• Farhat Sylvia C L SCL Emergency Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Children's Institute, Clinics Hospital , Marina B Almeida, Silva-Filho Luiz Vicente R F LVRF Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Virology Laboratory, Trop, Juliana Farhat, Joaquim C Rodrigues, and Braga Alfésio L F ALF Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São P.
• Emergency Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo. Electronic address: sylvia.farhat@gmail.com.
• Chest. 2013 Oct 1; 144 (4): 1186-1192.

BackgroundTropospheric oxidant pollutants may injure the respiratory tract. Cystic fibrosis (CF) respiratory disease involves significant inflammation and excessive oxidative stress, and exposure to air pollutants can magnify the lung damage. The objective of this study was to investigate the association between the short-term variation in the concentration of air pollutants in metropolitan São Paulo, Brazil, and the occurrence of respiratory exacerbations in children and adolescents with CF.MethodsA longitudinal panel of repeated measurements was obtained from 103 patients attending the outpatient center of our institution from September 6, 2006 through September 4, 2007. Daily concentrations of inhaled particulate matter, sulfur dioxide, nitrogen dioxide, ozone (O3), carbon monoxide, and meteorologic variables, such as the minimum temperature and relative humidity, were evaluated. The generalized estimation equation model for binomial distribution was used to assess the impact of these measurements on the occurrence of acute respiratory exacerbations.ResultsIn total, 103 patients with CF (median age, 8.9 years) made 408 visits, with a mean ± SD of 4 ± 1.74 visits per patient (range, 2-9). A respiratory disease exacerbation was diagnosed on 142 visits (38.4%). An interquartile range increase in the O3 concentration (45.62 μg/m3) had a positive, delayed (2 days after exposure) effect on the risk of a respiratory exacerbation (relative risk = 1.86; 95% CI, 1.14-3.02).ConclusionsThis study demonstrates that exposure to short-term air pollution in a large urban center increases the risk of a pulmonary exacerbation in patients with CF.

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