TY - JOUR T1 - Fibrotic interstitial lung diseases and air pollution: a systematic literature review JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0093-2020 VL - 29 IS - 157 SP - 200093 AU - Sergio Harari AU - Ganesh Raghu AU - Antonella Caminati AU - Mario Cruciani AU - Massimo Franchini AU - Piermannuccio Mannucci Y1 - 2020/09/30 UR - http://err.ersjournals.com/content/29/157/200093.abstract N2 - Background Air pollution is hypothesised to be a risk factor for interstitial lung diseases (ILD). This study systematically reviewed the literature regarding the impact of air pollution on idiopathic pulmonary fibrosis (IPF) and fibrotic interstitial lung diseases (ILD).Methods A computer-assisted literature search of electronic databases was performed to identify studies focused on the association between ILDs and air pollution. Other inclusion criteria required that the article had to be: 1) original; 2) a prospective or retrospective study; and 3) fully published in English. Both randomised clinical trials and observational studies were considered.Results Only seven studies met the inclusion criteria. All studies investigated the relationship between pollution and IPF, except one that dealt with the relationship between pollution and hypersensitivity pneumonitis. Outcome measures included exacerbation of IPF, mortality, disease severity, prevalence of hypersensitivity pneumonitis, progression and incidence of IPF. On the whole, air pollution levels were negatively associated with outcomes in patients with IPF and fibrotic ILD outcome. The heterogeneity in the measurement and reporting of the end-points limited the performance of a quantitative synthesis of data.Conclusions This systematic review provides supporting evidence linking exposure to air pollution to poor outcomes in patients with IPF and fibrotic ILD.There is supporting evidence to link ambient air pollution exposure and manifestation of IPF and F-ILD with poor outcomes. The WHO and governmental agencies need to take action to minimise factors contributing to air pollution. https://bit.ly/3bmGzKg ER -