Benefits of improved air quality on aging lungs - Impacts of genetics and obesity.

INTRODUCTION: The beneficial effect of improving air quality on lung function in the elderly remains unclear. We examined associations between decline in air pollutants and lung function and effect modifications by genetics and Body Mass Index (BMI) in elderly German women.

METHODS: Data were analysed from the prospective Study on the influence of Air pollution on Lung function, Inflammation and Aging (SALIA; N=601). Spirometry was conducted at baseline (1985-1994; 55 years), in 2007-2010 and in 2012-2013. Air pollution concentrations at home addresses were determined for each time point using land-use regression models. Global-Lung-Initiative-2012 z-scores were calculated. Weighted genetic risk scores (GRS) were determined from lung function-related risk alleles and used to investigate interactions with improved air quality. Multiple linear mixed models were fitted.

RESULTS: Air pollution levels decreased substantially during the study period. Reduction of air pollution was associated with an increase in z-scores for the forced expiratory volume in 1 s (FEV1 ) and the ratio between FEV1 and forced vital capacity (FVC). For a decrease of 10 µg·m-3 in nitrogen dioxide (NO2 ), the z-score for FEV1 increased by 0.14 (95%-confidence interval: 0.01; 0.26). However, with an increasing number of lung function-related risk alleles, the benefit from improved air quality decreased (GRSxNO2 -interaction: p=0.029). Interactions with BMI were not significant.

CONCLUSIONS: Reduction of air pollution is associated with a relative improvement of lung function in elderly women, but also depends on their genetic make-up.