Does air pollution increase the incidence of hypersensitivity pneumonitis?

This paper suggests that higher levels of ambient air pollution increase the risks of an interstitial lung disease being due to hypersensitivity pneumonitis. It is an interesting hypothesis in a data set with lots of problems. The outcome is the proportion of patients on an ILD register from large urban centres in India who are listed as having hypersensitivity pneumonitis. There are no diagnostic criteria for hypersensitivity pneumonitis, the are no incidence data (presumably because of the lack of a denominator), and no separation of those with a known cause from those without. Perhaps the most plausible explanation would be that inhaled pollution particles increase inflammation increasing the dose of the sensitising agent, but no data to support this is given. Never-the-less an interesting hypothesis.

References

	Singh S, Collins BF, Bairwa M, Joshi JM, Talwar D, Singh N, Samaria JK, Mangal DK, Singh V, Raghu G, Hypersensitivity pneumonitis and its correlation with ambient air pollution in urban India, Eur Respir J, 2019;:,DOI: 10.1183/13993003.01563-2018

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