Cystic Fibrosis Trust calls on Government to tackle dirty air

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Today, 30 June, Cystic Fibrosis Trust has published a new report, calling on governments locally and nationally to step up efforts to tackle air pollution to improve health, particularly for those with respiratory conditions like cystic fibrosis (CF). 

Air Quality and Cystic Fibrosis: A Pragmatic Review, compiled with the York Health Economics Forum, highlights the impact of poor air quality on people with CF, revealing the extra damage caused to the lungs by breathing in unclean air. 

A systematic review of existing research into air quality and CF health, the report shows that forced hot air central heating is associated with a faster decline in lung health and more hospitalisations in people with CF, compared to people with CF who were not exposed. Exposure to indoor mould is also linked with a greater likelihood of having fungi in the airway.

Outdoor air pollution, like vehicle emissions, can result in a higher risk of lung disease flare-ups, a faster reduction in lung function, and a higher risk of developing infections, for example from bugs like Pseudomonas aeruginosa. One study found that the closer someone with CF lived to a road, the higher their likelihood of having multiple exacerbations.

Studies analysed in the report also found that higher temperatures can lead to lower lung function, lower sodium levels and higher risk of catching infection-causing bugs.

In people with CF, the mucus in the lungs is thicker and stickier than the lungs of people without CF. This makes it difficult to clear, and easier for bacteria to get stuck and cause an infection. Frequent lung infections means people with CF are more likely to be impacted by harmful effects of poor air quality.

Ben and Alix have two children, Henry and Rufus. Rufus has cystic fibrosis. They moved from West Yorkshire to the seaside so that Rufus would have cleaner, sea air to breathe. They said: “We’d never consciously thought about the air quality, we’d lived with it. Rufus hated using the nebuliser and we worried about him playing in mud and near trees (due to risk of serious infection). I’d read about surfers in Australia being way healthier, not just because they were active but because they were in the sea air. 

“We moved here for his health and incorporated being on the beach, no matter the time of year, as part of his physio. We noticed straight away that he was less congested, he didn’t need nebulisers, he was getting fewer colds – or if he had one, he cleared it quicker.

“We’re lucky we had the opportunity to move, not everybody has that. I think it’s really important for politicians to know that the policies that they’re putting in place might be a minor change to them but it can have a massive impact on people living with health conditions and CF. We need meaningful changes.”

Cystic Fibrosis Trust is calling on Governments across the UK to prioritise the health of people with long-term health conditions, such as cystic fibrosis, and ensure a commitment to clean air policies by:

  • Strengthening air quality standards and monitoring with stricter regulations on outdoor pollutants  
  • Expanding access to air quality alerts so everyone can access localised air pollution forecasts and receive alerts  
  • Tightening building codes to prioritise minimising indoor pollutant exposure and improve indoor air quality in homes and public spaces 
  • Investing in research on CF-air quality interventions to evaluate the effectiveness of interventions to protect people with CF from poor air quality 

Poor air quality continues to be the biggest environmental risk to public health and those who are already vulnerable, like people with cystic fibrosis, are most affected. As our new report shows, poor air quality is causing a decline in people with CF’s lung function – leading to more time in hospital.

Urgent action is needed to ensure clean air is at the top of the agenda, with immediate steps to reduce pollution at the source.

David Ramsden, Cystic Fibrosis Trust Chief Executive

What research is the Trust funding on air pollution?

Cystic Fibrosis Trust has supported research at Imperial College London investigating the impact of air pollution on lung function for people with CF. The research study linked anonymous data from UK CF Registry with a database of environmental exposure data in London and the Trust co-funded a PhD student with the MRC to conduct this research.

Dr Frédéric B. Piel, said: “Our study, funded by Cystic Fibrosis Trust and using Cystic Fibrosis Registry data, shows that air pollutants have a negative long-term impact on lung function in people with CF. We need more studies about the impact of environmental factors, like air pollution, on people with CF, and for all people with a severe chronic condition, including the most vulnerable, to live in an environment which does not affect their health negatively.”

The PULSE-CF Innovation Hub, led by Professor Alex Horsley at the University of Manchester, is part of the Translational Innovation Hub Network for CF Lung Health and Infection, funded by the Trust and LifeArc. The Innovation Hub aims to better understand the causes and triggers of lung exacerbations, and why people respond differently to treatment. Their CF-Tracker Study, which is open for recruitment, is measuring home air pollution levels, alongside samples to measure health to try and find out more about what causes flare-ups.