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Air pollution and hospitalization of patients with idiopathic pulmonary fibrosis in Beijing: a time-series study

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posted on 17.06.2022, 15:41 authored by Lirong Liang, Yutong Cai, Baolei Lyu, Di Zhang, Shuilian Chu, Hang Jing, Kazem Rahimi, Zhaohui Tong


A small number of studies suggested that air pollution was associated with idiopathic pulmonary fibrosis (IPF) exacerbation, incidence and mortality. However, no studies to date were conducted in regions where air pollution is substantial. We aimed to investigate whether there are associations between acute increases in air pollution and hospitalization of patients with a confirmed primary diagnosis of IPF in Beijing. 


Daily count of IPF hospitalizations (International Classification of Disease-10th Revision, J84.1) was obtained from an administrative database for 2013–2017 while daily city-wide average concentrations of PM10, PM2.5, NO2, Ozone, SO2 were obtained from 35 municipal monitoring stations for the same period. The association between daily IPF hospitalization and average concentration of each pollutant was analyzed with a generalized additive model estimating Poisson distribution. Results Daily 24-h mean PM2.5 concentration during 2013–2017 was 76.7 μg/m3. The relative risk (RR) of IPF hospitalization per interquartile range (IQR) higher (72 μg/m3) in PM2.5 was 1.049 (95% CI 1.024–1.074) and 1.031 (95% CI 1.007–1.056) for lag0 and moving averages 0–1 days respectively. No significant associations were observed for other lags. Statistically significant positive associations were also observed at lag0 with SO2, Ozone and NO2 (in men only). Positive associations were seen at moving averages 0–30 days for PM10 (RR per 86 μg/m3: 1.021, 95% CI 0.994–1.049), NO2 (RR per 30 μg/m3: 1.029, 95% CI 0.999–1.060), and SO2 (RR per 15 μg/m3: 1.060 (95% CI 1.025–1.097), but not with PM2.5 or Ozone. 


Despite improvement in air quality since the implementation of clean air policy in 2013, acute exposure to higher levels of air pollution is significantly associated with IPF hospitalization in Beijing. Air quality policy should be continuously enforced to protect vulnerable IPF populations as well as the general public.


This research is funded by Beijing Municipal Science & Technology Commission (Grant number: Z201100005520028), and Beijing Municipal Administration of Hospitals Incubating Program (Grant number: PX2020014). YC and KR are supported by the PEAK-Urban Programme, funded by UK Research and Innovation’s Global Challenge Research Fund (Grant number: ES/P011055/1). YC acknowledges support from National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, a partnership between the UK Health Security Agency, the Health and Safety Executive and the University of Leicester.



Liang, L., Cai, Y., Lyu, B. et al. Air pollution and hospitalization of patients with idiopathic pulmonary fibrosis in Beijing: a time-series study. Respir Res 23, 81 (2022).

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Department of Health Sciences


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Respiratory Research




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