 second percent predicted (FEV_1pp). 

The residential addresses of recruited participants were geocoded and used to measure characteristics of the built environment in which they lived. The research team then used residential models to map the marginal and total impacts of particular geomarkers on individual rates of lung function decline. 

“Exposure to [traffic-related air pollution] and the neighborhoods in which patients reside are important predictors of pulmonary decline in cystic fibrosis that may be used to enhance clinical assessments of prognosis and enable personalized environmental health interventions,” the authors of the study concluded. 

Read more about cystic fibrosis etiology 

Children with cystic fibrosis usually experience a rapid decline in lung function when they reach their teenage years. However, early detection and effective treatment can slow deterioration in pulmonary health parameters. Studies have uncovered the pivotal role environmental exposures and the built environment play in driving lung function decline. A UK study indicates that children with cystic fibrosis who live in deprived areas have lower pulmonary function test performance than those living in more prosperous locations. 

A number of factors contribute to the environment that children with cystic fibrosis find themselves in. For example, traffic-related air pollution has been consistently associated with reduced lung health. Green space has been associated with increased allergen exposure. Neighborhood characteristics and resources have been linked to the risk of developing respiratory diseases. 

This study illustrates how physicians can use demographic and clinical data in order to monitor lung function performance and predict the risk of rapid decline. 

Reference

Gecili E, Brokamp C, Rasnick E, et al. Built environment factors predictive of early rapid lung function decline in cystic fibrosis. Pediatr Pulmonol. 2023;10.1002/ppul.26352. doi:10.1002/ppul.26352