Air pollution exposure modes, smoking and genetic risk with chronic respiratory diseases: a prospective study.

Summary

Using latent class analysis in the UK Biobank, this cohort study identified a “High air pollution” exposure mode associated with increased risks of lung cancer, IPF, COPD, and asthma. Strong additive interactions with smoking were observed, and combined smoking and air pollution accounted for over 40% of lung cancer, IPF, and COPD cases, with amplified risk among those with high genetic predisposition.

Key Findings

• High air pollution exposure mode increased risk: LC HR 1.28, IPF HR 1.23, COPD HR 1.28, asthma HR 1.09.
• Significant additive interactions between high air pollution and smoking for LC and COPD.
• Combined smoking and high air pollution explained >40% of LC, IPF, and COPD cases.
• RERI with high genetic risk plus smoking and high pollution: LC 2.74, IPF 3.93, COPD 1.68.

Clinical Implications

Prioritize smoking cessation and air quality interventions for individuals in high exposure modes, especially those with elevated polygenic risk; integrate exposure pattern assessment into respiratory disease prevention and screening strategies.

Limitations

• Observational design with potential residual confounding and exposure misclassification.
• Generalizability may be limited outside the UK Biobank population; follow-up duration not specified in the abstract.

Future Directions

Validate exposure modes in diverse populations, integrate personal monitoring and polygenic risk into risk tools, and test targeted prevention (e.g., smoking cessation plus air quality improvements) in high-risk groups.