Long-term exposure to air pollutants may increase the risk of idiopathic pulmonary fibrosis (IPF), according to a new study published in the European Respiratory Journal. Moreover, such risk seems to be increased by genetic susceptibility.

These findings suggest that improving air quality could help reduce the risk of IPF, especially in people who are genetically susceptible to the disease.

The exact link between air pollution and the risk of IPF is not known. In the present study, a team of researchers from China and the UK set out to decipher this association.

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The team, led by Yaohua Tian from Tongji Medical College, Huazhong University of Science and Technology, in Wuhan, China, analyzed 433,738 participants from the UK Biobank. Among these, the incidence of IPF was 27.45/100,000 person-years with a median follow-up of 11.78 years.

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For each interquartile range increase in nitrogen dioxide, other nitrogen oxides, and fine particulate matter with a diameter smaller than 2.5 μm in the air, the adjusted hazard ratios of IPF were 1.11, 1.07, and 1.09, respectively.

The pollutant with the highest risk in relation to IPF was fine particulate matter with a diameter smaller than 2.5 μm in the air, followed by nitrogen dioxide and other nitrogen oxides. 

The researchers also found additive interactions between these 3 pollutants and genetic susceptibility to the disease; people with higher polygenic risk scores who were exposed to higher air pollution had the highest risk of IPF. 

“There are additive effects of air pollutants and genetic susceptibility on IPF risk,” the researchers concluded. 

IPF is a chronic, progressive lung disease in which fibrotic tissue builds up in the pulmonary parenchyma causing shortness of breath and chronic, unproductive cough. The exact cause of IPF is not known and it is thought the interplay between genetic and environmental factors may contribute to the development of the disease. These environmental factors may include cigarette smoke and agricultural compounds, as well as microbial agents. 


Cui F, Sun Y, Xie J, et al. Air pollutants, genetic susceptibility and risk of incident idiopathic pulmonary fibrosis. Eur Respir J. 2022;22:2200777. doi:10.1183/13993003.00777-2022