Association of high PM 2.5 levels with short-term and medium-term lung function recovery in patients with pulmonary lobectomy.

The association between exposure to ambient fine particulate matter with an aerodynamic diameter of ≤ 2.5 μm (PM _2.5 ) and short- and medium-term lung function recovery (LFR) in patients undergoing lobectomy remains uncertain. This study investigated the associations between PM _2.5 concentrations and LFR in adult patients ( n = 526) who underwent video-assisted thoracoscopic (VATS) lobectomy in Guangzhou, China between January 2018 and June 2021. All patients underwent at least two spirometry tests. Environmental PM _2.5 concentrations in the same period were collected from the nearest monitoring station. A multiple linear regression (MLR) model was employed to investigate the associations between changes in PM _2.5 concentrations and LFR in patients who underwent lobectomy after adjusting for potential confounders. We assessed short- and medium-term LFR in patients who underwent lobectomy. The three- and 6-month average PM _2.5 concentrations in each patient's residential area were divided into regional mild pollution (PM _2.5 <25 μg/m ³ ), moderate pollution (25 μg/m ³ ≤ PM _2.5 <35 μg/m ³ ), and severe pollution (35 μg/m ³ ≤ PM _2.5 ) periods. The MLR model confirmed that PM _2.5 was an independent risk factor affecting short-term forced lung capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum expiratory flow at 50% vital capacity (MEF ₅₀ ) recovery (adjusted P = 0.041, 0.014, 0.016, respectively). The MLR model confirmed that PM _2.5 was an independent risk factor affecting medium-term MEF ₅₀ recovery (adjusted P = 0.046). Compared with the moderate and severe pollution periods, the short- and medium-term LFR (FVC, FEV1, MEF ₅₀ ) of patients in the mild pollution period were faster and better ( P < 0.001, P < 0.001, P < 0.001, P = 0.048, P = 0.010, P = 0.013, respectively). Thus, exposure to high PM _2.5 levels was associated with significantly reduced speed and degree of short- and medium-term LFR in patients who underwent lobectomy.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2022 Liu, Xiao, Huang, Hu, Wang, Chen, Huang and Yang.)